medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-6-59-65medsovet-5635Research ArticleИНФЕКЦИИ В ОТОРИНОЛАРИНГОЛОГИИINFECTIONS IN OTORHINOLARYNGOLOGYБиопленки и хронический риносинуситBiofilms and сhronic rhinosinusitishttps://orcid.org/0000-0001-8553-0489ШиленковаВ. B.ShilenkovaV. V.

Шиленкова Виктория Викторовна, доктор медицинских наук, профессор, профессор кафедры оториноларингологии

150000, Ярославль, ул. Революционная, д. 5

Viktoria V. Shilenkova, Dr. of Sci. (Med), Professor, Department of ENT Diseases

5, Revolyutsionnaya St., Yaroslavl, 150000

 

vikt@rambler.ruЯрославский государственный медицинский университет;РоссияYaroslavl State Medical UniversityRussian Federation202025052020065965Copyright © Шиленкова В.B., 20202020Шиленкова В.B.Shilenkova V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5635Введение

Введение. Биопленка представляет собой сообщество бактерий, встроенных в матрицу, состоящую из полисахаридов, нуклеиновых кислот и белков. Биопленки устойчивы к антибиотикам, антисептикам, факторам иммунной защиты организма человека. В настоящее время роль бактериальных биопленок в патогенезе хронических инфекций известна. Имеются многочисленные работы, подтверждающие обнаружение биопленок при заболеваниях верхних дыхательных путей и уха: при аденоидите, рецидивирующих и хронических отитах, ларингитах.

Биопленки и хронический риносинусит (ХРС). Биопленки могут играть значительную роль в пролонгировании воспаления в околоносовых пазухах. Биопленки обнаруживаются у 76,7% пациентов с ХРС. Данный факт может служить одним из объяснений рефрактерности медикаментозной терапии и рецидивов воспаления после хирургического лечения.

Методы борьбы с биопленками. Есть ли выход? Важным в стратегии устранения биопленки является разрушение ее структуры до планктонных форм, что позволит обеспечить контроль за течением ХРС. Применение только антибиотиков считается недостаточным. Ирригационная терапия может обеспечить нарушение целостности биопленки за счет механического разрушения ее матрикса и оказать значительное влияние на исход заболевания. Таким эффектом обладает препарат для ирригации, который содержит изотонический раствор морской воды с добавлением диоксида углерода (СО2-0,4%). В экспериментальном исследовании показано, что при обработке биопленки Staphylococus aureus 98% бактерий были нежизнеспособными.

Заключение

Заключение. Воздействие на биопленки должно быть комплексным, включать медикаментозные, физические средства, ирригацию полости носа.

Introduction

Introduction. A biofilm is a community of bacteria embedded in a matrix consisting of polysaccharides, nucleic acids, and proteins. Biofilms are resistant to antibiotics, antiseptics, and immune defense factors of the human body. Currently, the role of bacterial biofilms in the pathogenesis of chronic infections is known. There are a lot of articles confirming the detection of biofilms in diseases of the upper respiratory tract and ear: adenoiditis, recurrent and chronic otitis, laryngitis.

Biofilms and Chronic Rhinosinusitis (CRS). Biofilms can play a significant role in prolonging inflammation in the paranasal sinuses. Biofilms are found in 76.7% of patients with CRS. This fact can serve as one of the explanations for the refractoriness of drug therapy and recurrent inflammations after surgical treatment.

Methods for Controlling Biofilms. Is there a Way Out? As part of the strategy of removing biofilm, it is important to destroy its structure to planktonic forms, which will allow for the process of managing CRS progress. Antibiotic therapy alone is considered insufficient. Nasal irrigation can provide a violation of the biofilm integrity due to the mechanical destruction of its matrix and have a significant impact on the outcome of the disease. The nasal irrigation preparation containing isotonic sea water solution added with carbon dioxide (CO2-0.4%) has such an effect. In an experimental study, it was shown that 98% of the bacteria were non-viable when processing Staphylococus aureus biofilm.

Conclusion

Conclusion. The impact on biofilms should be complex, including medication, physical means, irrigation of the nasal cavity.

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