Pathogenetic features of Ureaplasma infection in chronic inflammatory diseases of the genitourinary system
Objective. Ureaplasma urealyticum is one of the most common etiological factors of inflammatory diseases of the genitourinary system. The pathogenic potential of ureaplasmas is determined by their concentration in the body, changes in the immune status of the patient, the presence of combined infection with other bacteria, as well as somatic diseases. Patients and methods. A comprehensive clinical and laboratory examination of 120 patients with chronic inflammatory diseases of the genitourinary system and urolithiasis was carried out. Ureaplasma infection was detected in 47 patients, which was 39.2% of the total number of examined. The main group included a group of 30 patients with chronic inflammatory processes of the genitourinary system, in whom U. urealiticum was detected in the diagnostic titer of more than 104 CFU / ml (main group). In addition, 30 patients were examined, who had no Ureaplasma infection in the spectrum of pathogens of inflammatory diseases (SRV group). Results. In the group of patients with Ureaplasma infection, a decrease in cellular and humoral factors of immunity was revealed: immunoglobulin A - 1.4 times, complementary activity C3 - 1.5 times, as well as a decrease in phagocytic activity of neutrophils. Patients with Ureaplasma infection were characterized by the development of associations with microorganisms such as Klebsiella, enterococci, fungi of the genus Candida. The presence of such associations contributed to the long course of the inflammatory process and the development of lithogenesis. Conclusion. When studying the nature of the formation of urinary stones depending on the type of microflora associated with Ureaplasma urealyticum, it was found that when combined with Ureaplasma Klebsiella, crystals of trippelphosphates, ammonium urate, oxalates predominate in the urine. The presence of the ability of Klebsiella to form bacterial biofilms enhanced the process of lithogenesis. In the Association of ureaplasmas with Enterococcus, the predominant was the formation of crystals of uric acid, calcium oxalate, sodium urate. In the presence of fungi of the genus Candida in combination with ureaplasmas, the formation of crystals of both calcium oxalate and uric acid, ammonium urate, trippelphosphates was observed. In Ureaplasma infection, not associated with other microflora, calcium oxalate crystals, urates, were predominant.