A CHANGE IN GUT MICROBIOTA PARAMETERS ACCORDING TO THE CHARACTERISTICS OF THE COURSE OF THE TUBERCULOSIS PROCESS

The paper gives the results of an investigation of the gut microbiota in patients with new-onset pulmonary tuberculosis (TB) according to the characteristics of the course of the tuberculosis process. The investigation enrolled 71 patients (37 (52.1%) males and 34 (47.9%) females) with new-onset respiratory TB diagnosed less than one month before their inclusion in the investigation and with no history of autoimmune diseases, cancers, HIV infection, viral hepatitis, alcoholism, drug addiction, or pregnancy. A control group consisted of 27 healthy volunteers. The patients’ age was 18-59 years. The gut microbiota was studied using a bacteriological assay of native feces before treatment. It was found that a decreased normal intestinal microflora level was less frequently observed in patients with focal TB and pulmonary tuberculomas. With the aggravation of the tuberculous process (infiltrative, disseminated and fibrocavernous TB), the frequency and magnitude of the reduced level of normal intestinal microflora substantially increased in patients. There was a more significant frequency and magnitude of the decreased level in the normal intestinal microflora (Bifidobacterium, Lactobacillus, typical Escherichia coli, and Enterococcus) in patients with the extent of the process affecting >2 lobes of the lung than on those with the process in the < 2 lobes. A reduced level of normal microflora (Lactobacillus, typical E. coli and Enterococcus) was more frequently observed in the presence of bacterial excretion. With enhanced bacterial excretion, the number of patients with the reduced level of Bifidobacterium and typical E. coli levels also increased. At the same time, there was no relationship between the frequency and magnitude of a decrease in the normal intestinal microflora and the spectrum of drug resistance of Mycobacterium tuberculosis.