The clinico-immuno-microbiological study of 24 patients with congenital heart diseases was made. Clinically, the patients were subdivided into two groups: 8 patients with diagnosed bacterial endocarditis (BE) prior to the operation and 16 patients without BE. The analysis of the results of investigation carried out prior to the operation showed that age, the form of the disease and its duration did not affect the level of anti-infectious resistance factors (AIRF): in both groups a decrease in the level of AIRF characteristics (cell-mediated and humoral) was noted and no characteristic differences were determined. The results of the study of microflora from the nasal and laryngeal mucosa showed no difference in both groups of the patients. At the same time the detailed analysis of the results made it possible to suggest that BE caused by Streptococcus epidermidis and Streptococcus aureus inhabiting the mucous membrane of the anterior sections of the nasal cavity, alpha-hemolytic streptococci and S. epidermidis inhibiting the laryngeal mucosa. The results of the analysis made 3-6 months after the operation were also indicative of the absence of essential differences between AIRF characteristics observed in patients with confirmed and clinically unconfirmed BE. The clinical manifestation of this fact was an increase in the percentage of diagnosed BE cases up to 70% as compared with that before the operation (33%). This clinico-immuno-microbiological study made it possible to come to the conclusion that any form of congenital heart disease develops in combination with BE and/or is its prodrome.
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