APPLICATION OF A COMPREHENSIVE APPROACH FOR EVALUATION OF TREATMENT EFFECTIVENESS OF MYCOPLASMA INFECTION IN CHILDREN WITH BRONCHIAL ASTHMA

Aim - improvement of efficiency assessment methods of therapy of mycoplasma infection in children with bronchial asthma. The effectiveness of treatment of mycoplasma infection in the period of exacerbation of bronchial asthma in 250 children, aged 1 to 7 years, was evaluated. The children were on basic therapy and received treatment with azithromycin: three courses at a dose of 10 mg/kg of weight for 3 days with an interval of 4 days 5-7 days. Microbiological (culturing), immunological (DIF, AHAA), and genetic (PCR) methods were used to identify mycoplasma markers. The main focus was on identifying two species - M. pneumoniae and M. hominis, most commonly found in mycoplasma respiratory infections, including bronchial asthma. In 250 children with bronchial asthma, antigens of Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Mycoplasma arthritidis and Mycoplasma fermentrans were detected in 62,8%, 42,8%, 46,8 %, 31,6%, 45,6% of cases, respectively. A detailed study of the presence of M. pneumoniae and M. hominis antigens in the blood of 83 children with bronchial asthma showed that before treatment, the detection rate of M. pneumoniae and M. hominis antigens was 67.5% and 50.6%, respectively, in the CIC - 65.1% and 61.5%, DNA in the blood serum - 4.8% and 16.9%, and in the CIC - 27.7% and 32.5%, respectively. From 7 CIC samples containing M. hominis DNA and 2 CIC samples containing M. pneumoniae DNA, atypical cultures of "mini-colonies" of M. hominis and M. pneumoniae were isolated, the specificity of which was confirmed not only by DIF and PCR, but also by the ability to grow on a solid medium for mycoplasmas. After treatment by azithromycin, the number of positive tests on antigens and DNA in free state and in structure of CIC significantly decreased. The identification of specific markers of mycoplasma cells in the comprehensive diagnostics of mycoplasma infection in children with exacerbation of asthma, increases the effectiveness of therapy control for mycoplasma infection and improves the prognosis of bronchial asthma in patients.