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The objective: to study the species and quantitative composition of fecal microbiota in children undergoing chemotherapy for drug-resistant respiratory tuberculosis. Subjects and Methods. The study included 17 children from 2 to 12 years old with respiratory tuberculosis who received treatment for drug-resistant respiratory tuberculosis from 2022 to 2024 at Central Tuberculosis Research Institute. Fecal microbiota was tested by real-time PCR using the ENTEROFLOR® Children reagent kit at the following time points: before the start of chemotherapy, after 2 and 4 months of chemotherapy. Results. The most pronounced disturbances in the intestinal microbiocenosis among representatives of normobiota were noted after 2 months of chemotherapy; by 4 months, those parameters did not deteriorate either in quantitative terms or frequency of deviations from reference values: for representatives of the phylum Actinomycetota (Actinobacteria) – in Bifidobacterium spp. and Coriobacteriia , for representatives of the phylum Bacteroidota (Bacteroidetes) – in Butyricimonas spp. , Parabacteroides spp., Prevotella spp. Changes in the composition of normobiota were associated with the elevated proportion of opportunistic microbiota by 2 months and persistence of these values by 4 months of chemotherapy. Representatives of pathogenic microbiota, which were not present before chemotherapy, appeared by 2 months of chemotherapy with the following frequency: Streptococcus agalactiae – in 35.3% of cases, Clostridioides difficile , with the toxigenic genes cdtA and cdtB – in 58.9%, and increasing to 71.5% by 4 months of chemotherapy. Conclusion. Treatment with chemotherapy regimens for drug-resistant tuberculosis has a statistically significant negative impact on intestinal microbiota in children: the proportion of normobiota decreases, the proportion of opportunistic microbiota increases, and pathogenic microbiota develops.
Published in: Tuberculosis and lung diseases
Volume 104, Issue 1, pp. 8-16