ETIOPATHOGENETIC REASONING OF URETHRAL MICROBIOTA REHABILITATION IN PATIENTS WITH ACUTE INFECTIOUS URETHRITIS

The microbiota of the male genitourinary tract is a complex dynamic system that has not been sufficiently studied. Unlike the microbiome of the female urethral mucosa, which is constantly changing, the taxonomic composition and population level of the male urethral microbiome is more stable and independent of age. The aim of the study. To improve the results of treatment of patients with inflammatory processes of the urethra by determining the taxonomic composition, population level and microscopic indicators of the "macroorganism-microbiome" ecosystem of the microbiota of the urethra in men with acute urethritis.Material and methods. The taxonomic composition and population level of the first portion of urine of 69 sexually mature men (average age 34.8±7.14 years) with acute infectious (nonspecific) urethritis were investigated. Isolation of conditionally pathogenic bacteria was carried out by the bacteriological method using optimal nutrient media, their pH, temperature and cultivation time for each taxon. The identification of isolated pure cultures was carried out according to morphological, tinctorial, cultural, biochemical properties, as well as signs of pathogenicity and antigenic structure. To determine the mechanisms of colonization of the mucous membrane of the urethra by conditionally pathogenic microorganisms, the microecological method was used.Research results. According to the taxonomic composition and the level of microecological indicators of the "macroorganism-microbiome" ecosystem of the urethra microbiota (Margalef's species richness index, Whittaker's species diversity index, and Simpson's and Berger-Parker's species dominance indices), vulgar (common), hemolytic, and enteropathogenic Escherichia coli, coagulase-positive staphylococcus. The leading role in the formation of urethritis is played by ordinary enterobacteria - E. coli, a slightly smaller etiological role in the formation of urethritis in men belongs to S. aureus (less by 17.83%), E. coli Hly+ (less by 28.35%), enteropathogenic Escherichia coli (by 83.12%). Other microorganisms have a minimal etiological role. Conclusions. Acute urethritis in men is a polyetiological disease. Enterobacteria E. coli, E. coli Hly+, enteropathogenic Escherichia coli, K. pneumoniae, S. aureus, S. epidermidis, S. viridans are involved in the formation of the inflammatory process of the urethra. The leading causative agents of acute urethritis in men are E. coli, S. aureus, E. coli Hly+, enteropathogenic escherichia, which belong to uropathogenic escherichia.