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cohort Clinical and Microbiological Study of Young Patients Infected with Seasonal Influenza Subtypes A/H3N2 (Victoria, Pert strains) and B Viruses in Ukraine: Pathophysiology Reaction of Large Intestinal Cavity Microbiota

Introduction: The ecologic intestinal system fulfills a myriad of functions. There is continuous interaction and communication between the flora and the gut-associated lymphatic tissue determining many aspects of host immunity and metabolism. The digestive tract's immune system is often referred to as gut-associated lymphoid tissue and works to protect the body from invasion. However, it is well-established that influenza virus much more easier attached to mucous membranes of upper respiratory tract in condition of decreased functions of local immunity, which probably accompanies with mucosa-associated lymphoid tissue.

Objectives: This article discusses about pathophysiology reaction of large intestinal cavity microbiota by the means of determination its species composition and populational level with evaluation of dysbiotic abnormalities level in young Caucasian patients infected with influenza A and influenza B in Ukraine.

Study design: Cohort variant of observational study enrolled 109 young Caucasian race persons were born since 1986 till 1995 in western Ukraine (Eastern Europe, Chernivtsi region, traditionally called Bukovina) which were infected with influenza A and B during 2011-2012 autumn-winter-spring seasons. Fresh samples of stool, vein blood, and nasopharyngeal swabs were investigated by means of serological reactions, PCR, bacteriological and mycological methods. Statistical analysis performed due to “Biostat” PC programme with evaluation of average error and P-value with purpose to appreciate confident valuable changes between two investigated groups.

Findings: In 51 (46.8%) patients A/H3N2/Pert/16/2009 virus was diagnosed, in 44 (40.4%) patients – A/H3N2/Victoria/361/2011 subtype and in 14 (12.8%) young patients causative agent of influenza had determined virus B/Visconsin/1/2010 by molecular biologic assay – PCR (polymerase chain reaction. Alterations in influenza A and influenza B infected patients the intestinal micoflora pronounced and included increased bacterial density and a higher incidence of opportunistic flora accompanied by decreased normal microflora activity.The level Bifidobacterium declined to 5.12±0.08 vs 9.17±0.19 lg CFU/g, Lactobacillus – to 6.14±0.08 vs 8.51±0.24 lg CFU/g respectively. Meanwhile the complete elimination of indigenous Enterococci simultaneously with appearance of haemolytic enterococci strains in high level – 8.66±0.06 lg CFU/g as well as peptostreptococci (8.90±0.08 lg CFU/g) noticed. The values of Candida fungi increased in five times, anaerobic Clostridium– twice, Staphylococcus – 1.8 times, coli bacilli in 1.2 times respectively.

Conclusion: Young Caucasian patients were borne in period of 1986-1995 and infected with A/H3N2/Pert/16/2009, A/H3N2/Victoria/361/2011 and B/Visconsin/1/2010 in 2011-2012 cold seasons had manifested typically moderate and mild clinical form of influenza accompanied with dysbiotic alterations of large intestinal microbiota. Since first days of influenza onset the clinical course in patients presented objective and laboratory data of that, logically explained as the pathophysiologic reaction by means of interaction between virus-induced immune dysfunction and mucosa-associated lymphoid tissue. Degree of alteration in microbiota of large intestine cavity depends on the type of virus: III degree in 76,5% persons infected A/H3N2/Pert/16/2009 in comparison with 54,5% persons infected with A/H3N2/Victoria/361/2011. II degree of abnormalities was determined in 17,6% patients (Pert strain) vs 34,1% patients (Victoria strain). Minimal intestinal abnormalities observed in 5,9% patients with A/H3N2/Pert/16/2009 influenza, in 11,4% – A/H3N2/Victoria/361/2011 and in absolutely all infected with B/Visconsin/1/2010 influenza virus.

Author(s): Moskaliuk V.D. , Sydorchuk A.S. , Randiuk Yu.O. , Sorokhan V.D. , Sydorchuk L.I. , Myndresku V.B.

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