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10Central Asian Research Journal For Interdisciplinary Studies (CARJIS)
ISSN (online): 2181-2454 Volume 2 | Issue 4 | April, 2022 | SJIF: 5,965 | UIF: 7,6 | ISRA: JIF 1.947 | Google Scholar |
www.carjis.org DOI: 10.24412/2181-2454-2022-4-99-103
THE MICROBIOLOGICAL FEATURES OF ROSACEA AND AND ITS INFLUENCE ON THE CLINICAL COURSE OF THE DISEASE
Mavlyanova Sh.Z., Sabirov U.Yu., Muminova S.R.
Republican Specialized Scientific and Practical Medical Center of Dermatovenerology and Cosmetology of the Ministry of Health of the Republic of
Uzbekistan
ABSTRACT
Among acne-like dermatoses, rosacea undoubtedly has a large proportion. Rosacea refers to common inflammatory dermatoses of the skin of the face. Rosacea is a chronic dermatosis characterized by a lesion of the facial skin in the form of erythema, papular - pustular elements and a variety of clinical manifestations In patients with acne-like dermatoses complicated by demodecosis, there is a wide species spectrum of facial skin microorganisms with the prevalence of highly virulent strains and an increase in the frequency of detection of virulence factors.
Keywords: dermatology, rosacea, Staphylococcus aureus, bacteriological studies.
INTRODUCTION
Rosacea is a chronic inflammatory dermatosis mainly affecting the cheeks, nose, chin, and forehead. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia. Antibiotics are usually prescribed in dermatological practice for various diseases, including vulgar acne and rosacea. It is important to note that they are often used for a long time in these inflammatory dermatoses. Changes in bacterial ecology associated with the administration of antibiotics have led to a decrease in the sensitivity of some bacterial organisms, such as Propionibacterium acnes, to antibiotics commonly prescribed by dermatologists. The potential clinical outcomes of altered bacterial sensitivity may vary depending on specific disease conditions and include a decrease in the therapeutic response and the need to change approaches to the treatment of the disease. In addition, changes in antibiotic sensitivity patterns and the emergence of more virulent pathogens, such as community-acquired methicillin-resistant Staphylococcus aureus, staphylococci and streptococci resistant to macrolides, and S.
Central Asian Research Journal For Interdisciplinary Studies (CARJIS)
ISSN (online): 2181-2454 Volume 2 | Issue 4 | April, 2022 | SJIF: 5,965 | UIF: 7,6 | ISRA: JIF 1.947 | Google Scholar |
www.carjis.org DOI: 10.24412/2181-2454-2022-4-99-103
aureus resistant to mupirocin has led to noticeable changes in how clinicians use antibiotics in clinical practice.
METHODOLOGY
We examined 124 patients with rosacea aged from 39 to 68 years who received inpatient and outpatient treatment. Of these, 48(38,7%) patients were male and 66 (53,2%) were female. According to clinical nosology, 66 (53,2%) patients were diagnosed with erythematose-telangiectatic form, papulopustular form was observed in 56 (45,1%) and phymatous rosacea - 2 (1,61%).
Clinical study was performed in all patients. Bacteriological study was performed in 94 patients. In order to study the microbiological status of the skin in patients with rosacea, we conducted bacteriological studies of the skin lesions, taking into account the determination of species, the level of contamination of the skin of patients and the determination of antibacterial sensitivity of staphylococcal microflora. The control group consisted of 70 healthy individuals of the appropriate age.
Microbiological studies were characterized by bacterioscopic and cultural studies of skin flakes from lesions in patients with rosacea. For cultural studies, 5% blood agar, Endo, Kligler medium, and salt agar with the addition of manitol were used and incubation was carried out in a thermostat at 36.8 degrees Celsius.
The results of the study were statistically processed using standard methods of variational statistics using the Student's t-test, using the Excel-Office-2003 application program on a Pentium IV computer. The average values are presented as M ± m (average ± average error of the average).
RESULTS
The results of bacteriological studies showed that among the examined 78 patients, they had a conditionally pathogenic microorganism of the Micrococaccea family - Staphylococcus spp., which amounted to 82,9% of cases. It should be note that bacterial skin studies were carried out during the exacerbation of rosacea. (Table 1).
Table 1. The sowing rate of Staphylococcus spp. on the skin of rosacea patients (abs,
%)
Healthy group rosacea
Examined patients 70 94
Bacteriological sowing 12 78*
% 17,1% 82,9*
Central Asian Research Journal For Interdisciplinary Studies (CARJIS)
ISSN (online): 2181-2454 Volume 2 | Issue 4 | April, 2022 | SJIF: 5,965 | UIF: 7,6 | ISRA: JIF 1.947 | Google Scholar |
www.carjis.org DOI: 10.24412/2181-2454-2022-4-99-103
Note: * is a confidence indicator in relation to the control group of healthy
individuals (P <0,05) As follows from Table 1, the sowing rate of staphylococcal flora in the control group of healthy individuals was noted in 12 out of 94, which was 12,7%. Whereas in patients with rosacea, sowing was noted in amounted 82,9% of patients (78 out of 94). Compared with the indicators of healthy control individuals, on average, from 6,5 times exceeded the degree of colonization of the staphylococcal flora and had a statistically significant character (P<0.05).
Taking into account the species identification of staphylococci in the examined patients, St.aureus was most often sown in 41 out of 78, which was 52,5%, St. epidermidis - in 32 (41,02%), St. saprophyticus - in 3 (2,01%) and St. Haemoliticus -in 2 (2,56%).
Table 2. Species identification of Staphylococcus spp. in patients with rosacea (%).
Group St. aureus St. epidermidis St. saprophyticus St. Haemoliticus
Rosacea patients n=78 41 (52,5%) 32(41,02%) 3 (2,01%) 2 (2,56%)
Healthy group n=70 3 (4,28) 6 (8,57%) _ -
As can be seen from Table 2, the examined rosacea patients had increased colonization of staphylococcal flora on the skin lesions, which statistically significantly differed from the control indicators of healthy individuals (P<0,05).
3% 0
Picture 1. Frequency of occurrence Staphylococcus spp.
Central Asian Research Journal For Interdisciplinary Studies (CARJIS)
ISSN (online): 2181-2454 Volume 2 | Issue 4 | April, 2022 | SJIF: 5,965 | UIF: 7,6 | ISRA: JIF 1.947 | Google Scholar |
www.carjis.org DOI: 10.24412/2181-2454-2022-4-99-103
The results obtained indicate that patients with rosacea have an increase in conditionally pathogenic flora on the skin, which causes bacterial contamination involved in exacerbation of the skin process.
To assess the state of the skin microbiota, the level of colonization of staphylococcal flora was given great importance. In this connection, we analyzed the state of colonization on the skin in the lesions of the examined patients.
The analysis of the obtained results indicates that in patients with skin lesions during the disease exacerbation, there is an increased colonization of opportunistic microorganisms, which may be one of the provoking factors in the development of not only exacerbations, but also complications of the main skin process by secondary infection.
It was interesting for us, to make a correlation between the severe degree of rosacea and the microbiological composition of the skin in patients.
Table 3. Indicators of correlation between the development of rosacea and opportunistic microorganisms of the Microcaccacea family (r).
St. aureus St. epidermidis St. saprophyticus St. Haemoliticus
Rosacea +0,4 +0,3 +0,4 +0,5
Controle group -0,08 -0,08
Note: r >0.3 - moderate degree of correlation; r >0.4 - noticeable; r > 0.5- high ;
In severe patients with rosacea was showed a significant correlation with St. Aureus and St. saprophyticus - r=+0.4 (P<0.05), St. Haemoliticus - r=+0.5 and St. epidermidis - r=+0.3 (P<0.05), respectively. In the control group, there was a negative correlation with microbiological status St. Aureus and St. saprophyticus - r=-0,08 (P<0.05) (Table 6).
Thus, the results obtained indicate that the role of conditionally pathogenic microorganisms in the clinical course of allergic skin dermatoses and rosacea is undoubtedly high, the degree of colonization plays an important role in the pathogenesis of dermatoses. In this regard, the assessment of the degree of contamination of conditionally pathogenic microorganisms can be an indicative criterion for laboratory diagnostics of the state of the skin microbiota.
Central Asian Research Journal For Interdisciplinary Studies (CARJIS)
ISSN (online): 2181-2454 Volume 2 | Issue 4 | April, 2022 | SJIF: 5,965 | UIF: 7,6 | ISRA: JIF 1.947 | Google Scholar |
www.carjis.org DOI: 10.24412/2181-2454-2022-4-99-103
CONCLUSION
Patients with rosacea have a wide species spectrum of microbiocenosis of the facial skin. Representatives of the Staphylococcus genotype, whose frequency of occurrence, dominated the microflora and colonization density significantly exceeded similar indicators in the comparison group. The most significant differences were found in S.aureus and S. Haemolyticus. In patients with rosacea there was a significant increase in the frequency of detection of staphylococcal virulence factors.
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