CORYNEBACTERIUM SPP. — ПРОБЛЕМНЫЕ ПАТОГЕНЫ РЕСПИРАТОРНОГО ТРАКТА ЧЕЛОВЕКА (ОБЗОР ЛИТЕРАТУРЫ)

Аннотация

Corynebacterium spp. — представители нормальной микрофлоры организма человека, однако известна их роль в развитии заболеваний, как у иммунокомпрометированных, так и иммунокомпетентных пациентов. Corynebacterim spp. (C. pseudodiphtheriticum, C. striatum, C. amycolatum, C. accolens, C. argentoratense, и др.) связывают с заболеваниями респираторного тракта: трахеитом, фарингитом, риносинуситом, бронхитом и др. Они могут передаваться воздушно-капельным, контактно-бытовым и, возможно, гематогенным путём. Corynebacterim spp. токсины не продуцируют, но способны к адгезии и инвазии, биопленкообразованию, продукции нейраминидазы, гиалуронидазы, гемолизина. Следует учитывать не столько видовую, сколько штаммовую принадлежность изолятов Corynebacterium spp., так как среди представителей одного вида недифтерийных коринебактерий (например, C. pseudodiphtheriticum), колонизирующих респираторный тракт, могут присутствовать штаммы, способные проявлять не только патогенные свойства, но и пробиотическую активность. Микробиологическая диагностика основана на их количественном определении в биологическом материале, фенотипических (культуральное исследование, тест-системы для биохимической идентификации, автоматизированные системы Vitek 2) и генотипических (секвенирование генов 16SpРНК и rpoB) методах. Возможно использование масс-спектрометрического анализа (MALDI-ToF-MS). Наибольшую активность в отношении Corynebacterium spp. при исследовании in vitro сохраняют ванкомицин, тейкопланин, линезолид. Сообщается об успешной терапии с использованием, по крайней мере, двух из следующих антимикробных препаратов (АМП): ванкомицин, рифампицин, линезолид, даптомицин. Чувствительность изолятов Corynebacterium spp. к АМП связана не с видовой принадлежностью, а обусловлена штаммовыми различиями, в связи с чем нужно тестировать каждый выделяемый штамм. Необходим постоянный мониторинг чувствительности штаммов Corynebacterium spp. к АМП ввиду наблюдаемой вариабельности этих признаков. Особую важность имеет выявление изолятов с множественной лекарственной устойчивостью, расцениваемых в настоящее время как высоко патогенные. При составлении обзора использованы базы данных РИНЦ, CyberLeninka, Scopus, Web of Science, The Cochrane Library.

Об авторах

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