ХРОНИЧЕСКИЙ ОСТЕОМИЕЛИТ, РОЛЬ В ЭТИОЛОГИИ И АНТИБИОТИКОРЕЗИСТЕНТНОСТЬ БАКТЕРИЙ ENTEROCOCCUS SPP.

Аннотация

Введение. В связи с растущей резистентностью, изучение свойств энтерококков необходимо для формирования подходов рациональной антимикробной терапии при лечении хронического остеомиелита.
Материал и методы. Исследование проведено на основе анализа резистентности к антибактериальным препаратам 182 штаммов Enterococcus spp., выделенных из раневого отделяемого и свищей 175 пациентов с хроническим остеомиелитом костей, за трехлетний период с 2020-2022 гг.
Результаты. Подавляющее большинство клинических изолятов Enterococcus spp., выделенных из ран пациентов c хроническим остеомиелитом, составляют ассоциации микроорганизмов, из них с бактериями рода Staphylococcus — 36,8%, с представителями энтеробактерий — 15,8%. Выявлены различия в профилях резистентности между штаммами Enterococcus spp., выделенными в монокультуре и из ассоциации бактерий. Ванкомицин и линезолид показали высокую эффективность в отношении изолятов E. faecalis. В то же время отмечено появление ванкомицин- и линезолид-резистентных штаммов среди изолятов E. faecium.
Заключение. Бактерии рода Enterococcus в пятерке лидеров по частоте встречаемости при хроническом остеомиелите, что позволяет считать их специфичными для этиологии данного заболевания. Полирезистентность Enterococcus spp. к антибиотикам, большой процент выделения из ассоциаций со стафилококками и энтеробактериями, в которых могут быть усилены болезнетворные свойства микроорганизмов, представляет значительные трудности в лечении пациентов, поскольку сужает спектр выбора эффективных препаратов.

Annotation

Introduction. Due to growing resistance, studying the properties of enterococci is necessary to develop approaches to rational antimicrobial therapy in the treatment of chronic osteomyelitis.
Material and methods. The study was conducted on the basis of an analysis of resistance to antibacterial drugs of 182 strains of Enterococcus spp., isolated from wound discharge and fistulas of 175 patients with chronic osteomyelitis of bones, over a three-year period from 2020-2022.
Results. The vast majority of clinical isolates of Enterococcus spp., isolated from wounds of patients with chronic osteomyelitis, are associations of microorganisms, of which 36.8% are with bacteria of the genus Staphylococcus spp., and 15.8% are with representatives of Enterobacteriaceae. Differences in resistance profiles were revealed between Enterococcus spp. strains isolated in monoculture and from bacterial associations. Vancomycin and linezolid showed high efficacy against E. faecalis isolates. At the same time, the emergence of vancomycin- and linezolid-resistant strains among E. faecium isolates was noted.
Conclusion. Bacteria of the genus Enterococcus are in the top five in terms of frequency of occurrence in chronic osteomyelitis, which allows them to be considered specific to the etiology of this disease. Multidrug resistance of Enterococcus spp. to antibiotics, a large percentage of isolation from associations with staphylococci and enterobacteria, in which the pathogenic properties of microorganisms can be enhanced, presents significant difficulties in the treatment of patients, since it narrows the range of choice of effective drugs.
Key words: chronic osteomyelitis; antibiotic resistance; Enterococcus spp., bacterial associations.

Об авторах

Список литературы

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