Chervinets V M, Mironov A Y, Chervinets Y V, Bazlov S N
Tver State Medical University, 170100, Tver, Russia.
G.N. Gabrichevskogo Moscow Research Institute for Epidemiology and Microbiology, 125212, Moscow, Russia.
Klin Lab Diagn. 2020;65(1):42-49. doi: 10.18821/0869-2084-2020-65-1-42-49.
The microflora of 64 biopsies taken during fibrogastroduodenoscopy of the mucous membrane of the esophagus, stomach and duodenum in healthy volunteers and 1120 samples obtained from the same parts of the digestive tract in patients with esophagitis, chronic gastritis and peptic ulcer disease were studied. The patients ranged in age from 18 to 62 years. Traditional bacteriological method was used to isolate and identify microorganisms. Staphylococcus spp., Streptococcus spp., Lactobacillus spp., Bacteroides spp., Stomatococcus spp., Enterobacteriaceae, Corynebacterium spp., Micrococcus spp., Neisseria spp., Veilonella spp. were isolated from biopsies of healthy respondents in an average amount from 3.2 to 4.68 lg CFU/g. H.pylori was found in 60% (5.66 lg CFU/g) in the esophagus, in 33.3% of cases (5.12 lg CFU/g) from the fundal part of the stomach, in 44.4% (5.25 lg CFU/g) from the antral part of the stomach, in 5.5% (4.2 lg CFU/g) in the duodenal mucosa. In samples obtained from the inflamed and eroded mucous membrane of the esophagus, stomach and duodenum, opportunistic bacteria of the genera Klebsiella, Enterobacter, Proteus, Pseudomonas, Peptococcus, Actinomyces, yeast fungi of the genus Candida etc. were detected in an amount exceeding 4 lg CFU/g. H. pylori isolated in 6.3-16.7% of patients (4.25-4.6 lg CFU/g) and did not dominate in relation to other microorganisms, and in most cases had a low frequency of its occurrence. In patients with the recurrence of peptic ulcer disease, exacerbation of chronic gastritis and esophagitis, dysbiosis was developed, characterized by an increase in the species and quantitative composition of opportunistic microflora, an increase in its enzymatic and cytotoxic activity, which can contribute to the maintenance of inflammatory and necrotic processes and inhibit the elimination of the pathological process.
对健康志愿者食管、胃和十二指肠黏膜进行纤维胃十二指肠镜检查时采集的64份活检样本，以及食管炎、慢性胃炎和消化性溃疡病患者从消化道相同部位获取的1120份样本的微生物区系进行了研究。患者年龄在18至62岁之间。采用传统细菌学方法分离和鉴定微生物。从健康受试者的活检样本中分离出葡萄球菌属、链球菌属、乳酸杆菌属、拟杆菌属、口腔球菌属、肠杆菌科、棒状杆菌属、微球菌属、奈瑟菌属、韦荣球菌属，平均数量为3.2至4.68 lg CFU/g。在食管中发现幽门螺杆菌的比例为60%（5.66 lg CFU/g），在胃底部为33.3%（5.12 lg CFU/g），在胃窦部为44.4%（5.25 lg CFU/g），在十二指肠黏膜中为5.5%（4.2 lg CFU/g）。在从食管、胃和十二指肠发炎和糜烂的黏膜获取的样本中，检测到克雷伯菌属、肠杆菌属、变形杆菌属、假单胞菌属、消化球菌属、放线菌属等机会性细菌以及念珠菌属酵母真菌等，数量超过4 lg CFU/g。在6.3 - 16.7%的患者中分离出幽门螺杆菌（4.25 - 4.6 lg CFU/g），相对于其他微生物不占优势，且在大多数情况下其出现频率较低。在消化性溃疡病复发、慢性胃炎和食管炎加重的患者中，发生了生态失调，其特征是机会性微生物区系的种类和数量组成增加，其酶活性和细胞毒性活性增强，这可能有助于维持炎症和坏死过程并抑制病理过程的消除。
