vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v14i2.1293vsp-65Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESНОСОГЛОТОЧНОЕ НОСИТЕЛЬСТВО STREPTOCOCCUS PNEUMONIAE У ВОСПИТАННИКОВ ДЕТСКИХ ДОМОВ, ДОШКОЛЬНЫХ УЧРЕЖДЕНИЙ И НЕОРГАНИЗОВАННЫХ ДЕТЕЙ МЛАДШЕ 5 ЛЕТNASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN ORPHANS, PRESCHOOL CHILDREN AND UNORGANIZED CHILDREN UNDER 5 YEARSЛазареваМ. А.LazarevaM. A.TKulichenko@yandex.ruКуличенкоТ. В.KulichenkoT. V.

доктор медицинских наук, заведующая отделением неотложной педиатрии Научного центра здоровья детей, доцент кафедры клинической аллергологии и иммунологии педиатрического факультета Первого МГМУ им. И.М. Сеченова Адрес: 119991, Москва, Ломоносовский проспект, д. 2, стр. 1, тел.: +7 (499) 134-30-83

Tkulichenko@yandex.ruАлябьеваН. М.Alyab'evaN. M.Tkulichenko@yandex.ruПономаренкоО. А.PonamarenkoO. A.Tkulichenko@yandex.ruЛазареваА. В.LazarevaA. V.Tkulichenko@yandex.ruКатосоваЛ. К.KatosovaL. K.Tkulichenko@yandex.ruМаянскийН. А.MayanskiiN. A.Tkulichenko@yandex.ruНаучный центр здоровья детей, Москва, Российская ФедерацияРоссияScientific Center of Children's Health, Moscow, Russian FederationRussian Federation201517042015142Вопросы современной педиатрии246255Copyright © Лазарева М.А., Куличенко Т.В., Алябьева Н.М., Пономаренко О.А., Лазарева А.В., Катосова Л.К., Маянский Н.А., 20152015Лазарева М.А., Куличенко Т.В., Алябьева Н.М., Пономаренко О.А., Лазарева А.В., Катосова Л.К., Маянский Н.А.Lazareva M.A., Kulichenko T.V., Alyab'eva N.M., Ponamarenko O.A., Lazareva A.V., Katosova L.K., Mayanskii N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/65

Носоглоточная колонизация Streptococcus pneumoniae является источником развития мукозальных респираторных и инвазивных инфекций. Для эффективной вакцинопрофилактики этих заболеваний необходим национальный мониторинг циркулирующих серотипов и антимикробной резистентности Streptococcus pneumoniae. Цель исследования: проанализировать серотиповое разнообразие и антимикробную резистентность S. pneumoniae при носоглоточном носительстве у детей в возрасте до 5 лет. Методы: в исследование были включены воспитанники детского дома, детских садов и дети, не посещающие детские дошкольные учреждения (неорганизованные дети) без респираторных инфекций и не получающие антибактериальную терапию. Проведены микробиологический анализ назофарингеальной флоры, серотипирование выделенных штаммов пневмококка, оценена их чувствительность к антибиотикам. Результаты: носоглоточное носительство S. pneumoniae обнаружено у 23%, Moraxella catarrhalis — у 23%, Haemophilus influenzae — у 16% из 246 детей, включенных в исследование. Серотип был определен у 54 изолятов пневмококка: преобладали серотипы 19F (21%), 6B (15%), 23F(14%), 14 (8%). Совпадение полученного спектра с серотипами, входящими в состав пневмококковых конъюгированных вакцин ПКВ7 и ПКВ10, составило 81%, в ПКВ13 —– 90%. Доля штаммов, нечувствительных к клиндамицину, составила 31%, к макролидам — 40%, к триметоприму / сульфаметоксазолу — 60%. Множественная устойчивость отмечена у 37% выявленных серотипов пневмококка. У эритромицин-резистентных штаммов резистентность была вызвана наличием ermB-гена (в 74% случаев) или mef-зависимым эффлюксом (9%) в качестве единственной детерминанты, в 17% случаев — их ассоциациацией. Наибольшая резистентность к антибиотикам отмечена у пневмококков вакцинных серотипов. Выводы: сопоставление результатов исследования с ранее полученными данными свидетельствует о стабильности на протяжении последних десятилетий спектра циркулирующих пневмококков в российской популяции детей. Отмечено существенное нарастание резистентности пневмококка (особенно вакцинных серотипов) к антибиотикам пенициллинового ряда, макролидам, клиндамицину.

 

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The authors declare that there are no conflicts of interest present.