The level of sensitivity of Klebsiella pneumoniae strains isolated from children of the first half of life with functional gastrointestinal disorders (FGID) to commercial bacteriophage preparations was assessed. The material was the feces of 67 children of the first half of life with FGID who are breastfed. Culture of K. pneumoniae isolated from faeces of children, amounted to two comparison groups, depending on the age of the patients. The first group included 43 K. pneumoniae strains isolated from the colon of children aged from birth to three months, in the second group - 24 strains, from children aged three to six months. The composition of the colon microbiota was studied using standard methods, and the results were evaluated in accordance with Industry Standard 91500.11.0004-2003. Identification of K. pneumoniae was performed by bacteriological methods. Determination of the level of lytic activity of K. pneumoniae, Klebsiella polyvalent and sextaphage bacteriophages to K. pneumoniae strains was conducted by the drip method (spot-test) according to clinical recommendations. It is shown that the formation of FGID symptoms in children correlates with age - the frequency of regurgitation decreased in children up to six months (from 23.3% to 4.2%) against the background of the formation of a symptom complex associated with defecation disorder. Bacteriological analysis showed that in General, phages show a low level of lytic activity, sensitivity to them Klebsiella also correlated with age and was higher in children of three to six months. Thus, in the first comparison group, the absence of Klebsiella lysis in relation to the Klebsiella pneumoniae bacteriophage was registered three times more often (30.2%, p<0.05) and twice less often (30.2%, p<0.05), the low level of lysis of K. pneumoniae strains to the Klebsiella polyvalent phage compared to the second group. The sensitivity of K. pneumoniae strains to sextaphage was comparable in comparison groups and varied from 2 to 10%. Thus, among the studied K. pneumoniae observed a low level of sensitivity to specific drugs - bacteriophage Klebsiella pneumoniae, Klebsiella polyvalent and sextaphage. This fact reflects the insufficient activity of phages and predicts low effectiveness of empirical phage therapy without elimination from the intestinal biocenosis of K. pneumoniae in children with FGID who are breastfed.
Keywords: Klebsiella pneumoniae; bacteriophages; breastfeeding; children of the first half of life; functional gastrointestinal disorders.