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Pharmacogenetic Markers of Favipiravir Safety in COVID-19 Treatment 法匹拉韦治疗COVID-19安全性的药物遗传学标志物
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-55-61
I. I. Temirbulatov, A. V. Kryukov, K. B. Mirzaev, N. P. Denisenko, S. P. Abdullaev, A. V. Petrova, E. P. Tkach, A. V. Shipacheva, D. A. Sychev
The aim of the study was to evaluate the associations of different variants of AOX1 and CYP1A2 genes with safety parameters of favipiravir therapy in patients with COVID-19. Material and Methods. The study included 86 patients hospitalized at Moscow Clinical Hospital No. 15 with a COVID-19 diagnosis who received favipiravir as etiotropic therapy. Frequency of adverse reactions (bradycardia, dyspeptic disorders, increased transaminase levels) and various laboratory parameters (levels of ALT, AST, leukocytes) were compared between the carriers of «wild» and polymorphic variants of the genes studied after administration of the drug. The dynamics of these indicators before and after the therapy depending on the carriage of the variants of the genes studied were also compared. Results. There was no significant difference in the frequency of ad- verse reactions and laboratory parameters between the carriers of various variants of the studied genes. Haplotype analysis of the combination of different gene variants also did not reveal associations with therapy safety parameters. Upon the comparison of the parameters before and after treatment, an increase in the level of AST was noted in carriers of the AA genotype for both studied loci of the AOX1 gene (P=0.018 и P=0.009). At the same time, the level of AST increased in carriers of polymorphic variants of the CYP1A2*F1 gene (P=0.024). Leukocyte number increase was noted in carriers of polymorphic variants of AOX1 (rs10931910) (P=0.044), as well as «wild» genotypes AOX1 (rs55754655) (P=0.002) and CYP1A2*F1 (P=0.05). Conclusion. The associations of carriers of different AOX1 and CYP1A2 gene variants on the dynamics of AST and leukocytes in patients with COVID-19 after favipiravir therapy were revealed.
本研究的目的是评估AOX1和CYP1A2基因不同变异与favipiravir治疗COVID-19患者安全性参数的相关性。材料和方法。该研究包括86名在莫斯科第15临床医院住院的诊断为COVID-19的患者,他们接受了法匹拉韦作为致病因治疗。不良反应的频率(心动过慢、消化不良、转氨酶水平升高)和各种实验室参数(ALT、AST、白细胞水平)在给药后研究基因的“野生”和多态变异携带者之间进行比较。还比较了这些指标在治疗前后的动态,这取决于所研究的基因变体的携带。结果。不同变异基因携带者之间的不良反应频率和实验室参数没有显著差异。不同基因变异组合的单倍型分析也没有揭示与治疗安全性参数的关联。比较治疗前后参数,AA基因型携带者AOX1基因两个研究位点的AST水平均升高(P=0.018或P=0.009)。同时,CYP1A2*F1基因多态性变异携带者的AST水平升高(P=0.024)。AOX1多态性变异(rs10931910)的携带者白细胞数量增加(P=0.044),以及“野生”基因型AOX1 (rs55754655) (P=0.002)和CYP1A2*F1 (P=0.05)。结论。揭示不同AOX1和CYP1A2基因变异携带者与新冠肺炎患者favipiravir治疗后AST和白细胞动态的关系。
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引用次数: 0
Analysis of The Antibiotic Resistance Problem 抗生素耐药性问题分析
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-39-48
M. A. Maistrenko, E. N. Yakusheva, D. S. Titov
Antibiotic resistance is a global health problem. Its solution requires concerted efforts on the scale of global cooperation. Programs to prevent the development of antibiotic resistance, as well as to stimulate the development of new drugs with antimicrobial activity are implemented in a lot of countries. The use of antibacterial drugs, including inappropriate use, has increased during the COVID-19 pandemic, which may contribute to the growth of antibiotic resistance. The aim of this study is to assess the measures aimed at combating the growing antibiotic resistance in the world, analyze the market of antimicrobial drugs in the Russian Federation, as well as collect and process information on the antibiotic resistance of microorganisms that cause infectious diseases that develop against the backdrop of COVID-19. The analysis of the state register of the Russian Federation for antibacterial drugs was carried out. Mathematical and statistical processing of antibiotic resistance was performed according to the data of the European Surveillance Atlas of Infectious Diseases for Klebsiella pneumonia in relation to fluoroquinolones, aminoglycosides, third-generation cephalosporins, as well as combined resistance to these antibacterial drugs over the past sixteen years.
抗生素耐药性是一个全球性的健康问题。解决这一问题需要全球合作的共同努力。许多国家都实施了预防抗生素耐药性发展以及刺激开发具有抗菌活性的新药的规划。在2019冠状病毒病大流行期间,抗菌药的使用(包括不当使用)有所增加,这可能导致抗生素耐药性的增长。本研究的目的是评估旨在应对世界上日益严重的抗生素耐药性的措施,分析俄罗斯联邦的抗菌药物市场,以及收集和处理在2019冠状病毒病背景下导致传染病的微生物的抗生素耐药性信息。对俄罗斯联邦国家抗菌药物登记册进行了分析。根据欧洲肺炎克雷伯菌传染病监测图集的数据,对过去16年对氟喹诺酮类药物、氨基糖苷类药物、第三代头孢菌素以及对这些抗菌药物的联合耐药性进行了抗生素耐药性的数学和统计处理。
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引用次数: 0
Study of the Toxic Manifestation of Etoposide the Concomitant Exposure of Acetyl Salicylic Acid As a Protector on the Example of C57Bl/6J Mice Line 以C57Bl/6J小鼠为例,乙酰水杨酸保护剂伴随暴露时依托泊苷毒性表现的研究
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-33-38
O. N. Antosyuk, A. V. Gorskaya, D. V. Petrovskii, T. D. Dubatolova
The paper presents the results of evaluating the genetic and cytogenetic toxicity of etoposide, as well as the evaluation results of protective properties of aspirin against the toxicity of etoposide in C57Bl/6J mice. The cytogenetic activity and protective properties assessment was carried out using the chromosome aberration analysis in metaphase cells. Etoposide was tested at a concentration of 15 and 3 mg/kg and aspirin — at a concentration of 25 mg/kg of the animal. The results of metaphase analysis showed that etoposide exhibits cytogenetic toxicity in both doses, and aspirin exhibits protective properties against the toxicity of etoposide at a concentration of 15 mg/kg. The results of chromosome analysis regarding the protective properties of aspirin against etoposide at a concentration of 3 mg/kg are ambiguous and require further experiments.
本文介绍了依托泊苷遗传毒性和细胞遗传学毒性的评价结果,以及阿司匹林对C57Bl/6J小鼠依托泊苷毒性的保护作用的评价结果。利用染色体畸变分析对中期细胞的细胞遗传学活性和保护特性进行了评价。动物体内的依托泊苷浓度分别为15和3 mg/kg,阿司匹林浓度为25 mg/kg。中期分析结果表明,两种剂量的依托泊苷均表现出细胞遗传毒性,而阿司匹林在浓度为15 mg/kg时对依托泊苷的毒性表现出保护作用。染色体分析关于阿司匹林对浓度为3mg /kg的依托泊苷的保护作用的结果是不明确的,需要进一步的实验。
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引用次数: 0
Dynamics of Reserve Antimicrobial Drug Consumption in Russian Hospitals: Impact of the COVID-19 Pandemic 俄罗斯医院储备抗菌药物消费动态:COVID-19大流行的影响
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-62-68
Y. M. Gomon, A. A. Kolbin, D. S. Budanov
The aim of the study is the assessment of the resistance levels dynamics in clinically significant infectious agents based on the consumption dynamics of antimicrobial drugs potentially effective against bacteria with acquired drug resistance in the hospitals of the Russian Federation during the COVID-19 pandemic (2020–2022) in comparison with 2019. Material and methods . Data on antimicrobial drugs used in the Russian Federation in the period 2019–2022 in the hospital segment were downloaded from the database provided by the analytical company AlphaRM. Calculation of the indicator «Frequency of prescribing antimicrobial drugs effective against multidrug-resistant pathogens per year» in each year of observation was performed. Results . During the COVID-19 pandemic, an almost twofold increase was registered in the frequency of prescribing antimicrobial drugs potentially effective against resistant strains of both Gram-negative and Gram-positive pathogens in the hospital segment: from 1.2 in 2019 to 2% in 2021; with a subsequent decrease to 1.92% in 2022 for antimicrobial drugs effective against Gram-negative pathogens; from 0.47 in 2019 to 1.17% in 2022 for antimicrobial drugs potentially effective against Gram-positive pathogens. Conclusions. Due to the fact that the appointment of antimicrobial drugs, potentially effective against resistant strains of Gram-positive and Gram-negative pathogens, is carried out not only in cases of confirmed bacterial infections, but also empirically, and taking into account the nosocomial nature of secondary bacterial infections, further epidemiological and pharmacoepidemiological studies are required to assess the contribution of excessive consumption of antimicrobial drugs in the escalation of the problem of bacterial resistance.
该研究的目的是通过与2019年相比,在2019 -19大流行期间(2020-2022年)俄罗斯联邦医院中可能对获得性耐药细菌有效的抗菌药物的消费动态,评估临床重要感染性病原体的耐药水平动态。材料和方法。从分析公司AlphaRM提供的数据库下载了2019-2022年期间俄罗斯联邦医院部分使用的抗菌药物数据。计算每一年观察中“每年对耐多药病原体有效的抗菌药物处方频率”指标。结果。在2019冠状病毒病大流行期间,医院部门使用可能对革兰氏阴性和革兰氏阳性病原体耐药菌株有效的抗菌药物的频率增加了近两倍:从2019年的1.2%增加到2021年的2%;对革兰氏阴性病原体有效的抗菌药物随后在2022年降至1.92%;对革兰氏阳性病原体有效的抗菌药物的比例从2019年的0.47%上升到2022年的1.17%。结论。由于对革兰氏阳性和革兰氏阴性病原体耐药菌株可能有效的抗菌药物的指定不仅要在确诊的细菌感染病例中进行,而且要根据经验进行,并考虑到继发细菌感染的医院性质,需要进行进一步的流行病学和药物流行病学研究,以评估过度使用抗菌药物在细菌耐药性问题升级中的作用。
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引用次数: 0
Modern Ideas about Vaccination of Patients with Rheumatic Diseases: the View of ACR Experts 风湿病患者疫苗接种的现代观念:ACR专家的观点
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-77-84
B. S. Belov, N. V. Muravyeva
The review presents the recommendations of the American College of Rheumatology on vaccination of patients with rheumatic diseases. The indications for vaccination against major infections and the tactics of immunization with inactivated vaccines are highlighted. The possibility of safe vaccination with any disease activity and simultaneous administration of several vaccines is emphasized. The conditions of immunization with live attenuated vaccines are considered. The principles of vaccination of children born to mothers treated with biological drugs, as well as recommendations for the contacts of rheumatological patients with vaccinated population are reflected. Emphasis is placed on the need for joint decision-making by the rheumatologist and the patient.
这篇综述介绍了美国风湿病学会对风湿病患者接种疫苗的建议。重点介绍了预防重大感染疫苗接种的适应症和灭活疫苗免疫策略。强调安全接种任何疾病活动性疫苗和同时接种几种疫苗的可能性。考虑了减毒活疫苗免疫的条件。其中反映了对接受生物药物治疗的母亲所生儿童接种疫苗的原则,以及风湿病患者与接种疫苗人群接触的建议。重点放在风湿病学家和患者共同决策的需要上。
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引用次数: 0
Rationality of Cytoflavin Inclusion in the Treatment of Patients with Dermatological Pathology Comorbid with Mental Disorders 细胞黄素包涵治疗皮肤病理合并精神障碍患者的合理性
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-49-54
M. M. Khaydarov, A. L. Kovalenko, A. Yu. Petrov, N. T. Khaidarova
With the help of literature data, the effectiveness of Cytoflavin inclusion in the treatment regimens for patients with psoriasis, microbial eczema, and rosacea in the period of exacerbation was analyzed based on the assessment of subjective and objective data of the DLQI (Dermatology Life Quality Index), WAM (Well-being, Activity, Mood), DISS (Dermatological Index of the Symptom Scale). It was revealed that, according to the results of testing before the start of treatment, all patients had mental disorders, which manifested in an increase in indicators on the DLQI and DISS scales and a decrease on the WAM scale. The reduction of clinical manifestations and the decrease in DISS (by 86.0%, (P≤0.05) for rosacea, by 83.0% (P≤0.01) for eczema) was found to be more pronounced after a course of therapy with the inclusion of Cytoflavin (2 tablets 2 times a day 30 minutes before meals, course — 25 days), compared with standard therapy. This had a positive effect on well-being (the value of the indicator increased by 63,9% for rosacea, by 66,0% for eczema, and 27.8% for psoriasis), activity (56,1% for rosacea, 66.1 % for eczema, and 22.1% for psoriasis), mood (51,9% for rosacea, 54.3% for eczema, and 23.7% for psoriasis), and improved quality of life: indicator DLQI decreased by 42,9% in rosacea, 62.4% in eczema, and 61.5% in psoriasis. Thus, the analysis of literature data made it possible to confirm that the inclusion of Cytoflavin in the treatment regimens for patients with the above-mentioned skin pathologies, comorbid with mental disorders, improves the effectiveness of basic therapy, which is manifested by a faster and more pronounced reduction in clinical manifestations and an increase in the quality of life of patients.
借助文献资料,通过皮肤生活质量指数(DLQI)、幸福感、活动度、情绪指数(WAM)、症状量表皮肤指数(DISS)主客观数据评估,分析细胞黄素纳入银屑病、微生物性湿疹、酒渣鼻加重期患者治疗方案的有效性。根据治疗开始前的检测结果显示,所有患者均存在精神障碍,表现为DLQI和DISS量表指标升高,WAM量表指标下降。与标准治疗相比,加入细胞黄素(2片,每天2次,餐前30分钟,疗程- 25天)治疗一个疗程后,临床表现的改善和DISS的降低(酒渣鼻为86.0%,P≤0.05),湿疹为83.0% (P≤0.01)。这对幸福感(酒渣鼻指数增加63.9%,湿疹指数增加66.0%,牛皮癣指数增加27.8%)、活动(酒渣鼻指数增加56.1%,湿疹指数增加66.1%,牛皮癣指数增加22.1%)、情绪(酒渣鼻指数减少51.9%,湿疹指数减少54.3%,牛皮癣指数减少23.7%)和改善生活质量有积极影响:酒渣鼻指数减少42.9%,湿疹指数减少62.4%,牛皮癣指数减少61.5%。因此,通过对文献资料的分析,可以证实将Cytoflavin纳入上述伴有精神障碍的皮肤病变患者的治疗方案中,提高了基础治疗的有效性,表现为临床表现的更快、更明显的减轻,患者的生活质量的提高。
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引用次数: 0
The Results of Preclinical Studies Assessing the Effect of Riamilovir on the Reproductive Function and Postnatal Growth of Offspring in Laboratory Animals 利阿米洛韦对实验动物生殖功能和后代出生后生长影响的临床前研究结果
Q4 Medicine Pub Date : 2023-10-23 DOI: 10.37489/0235-2990-2023-68-5-6-24-32
A. U. Sabitov, L. P. Larionov, M. N. Dobrinskaya, O. V. Ledyankina, A. V. Osipenko, I. E. Valamina, E. V. Philippova, I. M. Fatikhov
The paper presents the results of extended preclinical studies demonstrating the safety using the direct-acting antiviral drug Riamilovir in immature white rats. Riamilovir did not show any toxic effects on the growth of animals, their fertility, behavior, hematological and biochemical parameters, as well as morphology of visceral organs when used in a course. According to the results of the studies, Ramilovir can be recommended for multicenter clinical trials in adolescents and children of younger age groups.
本文介绍了在未成熟大鼠中使用直接作用抗病毒药物利亚米洛韦的安全性的扩展临床前研究结果。在一个疗程中使用利阿米洛韦对动物的生长、繁殖、行为、血液学和生化参数以及内脏器官的形态没有任何毒性作用。根据研究结果,拉米洛韦可推荐用于青少年和低龄儿童的多中心临床试验。
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引用次数: 0
Practical Application of the AMRcloud Online Platform for Veterinary Monitoring of Antibiotic Resistance of Zoonotic Pathogens AMRcloud在线兽医人畜共患病原体抗生素耐药性监测平台的实际应用
Q4 Medicine Pub Date : 2023-10-20 DOI: 10.37489/0235-2990-2023-68-5-6-19-23
A. L. Krotova, S. A. Makavchik, A. A. Sukhinin
Background . Veterinary monitoring of antibiotic resistance in pathogens of zoonotic diseases is necessary for the rational use of antibiotics. Integration and use of the AMRcloud online platform in veterinary institutions will significantly simplify data processing, increase the speed of data analysis of monitoring results, and help overcome the interagency barrier in the exchange of information between human medicine and veterinary medicine. The aim of the study is the practical ap- plication of the AMRcloud online platform for veterinary monitoring of antibiotic resistance in pathogens of zoonotic origin. Material and methods. In the course of veterinary monitoring, the susceptibility of 275 isolates (16 species of bacteria) to 13 antimicrobial drugs most commonly used in animal husbandry was determined. Among the antimicrobial drugs were: amoxiclav, ampicillin, benzylpenicillin, gentamicin, clindamycin, streptomycin, tetracycline, tobramycin, cephalexin cefotaxime, ceftriaxone, erythromycin, and colistin. The data obtained were combined into a single system using the AMRcloud online platform. Results . The most common causative agents of mastitis were identified: Streptococcus agalactiae (n=96), Escherichia coli (n=55), Staphylococcus aureus (n=33) and Enterococcus faecalis (n=31). ESBL production have been detected in 13 (19.7%) of 66 isolates of the order Enterobacterales, isolated from clinical material of cattle and small ruminants, which limits the use of beta-lactam antibiotics for the treatment of mastitis. Conclusion. The use of the AMRcloud online platform in veterinary laboratories greatly simplifies data processing, increases the result analysis speed, and provides an opportunity to exchange information on antibiotic resistance between laboratories.
背景。兽医对人畜共患疾病病原菌的耐药性监测是合理使用抗生素的必要条件。在兽医机构中整合和使用AMRcloud在线平台将大大简化数据处理,提高监测结果的数据分析速度,并有助于克服人类医学和兽医医学之间信息交流的机构间障碍。该研究的目的是实际应用AMRcloud在线平台,用于兽医监测人畜共患源性病原体的抗生素耐药性。材料和方法。在兽医监测过程中,测定了275株分离菌(16种)对13种畜牧业常用抗菌药物的敏感性。抗菌药物包括:阿莫昔酸、氨苄西林、青霉素、庆大霉素、克林霉素、链霉素、四环素、妥布霉素、头孢氨苄、头孢曲松、红霉素、粘菌素。使用AMRcloud在线平台将获得的数据合并到一个系统中。结果。乳腺炎最常见的病原体为:无乳链球菌(96)、大肠杆菌(55)、金黄色葡萄球菌(33)和粪肠球菌(31)。从牛和小反刍动物的临床材料中分离的66株肠杆菌目分离株中有13株(19.7%)检测到ESBL的产生,这限制了β -内酰胺类抗生素用于治疗乳腺炎的使用。结论。兽医实验室使用AMRcloud在线平台大大简化了数据处理,提高了结果分析速度,并提供了在实验室之间交换抗生素耐药性信息的机会。
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引用次数: 0
Experimental Justification of Reprofiling of the Drug Maxar® for the Treatment of Viral Infections 治疗病毒感染的药物Maxar®基因重组的实验依据
Q4 Medicine Pub Date : 2023-10-20 DOI: 10.37489/0235-2990-2023-68-5-6-4-10
T. S. Zaporozhets, N. V. Krylova, S. A. Fedoreyev, O. V. Iunikhina, A. B. Pott, D. V. Tarbeeva, N. P. Mishchenko, M. Yu. Shchelkanov
Relevance. The development of highly effective broad-spectrum antiviral agents is one of the priorities in medicine, virology, and pharmacology. The strategy of repurposing (repositioning) registered drugs is of special interest along with significant progress in this area due to the use of the latest technologies for target identification, discovery and optimization of the lead compound, biological testing. The advantages of repositioning are, among other things, in reducing the time and cost of some of the necessary stages of research. The aim of the work is to study the antiviral activity of the polyphenol complex (PPC) from Maackia amurensis , the active substance of the drug Maksar®, as well as to expand the field of medical application of the drug. Material and methods. The antiviral activity of PPC against herpes simplex virus type I (HSV-1) and enterovirus B (ECHO-1) grown on Vero cell culture was assessed by inhibition of the cytopathogenic effect (CPE) of the virus using the MTT assay. Results . PFC from Maackia amurensis wood effectively prevents the attachment of HSV-1 and ECHO-1 to Vero cells and exhibits high activity, exerting a virucidal effect, as well as inhibiting the early stage of viral particle replication. Conclusion . The data obtained expand the spectrum of pharmacological activity of Maxar® and determine the need for further studies of this drug in vivo to establish its antiviral properties in animal experiments. The final conclusion related to efficacy and safety can be drawn from the results of controlled randomized clinical trials with significant clinical results.
的相关性。高效广谱抗病毒药物的开发是医学、病毒学和药理学的重点之一。由于使用了最新的靶标识别、先导化合物的发现和优化、生物测试等技术,重新定位注册药物的策略随着这一领域的重大进展而受到特别关注。重新定位的好处是,除其他外,减少了一些必要研究阶段的时间和费用。本研究的目的是研究药物Maksar®的活性物质——麻瓜(Maackia amurensis)中的多酚复合物(PPC)的抗病毒活性,并扩大该药物的医学应用领域。材料和方法。采用MTT法测定PPC对Vero细胞培养的单纯疱疹病毒I型(HSV-1)和肠病毒B型(ECHO-1)的抑制作用,评价PPC对Vero细胞培养的单纯疱疹病毒I型(HSV-1)和肠病毒B型(ECHO-1)的抗病毒活性。结果。桦木PFC能有效阻止HSV-1和ECHO-1附着在Vero细胞上,表现出较高的活性,具有杀病毒作用,并能抑制病毒颗粒复制的早期阶段。结论。获得的数据扩展了Maxar®的药理活性谱,并确定了该药物在体内进一步研究的必要性,以确定其在动物实验中的抗病毒特性。与疗效和安全性相关的最终结论可以从临床结果显著的对照随机临床试验的结果中得出。
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引用次数: 0
Biological Properties and Antibiotic Resistance of <i>Klebsiella pneumoniae</i> and Its Role in the Etiological Structure of Community-Acquired Pneumonia Pathogens 肺炎克雷伯菌的生物学特性及耐药性研究及其在社区获得性肺炎病原体病原学结构中的作用
Q4 Medicine Pub Date : 2023-10-20 DOI: 10.37489/0235-2990-2023-68-5-6-11-18
A. S. Anisimova, N. V. Pavlovich, N. V. Aronova, M. V. Tsimbalistova, E. N. Gudueva, N. I. Pasyukova, E. D. Teplyakova, A. K. Noskov
Background . In a novel coronavirus pandemic, the most common complications of viral pneumonia are secondary infections of bacterial and fungal etiology. At the same time, the spread of multidrug-resistant bacteria remains a global threat to public health. One of such microorganisms of the Enterobacteriaceae family is Klebsiella pneumoniae, which belongs to dangerous resistant pathogens of the ESKAPE group. The aim of the study was the comparative analysis of the biological properties of classical and hypermucoid strains of K.pneumoniae isolated from patients with community-acquired pneumonia (CAP): characterization of their sensitivity to antibacterial drugs, Klebsiella bacteriophage, and a disinfectant (polyhexamethylene guanidine hydrochloride), as well as assessment of the strains’ virulence in the model of experimental infection in white mice. Material and methods. 56 strains of Klebsiella isolated in diagnostic quantities from patients’ sputum samples were studied. Species identification of cultures was carried out using bacteriological and mass spectrometric methods. The sensitivity of bacteria to antibiotics, bacteriophage, and the disinfectant was determined in accordance with regulatory documents. Results. In the course of the study, 243 gram-negative cultures were isolated, of which 30% were bacteria of the genus Klebsiella spp. An analysis of their species composition showed that K.pneumoniae occupied a dominant place in the structure. Based on colony morphology, Burri-Gins smear staining, and a positive string test, 14 strains with a hypermucoid phenotype were identified. These strains differed from the classic K.pneumoniae strain by the presence of a thicker capsule in smears, virulence in white mice (DCL≤103 mc), and increased resistance to commercial Klebsiella bacteriophage. At the same time, they were characterized by a wider spectrum of sensitivity to antibiotics. There were no significant differences in sensitivity to the disinfectant in strains of both morphotypes. Conclusion . The results obtained demonstrated the important role of K.pneumoniae in the etiological structure of CAP pathogens.
背景。在新型冠状病毒大流行中,病毒性肺炎最常见的并发症是细菌和真菌继发感染。与此同时,耐多药细菌的传播仍然是对公共卫生的全球性威胁。其中一种肠杆菌科的微生物是肺炎克雷伯菌,它属于ESKAPE组的危险耐药病原体。本研究的目的是比较分析从社区获得性肺炎(CAP)患者中分离的肺炎克雷伯菌经典菌株和高黏液样菌株的生物学特性,表征它们对抗菌药物、克雷伯菌噬菌体和消毒剂(盐酸聚六亚甲基胍)的敏感性,并在小鼠实验感染模型中评估菌株的毒力。材料和方法。从患者痰中分离出56株诊断量克雷伯氏菌。利用细菌学和质谱方法对培养物进行物种鉴定。细菌对抗生素、噬菌体和消毒剂的敏感性按照规定进行测定。结果。研究过程中共分离革兰氏阴性培养物243株,其中30%为克雷伯氏菌属,物种组成分析表明,克雷伯氏菌在结构中占优势地位。根据菌落形态、Burri-Gins涂片染色和阳性串试验,鉴定出14株具有超黏液样表型。这些菌株与经典肺炎克雷伯菌菌株的不同之处是,在涂片中存在更厚的荚膜,在白小鼠中具有毒力(DCL≤103 mc),并且对商业克雷伯菌噬菌体的耐药性增强。同时,它们对抗生素的敏感性范围更广。两种形态菌株对消毒剂的敏感性无显著差异。结论。结果表明肺炎克雷伯菌在CAP病原菌病原学结构中的重要作用。
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Antibiotiki i Khimioterapiya
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