USE OF THE PROBIOTICS AEROCOCCUS VIRIDIANS IN THE PROPHYLAXIS OF LACTATIONAL MASTITIS IN PARTURIOUS WOMEN WITH LACTOSTASIS

Abstract

Numerous studies have demonstrated the essential role of the human microbiome for its health. At the present stage, the microbiota of breast milk can be defined as a set of commensal interactions between microorganisms, representing a complex organized ecosystem.In previous studies, it was found that in pregnant women before childbirth and women in labor without foci of infection in the mammary gland, representatives of the obligate microflora – Aerococcus viridans, which have strong hydrogen peroxide production, live Over time, in the postpartum period, there was an increase in the sowing of Aerococcus viridans from 23.8% to 86.7% (p<0.05).The above-mentioned trend occurred in parallel with a decrease in the colonization of various areas of the mammary gland by Staphylococcus aureus and Gram-negative enterobacteria.The conducted studies make it possible to apply a promising method of preventing mastitis using a probiotic consisting of Aerococcus viridians.Purpose of the study. To determine the microbiological state of the mammary glands in postpartum women with lactostasis before and after the use of a probiotic containing Aerococcus viridan and its effectiveness in the prevention of lactational mastitis.Materials and methods of the study. The microbiological state of the mammary glands was carried out from the areola mammae and papilla mammae areas in 34 parturient women with lactostasis before and after oral administration of a probiotic, with subsequent identification of the bacterial flora. A selective indicator medium was used for sowing Aerococcus viridians.Results and discussion. A microbiological study was conducted in 34 parturient women with lactostasis before and after oral administration of a probiotic containing Aerococcus viridians. The bacteriological composition was represented by 13 species of pathogenic, opportunistic and saprophytic microflora.In parturient women with lactostasis, significant colonization of Staphylococcus aureus (52.9%–73.5%) and enterobacterial microflora, which cause the development of lactational mastitis, was observed in different areas of the mammary glands. At the same time, a very low percentage of colonization of Aerococcus viridians was observed from different areas of the mammary gland (5.9±4.0%).After using the probiotic, the number of Staphilococcus epidermidis, Staphilococcus aureus, Micrococcus sp. Enterobacter aerogenes, E. coli, Klebsiella pneumonia was significantly reduced. There were no significant changes in the number of Staphilococcus saprofiticus, Bacillus sp. and Candida sp. The number of Aerococcus viridians significantly increased to 82.3% (p<0.05).In 34 women with lactostasis, clinical manifestations disappeared on the 3-7th day after taking the probiotic. In 1 case (2.9%), the course of lactostasis ended with the appearance of lactational mastitis.Conclusions. The use of a probiotic containing Aerococcus viridians in parturient women with lactostasis leads to a change in the microbiota of the mammary gland from a decrease in pathogenic microflora to an increase in microorganisms that have significant antagonistic properties against pathogens of lactational mastitis.