Abstract

Topicality: One of the reasons of chronic recurrent inflammatory processes is the ability of bacteria to form a biofilm – a complex grouping that occurs both in the environment and in the human body. The coexistence of pathogenic and conditionally pathogenic microflora in the form of a biofilm creates conditions for the development of a chronic purulent inflammatory process. This form of existence provides a higher resistance and tolerance to antibiotics than planktonic forms, reducing their sensitivity by 1000 times.

The purpose of the study is to improve the quality of treatment of patients suffering from chronic pathology of the nose and lymphopharyngeal ring, using data from the quantitative and qualitative determination of flora in the centre of inflammation and the ability of these microorganisms to form biofilms, to search for the most optimal drugs that destroy biofilms.

Concept of work

In the work with biofilms, the method of determining the optical density of the biofilm was used and, accordingly, the higher the density, the greater the ability of microorganisms to form biofilms. Then, the tested substances were applied in different dilutions to the identified microorganisms in the biofilm, and their predominant ability was determined again by the optical density of the biofilm after exposure to the tested substances, and treatment was carried out with the studied drugs.

56 people with various pathologies of the ENT organs were examined. We can see that St. Aureus has the greatest biofilm-forming ability. In the nose, 33 cases of biofilm formation of moderate optical density and 3 cases of high optical density were noted. In 3 cases, biofilms are not formed. The substances with the greatest destructive ability of biofilms are colloidal silver in 27 cases without dilution and in 6 cases in 1:10 dilution, Povidone-iodine in 24 cases, of which 17 in 1:10 dilution, 6 in 1:20 dilution and 1 case in 1:40 dilution; probiotic drug Bacillus megaterium – in 18 cases, in 1:10 dilution in 9 cases. In the throat, 33 cases of detection of St. Aureus, of which no biofilm is formed in 12 cases, moderate density is formed in 15 cases, and high density in 6 cases.  Medicinal substances under study that suppress biofilm-forming ability are the following – Lysozyme – 21 without dilution, Biclotymolum 18 without dilution and 9 in a 1:10 dilution, probiotic drug Streptococcus salivarius 24 cases without dilution, probiotic drug Bacillus megaterium in 12 cases without breeding.

Streptococcus viridans is the next in number of detected microorganisms. In the nose, 4 cases with a low degree of biofilm formation were found, the examination for sensitivity to medical drugs was not carried out. In the pharynx – 54 cases, of which biofilms are not formed in 12 cases, in 33 cases they are moderate, in 6 cases they are dense. In terms of sensitivity to drugs, we can see the following – Lysozyme 24 without dilution, 3 in a 1:10 dilution; Biclotymolum 27 without dilution, 12 in 1:10 dilution, 3 in 1:20 dilution; probiotic preparation Streptococcus salivarius 30 cases without dilution, 15 cases in dilution 1:10 and 9 – 1:20; Coagulans – 15 without dilution, 3 in 1:10 dilution, 5 in 1:20 dilution; probiotic drug Bacillus megaterium in 21 cases without dilution, 6 in 1:10 dilution. The remaining microorganisms were seeded in small quantities.

Conclusions

1. The method of determining the biofilm-forming ability of microorganisms based on the optical density of the material must be duplicated by quantitative sowing of flora and sensitivity to antibiotics for greater reliability of the data obtained and the possible use of antibiotics, according to the sensitivity during treatment.
2. As a result of our research, microorganisms with the greatest ability to form biofilms were identified, as well as a selected range of medical drugs that are available and most effective in suppressing the biofilm-forming abilities of microorganisms, but it is desirable to approach each patient individually.
3. A number of drugs have been identified that effectively destroy biofilms, especially without dilutions, but only Povidone-iodine does this even at a significant dilution (1:40).
4. Using the data we received regarding drugs that suppress the biofilm-forming ability of microorganisms, we consider it necessary to continue the work and confirm it on a larger number of examined and treated patients.

Key words: microorganisms, inflammatory diseases of the nose and pharynx, biofilms, drugs that destroy biofilms, pain in the pharynx.