Dziublyk Y. Community-acquired low respiratory tract infections: technologies of etiological diagnosing and optimization of antimicrobial chemotherapy

Object of study: community-acquired low respiratory tract infections (CALRTI) - community-acquired pneumonia (CAP) and infectious exacerbation of chronic obstructive pulmonary disease (COPD), the goal - to develop new strategies of etiological diagnosing of CALRTI based on the use of modern technologies of bacterial and viral pathogens identification and to substantiate scientifically the differentiated antimicrobial chemotherapy in these patients considering pharmaco-economics aspects; study methods: clinical, radiological, biochemical, functional, bacteriological, molecular with polymerase chain reaction (PCR), mono- and multiplex PCR laboratory, real-time PCR for identification of bacterial and viral pathogens, immunochromatographic (ICA) quick tests, mathematical and statistical methods; novelty: a strong correlation was revealed between the level of influenza morbidity and the morbidity due to respiratory diseases, and between influenza and pneumonia morbidity; the peculiarities of antibiotic resistance of key CALRTI pathogens (pneumococcus and Heamophilus influenzae) were studied in different regions of the country; novel approaches and strategies of etiological diagnosing of CALRTI were developed on the background of modern technologies of bacterial and viral pathogens identification; an algorithm of etiological diagnosing of CALRTI was created and introduced into practice, which implemented multiplex real-time PCR and ICA-tests; the effectiveness of antiviral compound vitaglutam was proved in management of viral-bacterial CALRTI patients; based on antibiotic resistance pattern of major respiratory pathogens and data from pharmaco-economics analysis, the regimens of antimicrobial chemotherapy were optimized and subsequently included into national guidelines for the management of LRTI patients. Field of application - medicine.