State of the Large Intestine Microbiota in Patients with Type 1 Diabetes Mellitus Depending on the Severity of Clinical Course
Background. Type 1 diabetes mellitus (DM) results in the development and unfavorable clinical course of chronic inflammatory diseases, including those of ENT organs. Aim of the study — to explore the species composition and population level of the large intestine microflora in patients with type 1 DM depending on the severity of its clinical course. Materials and methods. By means of bacteriological and mycological methods, we have examined the content of the large intestine cavity in 50 patients aged 15 to 60 years with moderate and severe DM type 1, as well as in 30 apparently healthy individuals of the same age, who considered themselves to be healthy and were not affected by any diseases during the previous six months. The severe form of DM was diagnosed in 39 of 50 patients, and the clinical course of moderate severity — in 11 patients. Results. In moderate and severe course of type 1 DM, the deficiency of autochtonous bacteria of the genus Bifidobacterium, Lactobacillus, Peptostreptococcus, Enterococcus is formed in the content of the large intestine cavity, they are the most important by their representation in the large intestine microbiocenosis. Against this background, there is a contamination of the large intestine cavity with pathogenic (E.coli Hly+, EPEC) and opportunistic (Enterobacter, Citrobacter, Serratia, Proteus) enterobacteria, as well as opportunistic bacteria of the genus Bacteroides, Clostridium, P.niger, Staphylococcus, and yeast-like fungi of the Candida genus reaching a high population level. Conclusions. In the microbiocenosis of the large intestine cavity of patients with type 1 DM, there is a significant increase in the level of enterotoxigenic and enterotoxic (61.38 %) and opportunistic bacteria (71.24 %). A change of the species composition, Berger-Parker dominance index, constancy index results in the changes in a role of each component of the large intestine microbiocenosis of patients with type 1 DM both of a moderate and, to a greater extent, of severe course. In the large intestine cavity of patients with moderate and severe DM type 1, there is a significant (p < 0.05–0.001) deficiency of obligate bacteria of Bifidobacterium genus — 50.04 %, Lactobacillus — 34.82 %, Peptostreptococcus — 16.0 %, Enterococcus — 11.68 %. The more severe the clinical course, the more pronounced the deficiency, and a clear pattern of a decreased role of Bifidobacterium and Lactobacterium in the large intestine microbiocenosis is prognosticated. The findings are the reason to study the efficacy of probiotics in a comprehensive treatment of patients with type 1 DM before, after and 3 months after the treatment on the basis of the analysis of the species composition and population level of the large intestine microflora, as well as to work out the therapeutic modality for purulent sinusitis in patients with type 1 DM with inclusion of probiotics into the schemes of a comprehensive treatment.
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