pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2022-4144pulmo-4144Research ArticleОБЗОРЫREVIEWМикрофлора легких: норма, патологии, влияние вакцинацииMicroflora of the lungs in health and disease, the impact of vaccinationhttps://orcid.org/0000-0002-4806-050XЗолотовМ. О.ZolotovM. O.

Золотов Максим Олегович – кандидат медицинских наук, ассистент кафедры общей и клинической микробиологии, иммунологии и аллергологии.

443099, Самара, ул. Чапаевская, 89; тел.: (846) 374-10-04, доб. 457

Maxim O. Zolotov - Candidate of Medicine, Assistant, Department of General and Clinical Microbiology, Immunology and Allergology.

Ul. Chapaevskaya 89, Samara, 443099; tel.: (846) 374-10-04, ext. 457

m.o.zolotov@gmail.comhttps://orcid.org/0000-0002-3960-830XЖестковА. В.ZhestkovA. V.

Жестков Александр Викторович – доктор медицинских наук, профессор, заведующий кафедрой общей и клинической микробиологии, иммунологии и аллергологии.

443099, Самара, ул. Чапаевская, 89; тел.: (846) 374-10-04, доб. 457

Alexander V. Zhestkov - Doctor of Medicine, Professor, Head of the Department of General and Clinical Microbiology, Immunology, and Allergology.

Ul. Chapaevskaya 89, Samara, 443099; tel.: (846) 374-10-04, ext. 457

avzhestkov2015@yandex.ruhttps://orcid.org/0000-0002-5905-1895ЛяминА. В.LyaminA. V.

Лямин Артем Викторович – доктор медицинских наук, профессор кафедры общей и клинической микробиологии, иммунологии и аллергологии.

443099, Самара, ул. Чапаевская, 89; тел.: (846) 374-10-04, доб. 457

Artem V. Lyamin - Doctor of Medicine, Professor, Department of General and Clinical Microbiology, Immunology, and Allergology.

Ul. Chapaevskaya 89, Samara, 443099; tel.: (846) 374-10-04, ext. 457

avlyamin@rambler.ruhttps://orcid.org/0000-0003-4307-9321ФедотовВ. Д.FedotovV. D.

Федотов Василий Дмитриевич – кандидат медицинских наук, доцент кафедры госпитальной терапии имени В.Г.Вогралика Федерального государственного бюджетного образовательного учреждения высшего образования «Приволжский исследовательский медицинский университет» Министерства здравоохранения Российской Федерации, старший научный сотрудник клинического отдела Нижегородский НИИГП Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека; главный внештатный пульмонолог министерства здравоохранения Нижегородской области.

603005, Нижний Новгород, пл. Минина и Пожарского, 10 / 1; 603105, Нижний Новгород, ул. Семашко, 20; тел.: (831) 419-61-94

Vasily D. Fedotov - Candidate of Medicine, Associate Professor, Department of Hospital Therapy named after V.G.Vogralik, Federal State Budgetary Educational Institution of Higher Education Privolzhsky Research Medical University, Senior Researcher, Clinical Department, Nizhny NSRIHygiene and Occupational Pathology” of the Federal Service for Supervision of Consumer Rights Protection and Human Wellbeing; Chief Freelance Pulmonologist of the Ministry of Health of the Nizhny Novgorod Region.

Pl. Minina i Pozharskogo 10/1, Nizhny Novgorod, 603005; ul. Semashko 20, Nizhny Novgorod, 603105; tel.: (831) 419-61-94

basil11@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Приволжский исследовательский медицинский университет» Министерства здравоохранения Российской Федерации; Федеральное бюджетное учреждение науки «Нижегородский научно-исследовательский институт гигиены и профпатологии» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человекаРоссияFederal State Budgetary Educational Institution of Higher Education “Privolzhsky Research Medical University” of the Ministry of Health of the Russian Federation; Federal Budgetary Scientific Institution “Nizhny Novgorod Research Institute for Hygiene and Occupational Pathology”, Federal Service for Supervision of Consumer Rights Protection and Human WelfareRussian Federation202313122023336792797Copyright © Золотов М.О., Жестков А.В., Лямин А.В., Федотов В.Д., 20232023Золотов М.О., Жестков А.В., Лямин А.В., Федотов В.Д.Zolotov M.O., Zhestkov A.V., Lyamin A.V., Fedotov V.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4144

Разработка новых методов диагностики инфекционных заболеваний, таких как полимеразная цепная реакция, секвенирование и массспектрометрия, позволила расширить представление о микрофлоре различных локусов организма человека в целом и респираторного тракта в частности. В легких наиболее распространены представители Proteobacteria (Pseudomonas spp., Haemophilus spp.), Bacteriodetes (Prevotella spp., Porphyromonas spp.) и Firmicutes (Veillonella spp., Streptococcus spp.). Формирование патологического процесса в нижних дыхательных путях приводит к изменению их микробиома. Так, у пациентов с хронической обструктивной болезнью легких обнаруживаются микроорганизмы родов Moraxella, Haemophilus и Acinetobacter. К основным возбудителям внебольничной пневмонии (ВП) относятся Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae и другие энтеробактерии. Атипичные возбудители пневмонии представлены Mycoplasma pneumoniae, Chlamydia pneumoniae и Legionella pneumophila. Широкая распространенность S. pneumoniae в популяции подтверждает необходимость применения вакцин для профилактики развития инвазивных и неинвазивных форм инфекции.

Целью исследования явился анализ данных литературы о структуре нормальной микрофлоры легких и изучение ее роли в развитии патологических состояний.

Заключение. Все больше исследований подтверждают важную роль нормальной микрофлоры дыхательных путей. Применение вакцинации для профилактики болезней бронхолегочной системы позволяет снизить заболеваемость и смертность от пневмонии. Однако проблема ВП не теряет своей актуальности, в частности, представляет большой интерес динамика изменений структуры возбудителей этого заболевания. Проведение вакцинопрофилактики против респираторных патогенов в совокупности с бесконтрольным приемом антибактериальных препаратов во время пандемии новой коронавирусной инфекции могли способствовать изменению как структуры микрофлоры нижних дыхательных путей в целом, так и возбудителей бактериальной ВП в частности. Выявление изменения доминирующего возбудителя влечет за собой необходимость пересмотра этиотропного лечения и организации плановой профилактики при наличии соответствующих вакцин.

The development of new methods for diagnosing infectious diseases, such as polymerase chain reaction, sequencing, and mass spectrometry, has made it possible to expand our understanding of the microflora of the human body in general and of the respiratory tract in particular. The most common microorganisms in lungs include Proteobacteria (Pseudomonas spp., Haemophilus spp.), Bacteriodetes (Prevotella spp., Porphyromonas spp.) and Firmicutes (Veillonella spp., Streptococcus spp.). Pathological processes in the lower respiratory tract change the microbiome. Consequently, Moraxella, Haemophilus, and Acinetobacter microorganisms are found in patients with chronic obstructive pulmonary disease. The main causative agents of community-acquired pneumonia include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae and other enterobacteria. Atypical causative agents of pneumonia include Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. The wide prevalence of S. pneumoniae in the population confirms the need for vaccines to prevent the development of invasive and noninvasive forms of infection.

The aim of the study was to analyze literature data on the structure of the normal microflora of the lung and to investigate its role in the development of pathological conditions.

Conclusion. A growing body of research confirms the important role of the normal microflora of the respiratory tract. Vaccination against diseases of the bronchopulmonary system may reduce the incidence and mortality of pneumonia. However, the problem of community-acquired pneumonia is still relevant. In particular, the changes in the structure of the pathogens of this disease is of great interest. Vaccination against respiratory pathogens in combination with uncontrolled use of antibiotics during the pandemic of the new coronavirus infection could contribute to a change in the structure of both the lower respiratory microflora in general and the pathogens of bacterial community-acquired pneumonia in particular. The detection of a change in the predominant pathogen calls for revising etiotropic treatment and organizing planned prophylaxis if the appropriate vaccines are available.

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The authors declare that there are no conflicts of interest present.