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Evaluation of antibiotic sensitivity of microorganisms, which were isolated from patients with acute pyelonephritis in the stage of purulent inflammation and located inside red blood cells (in vitro experiment)
DOI: https://dx.doi.org/10.18565/urology.2021.6.25-29
E.A. Shchuplova, M.D. Kuzmin
Institute of Cellular and Intracellular Symbiosis, Ural Branch of the RAS, Orenburg, Russia
Aim. To study the antibiotic sensitivity of strains of microorganisms isolated from patients with a purulent stage of acute pyelonephritis and located inside the erythrocytes.
Materials and methods. In this study, a total of 15 strains of microorganisms isolated from the blood of patients with a purulent form of acute pyelonephritis were used. The bacteria were detected and identified in the blood of patients using a modern molecular genetic method, fluorescent in situ hybridization (FISH), and the classical bacteriological study was done to isolate blood cultures of microorganisms. When studying the effect of antibiotics on the microorganism strains located inside red blood cells, the method of staged lysis was used.
Results. It was found that microorganisms isolated from patients with a purulent stage of acute pyelonephritis and, subsequently, inside red blood cells (in vitro experiment) in 80% of cases were resistant to antibacterial drugs of different groups (fluoroquinolones, aminoglycosides, macrolides, phosphonic acid derivatives). Outside of red blood cells, the same pathogens were sensitive to the antibiotics used in the work. Apparently, it is possible to consider the resistance to antibiotics of uropathogens located inside red blood cells as a result of insufficient intracellular concentration of the drug even when it is delivered by the method of stepwise lysis.
Conclusion. When treating patients with acute pyelonephritis in the stage of purulent inflammation, it is necessary to consider that microorganisms can penetrate into red blood cells. In vitro experiments have shown that microorganisms inside red blood cells exhibit antibiotic resistance to antibacterial drugs of different groups. It is necessary to further study the intraerythrocytic microorganisms in the purulent stage of acute pyelonephritis, as a new pathogenesis mechanism of its development. Perhaps, these results can result in revision of the principles of antibiotic therapy.
Materials and methods. In this study, a total of 15 strains of microorganisms isolated from the blood of patients with a purulent form of acute pyelonephritis were used. The bacteria were detected and identified in the blood of patients using a modern molecular genetic method, fluorescent in situ hybridization (FISH), and the classical bacteriological study was done to isolate blood cultures of microorganisms. When studying the effect of antibiotics on the microorganism strains located inside red blood cells, the method of staged lysis was used.
Results. It was found that microorganisms isolated from patients with a purulent stage of acute pyelonephritis and, subsequently, inside red blood cells (in vitro experiment) in 80% of cases were resistant to antibacterial drugs of different groups (fluoroquinolones, aminoglycosides, macrolides, phosphonic acid derivatives). Outside of red blood cells, the same pathogens were sensitive to the antibiotics used in the work. Apparently, it is possible to consider the resistance to antibiotics of uropathogens located inside red blood cells as a result of insufficient intracellular concentration of the drug even when it is delivered by the method of stepwise lysis.
Conclusion. When treating patients with acute pyelonephritis in the stage of purulent inflammation, it is necessary to consider that microorganisms can penetrate into red blood cells. In vitro experiments have shown that microorganisms inside red blood cells exhibit antibiotic resistance to antibacterial drugs of different groups. It is necessary to further study the intraerythrocytic microorganisms in the purulent stage of acute pyelonephritis, as a new pathogenesis mechanism of its development. Perhaps, these results can result in revision of the principles of antibiotic therapy.
About the Autors
Corresponding author: Kuzmin M.D. – Ph.D., MD, Leading Researcher of the Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences, a separate structural subdivision of the OFIC Ural Branch of the Russian Academy of Sciences, Orenburg, Russia; e-mail: mdk-49@mail.ru
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