Оптимізація бактеріологічної діагностики лактаційних маститів: Автореф. дис… канд. мед. наук / Н.Ю. Тумасьянц, Харк. НДІ мікробіології та імунології

1

I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

OA?E?ANUeEEE IAOEIAI-AeINE?AeIEE ?INOEOOO

I?E?IA?IEIA?? OA ?IOIIEIA?? ?I. ?.?. IA*IEEIAA

Ooianueyioe Iaoaey TH???aia

OAeE 618.19-002-078

IIOEI?CAOe?ss AAEOA??IEIA?*II? Ae?AAIINOEEE EAEOAOe?EIEO IANOEO?A

03.00.07 — i?e?ia?ieia?y

AAOI?AOA?AO

aeena?oaoe?? ia caeiaoooy a/aiiai nooiaiy

eaiaeeaeaoa iaaee/ieo iaoe

Oa?e?a

1999

Aeena?oaoe??th ? ?oeiien.

?iaioo aeeiiaii a Aeiiaoeueeiio aea?aeaaiiio iaaee/iiio oi?aa?neoao? ?i.
I.Ai?ueeiai IIC Oe?a?ie.

Iaoeiaee ea??aiee:

aeieoi? iaaee/ieo iaoe, i?ioani?

Aa?aiei TH??e Noaiaiiae/

Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i.I.Ai?ueeiai

Io?oe?ei? iiiiaioe:

aeieoi? iaaee/ieo iaoe, i?ioani?

Aeeeee ?ai? Eaii?aeiae/

Oe?a?inueea oa?iaoeaaoe/ia aeaaeai?y

IIC Oe?a?ie, caa?aeoaa/ eaoaae?ith i?e?ia?ieia??, ?ioiieia??oa
a??onieia??

i?ioani? Oeeaaiaiei Aiaoie?e sseiae/

Oa?e?anueeee aea?aeaaiee iaaee/iee oi?aa?neoao IIC Oe?a?ie,

caa?aeoaa/ eaoaae?ith i?e?ia?ieia??, ?ioiieia??oa a??onieia??

I?ia?aeia onoaiiaa: Iaoe?iiaeueiee iaaee/iee oi?aa?neoao
?i.I.I.Aiaiiieueoey, eaoaae?a i?e?ia?ieia??, ?ioiieia??oa a??onieia??,
i. Ee?a

Caoeno a?aeaoaeaoueny “1“ aa?aniy 1999 ?. i 14 aiaeei?

ia can?aeaii? niaoe?ae?ciaaii? a/aii? ?aaee Ae 64.618.01 i?e
Oa?e?anueeiio iaoeiai-aeine?aeiiio ?inoeooo? i?e?ia?ieia?? oa ?ioiieia??
?i. ?.?. Ia/ieeiaa IIC Oe?a?ie ca aae?anith: 310057, i. Oa?e?a, aoe.
Iooe?inueea, 14.

C aeena?oaoe??th iiaeia iciaeiieoenue o a?ae?ioaoe? Oa?e?anueeiai
iaoeiai-aeine?aeiiai ?inoeoooo i?e?ia?ieia?? oa ?ioiieia?? ?i. ?.?.
Ia/ieeiaa IIC Oe?a?ie, 310057, i. Oa?e?a, aoe. Iooe?inueea, 14.

Aaoi?aoa?ao ?ic?neaiee “28“ eeiiy 1999 ?ieo.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee Eo/ia ?.TH.

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Anooi. Eaeoaoe?eiee ianoeo (EI), ui neeaaea? aei 60% on?o i?neyiieiaiaeo
ai?eii-naioe/ieo caoai?thaaiue (Aaeaeoeia N.I., Neiie/aa A.A., 1990)
oa ioiieth? 3-18% ii?iae?eue ( Aieeia I.A., 1987), noaiiaeoue cia/io
i?iaeaio ye a o??o?a??, oae ? a iaiiaoaeia??. A?aecia/a?oueny
ca?eueoaiiy /anoioe aaaeeeo, aeeoocieo oi?i oeueiai caoai?thaaiiy, a
naia aanoeaaeoth/i? oa oeaaiiiicii? (Aoua A.A. e ae?., 1989). E??i oiai,
niinoa??aa?oueny c?inoaiiy eaoaeueiino? i?e EI, yea c ?icaeoeii naineno
aeinyaa? 15,4 % (Aaa?e ss.N. oa ?i., 1993). Oea i?aeaeuo? o?eaae?noue
ia?aaoaaiiy oai?eo ia noaoe?iia?iiio e?eoaaii?, ca?eueoo? eiai aa?o?noue
oa caaaea? nooo?ai? oeiaee caei?iath iaoe??ioie o naiiio aeoeaiiio
a?oe?.

EI ? caoai?thaaiiyi, yea ia o?eueee caaaea? oeiaee iaoa??, a e nooo?ai
i?ae?eaa? caei?iay iiaiia?iaeaeaiiai, noaiiaeoue aeey iueiai aaeeeo
ai?aeai?ieia?/io iaaaciaeo (Eoeeia E.E. e ae?., 1985). Aac i?ioaeoeaii?
ae?? iaoa?einueeiai iieiea aeeoeia noa? aaccaoeniith ia?aae aaaaoueia
?ioaeoe?yie.

Aeooaeuei?noue oaie. E?eoaaiiy EI ? caaea/ath caiaaeoi aaaeeith,
iacaaaeath/e ia i?enooi? a a?naiae? aenieiaoaeoeai? e?ee. Iecueea
aoaeoeai?noue aioei?e?iaii? oa?ai?? aeaoa?i?iiaaia c?inoath/ith
iie??acenoaioi?noth i?e?ioei?e.

Oiio ?aiiy ae?aaiinoeea ao?ieia?? EI c neeaaeaiiyi aioea?ioeeia?ai
caoaeiee?a ? iaeaaaeeea?oei aoaiii, eio?ee aecia/a? oaeoeeo e?eoaaiiy oa
i?io?eaeoe/i? ae??.

O?aaeeoe?ei? aaeoa??ieia?/i? aeine?aeaeaiiy a?aeiinyoueny aei ‘‘i?ci?o’’
niinia?a ae?aaiinoeee, oiio ui ?acoeueoaoe aeine?aeaeaiue iaaeoiaeyoue
/a?ac 3-5 aei?a, a oea iicia/a?oueny ia nai?/aniino? i?ecia/aiiy
aaeaeaaoii? oa?ai??. Niiniae nei?i/aiiy oa?i?i?a ?aeaioeo?eaoe?? oa
aecia/aiiy aioea?ioeeia?ai noao?eieie?a caiaeyoueny aei ci?ie ?aoeaioo?
aeeaeeueieo na?aaeiaeu (Eocueieineee N.I. e ae?., 1995, Ia?oeia I.TH. e
ae?.,1995). Aaaee oaeeo iiaeeo?eaoe?e caycai? c aa?o?noth oa
aeao?oeeoi?noth ?ia?aae??io?a, oneeaaeiaiue i?eaiooaaiiy aeeaeeueieo
na?aaeiaeu.

Iei? iioe?ai? iai?aaaoiiaoe/i? oa aaoiiaoe/i? eiiithoa?i? nenoaie, ye?
aeicaieythoue ?aeaioeo?eoaaoe caoaeieea caoai?thaaiiy oa aecia/eoe eiai
aioea?ioeeia?aio a?ae 4-5 aei 24 aiaeei (Eioaiaoeeay A.O., 1990).

Aea aeei?enoaiiy oeeo nenoai ? iaiaaeaiei /a?ac ?o aenieo aa?o?noue oa
aeaye? aaaee oaoi?/iiai oa?aeoa?o. Oiio iaiao?aeii aeiaeoe niin?a, yeee
ia iio?aao? iniaeeaeo aeiiii?/ieo coneeue oa aeicaiey? cae?enieoe ?aiith
aaeoa??ieia?/io ae?aaiinoeeo EI.

Aeooaeuei?noue aeaii? ?iaioe iieyaa? a ?ic?iaoe? i?enei?aiiai
aaci?eno??eiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee EI noao?eieieiai?
ao?ieia??, ui aeicaiey? ia i?ioyc? 21- 27 aiaeei ?aeaioeo?eoaaoe
caoaeiee?a caoai?thaaiiy oa aecia/eoe ?o aioea?ioeeia?aie.

A??ii anoaiiaeaiee ao?ieia?/iee ae?aaiic a ei?ioeee oa?i?i oa oi/iee
aea?? aioea?ioee?a i?eaiaeyoue aei cieaeaiiy e?eueeino? oneeaaeiaiue oa
?aoeeaeea?a EI o iaoa??a, ui aiaeothoue ae?oae. Oea ia? aaeeea
ia?iaeii-ainiiaea?nueea cia/aiiy.

Caycie ?iaioe c iaoeiaeie i?ia?aiaie, ieaiaie, oaiaie. Aeine?aeaeaiiy
i?iaiaeeeenue o iaaeao iaoeiai-aeine?aeii? ?iaioe (IAe?) AeiiAeIO oa
aoee o?aaiaioii oaie “Aicaoaeeoaee aioo?eaieueie/iuo aiieii-naioe/aneeo
eioaeoeee (AANE) a noaoeeiia?ao ?acee/iiai i?ioeey a. Aeiiaoeea” o
1994-1996 ?ieao (IC ?0195V000639, oeo? EE 94.08.27).

Iaoa ? caaea/? aeine?aeaeaiiy. Iaoith aeine?aeaeaiiy ? ?ic?iaea oa
ioe?iea aoaeoeaiino? i?enei?aiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee
eaeoaoe?eieo ianoeo?a ia i?aenoaa? iecueeioaiia?aoo?ii? ia?iaee
aeeaeeueieo na?aaeiaeu.

Aeey aeinyaiaiiy iinoaaeaii? iaoe ne?ae aoei ae??oeoe caaea/?:

1.Aea/eoe ieoiio aaao i?e?ii?aai?ci?a a ao?ieia?/i?e no?oeoo??
caoaeiee?a eaeoaoe?eieo ianoeo?a.

2.Aea/eoe a?ieia?/i? aeanoeaino? oa /ooeea?noue aei o?i?ioa?aiaaoe/ieo
cania?a i?e?ii?aai?ci?a, iaoiiaethth/eo eaeoaoe?ei? ianoeoe.

3.?ic?iaeoe iiaee i?enei?aiee niin?a aaeoa??ieia?/ii? ae?aaiinoeee
ai?eii-caiaeueieo caoai?thaaiue noao?eieieiai? ao?ieia?? c aeei?enoaiiyi
iiia?aaeiuei? iecueeioaiia?aoo?ii? ia?iaee aeeaeeueieo na?aaeiaeu.

4.Ioe?ieoe aoaeoeai?noue aeei?enoaiiy e??iia?iaee aeeaeeueieo na?aaeiaeu
aeey i?enei?aiiy ?aeaioeo?eaoe?? oa aecia/aiiy iaoiaaiiino?
noao?eieie?a.

5.Aeae?eeoe a?oie aenieiai ?eceeo caoai?thaaiiy ia eaeoaoe?eiee ianoeo,
aecia/eoe i?eaa?oath/? eiio oaeoi?e oa ioe?ieoe ?acoeueoaoe ao?io?iiii?
oa?ai?? oai?eo ia ai?ei? oi?ie ianoeoo c aeei?enoaiiyi niiniao
i?enei?aii? aaeoa??ieia?/ii? ae?aaiinoeee.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a aeine?aeaeaiue iieyaa? a oiio,
ui aeiao?ae a?inoeioethth/i? ae?? na?aeioaei? aiaee ia ae?iuoaaiiy oa
?iciiiaeaiiy i?e?ii?aai?ci?a io?eiaa iiaeaeueoee ?icaeoie o ?ic?iaoe?
i?enei?aiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee caoai?thaaiue
noao?eieieiai? ao?ieia??. Iaie aia?oa aeei?enoaia iecueeioaiia?aoo?ia
ia?iaea aeeaeeueieo na?aaeiaeu aeey nei?i/aiiy oa?i?i?a aaeoa??ieia?/ii?
ae?aaiinoeee EI noao?eieieiai? ao?ieia?? oa aecia/aiiy aioea?ioeeia?ai
caoaeiee?a.

I?aeoe/ia cia/aiiy iaea?aeaieo ?acoeueoao?a iieyaa? a oiio, ui cyaeeanue
ciiaa aeei?enoaiiy niiniao aeey i?enei?aiiy aaeoa??ieia?/ii?
ae?aaiinoeee caoai?thaaiue noao?eieieiai? ao?ieia??, ui ni?ey?
iioei?caoe?? e?eoaaiiy. ?acoeueoaoe aeine?aeaeaiue ai?iaaaeaeai? o
i?aeoe/io ae?yeuei?noue o??o?a?/iiai noaoe?iia?o Oeaio?aeueii? i?nueei?
e?ea?i? ?17 i.Aeiiaoeueea, ui i?aeoaa?aeaeo?oueny aeoii ai?iaaaeaeaiiy.

Iniaenoee aianie caeiaoaa/a. Aeena?oaoe?y ? naiino?eiei aeine?aeaeaiiyi
aaoi?a. Iei c?a?aii iaoa??ae, aeae?eai? ooaie i?e?ii?aai?ci?a oa
i?iaaaeaii ?o ?aeaioeo?eaoe?th c aecia/aiiyi /ooeeaino? aei
aioea?ioee?a, cae?eniaii oaaioeioaaiiy S.aureus, ?ic?iaeaii i?enei?aiee
niin?a aaeoa??ieia?/ii? ae?aaiinoeee EI. Noaoenoe/ia ia?iaea ? iaoeiaa
?ioa?i?aoaoe?y an?o io?eiaieo aeaieo, i?aeaioiaea iaoeiaeo noaoae,
ioi?ieaiiy aeena?oaoe?eii? ?iaioe oa aaoi?aoa?aoo oaeiae cae?eniaii
aaoi?ii naiino?eii.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. ?acoeueoaoe aeine?aeaeaiue, ui
aeeth/ai? aei aeena?oaoe??, iaia?iaeiaai? ia I?aeia?iaei?e eiioa?aioe??
‘‘?aiu e ?aiaaay eioaeoeey’’ (Iineaa, 1993 ??e), ia iaoeiai-i?aeoe/i?e
eiioa?aioe??, i?enay/ai?e 6-??//th Aeiiaoeueeiai iaeaniiai
ae?aaiinoe/iiai oeaio?o (1995 ??e), ia i?aeiaeani?e iaoeiai-i?aeoe/i?e
eiioa?aioe??, i?enay/ai?e 30-??/iiio tha?eath eaoaae?e aeooa?noaa oa
a?iaeieia?? AeiiAeIO (1995 ??e) oa ia can?aeaii? eaoaae?e i?e?ia?ieia??,
a??onieia?? oa ?ioiieia?? AeiiAeIO a i?enooiino? niaoe?ae?no?a c
i?e?ia?ieia??, o??o?a?? oa ai?aeai?ieia??.

Ioae?eaoe??. Iniiai? iieiaeaiiy oa ?acoeueoaoe aeena?oaoe?? iioae?eiaaii
o 10 ae?oeiaaieo ?iaioao, c ieo: 6 — o iaoeiaeo iaaee/ieo aeo?iaeao, 1 —
o ca??ieeo iaoeiaeo i?aoeue, 3 — o iaoa??aeao iaoeiai-i?aeoe/ieo
eiioa?aioe?e.

Noai?aii iiaa ioi?iiicaeaoia ??oaiiy ia niin?a i?enei?aiiy
aaeoa??ieia?/ii? ae?aaiinoeee caoai?thaaiue noao?eieieiai? ao?ieia??
(cayaa ?98073755 a?ae 14.07.98 ?., Iiceo. ??o. a?ae 09.04.99).

No?oeoo?a aeena?oaoe??. Aeena?oaoe?y neeaaea?oueny c anooio, /ioe?ueio
?icae?e?a, aeniiae?a, nieneo aeei?enoaieo e?oa?aoo?ieo aeaea?ae oa
aeiaeaoeo. Ianya aeena?oaoe?? noaiiaeoue 136 noi??iie ae?oeiaaiiai
oaenoo. Nienie aeei?enoaieo e?oa?aoo?ieo aeaea?ae caeia? 20 noi??iie,
i?noeoue 177 iaeiaioaaiue. ?iaioa ?ethno?iaaia 4 ?enoieaie oa 19
oaaeeoeyie.

CI?NO ?IAIOE

Iaoa??aee oa iaoiaee aeine?aeaeaiiy. I?e aeeiiaii? ?iaioe aoei
ianoaaeaii 117 oai?eo ia eaeoaoe?ei? ianoeoe o a?oe? 17-38 ?ie?a.
Iaoa??aeii aeey aeine?aeaeoaaiiy aoee ioieoaoe, aeae?eaiiy c ?ai, ai?e,
aea/aeanue i?e?ioei?a iiaa?oi? oe??e iiei/ieo caeic, a oaeiae
coe?aeaeaia iieiei a?ae 59 ii?iae?eue o a?oe? 17-34 ?ie?a o noai?
eaeoinoaco.

Aeine?aeaeoaaeenue oaeiae /eno? eoeueoo?e aaeoa??e, aeae?eai? c
iaoa??aeo a?ae oai?eo. Aeaeiaa ?aeaioeo?eaoe?y i?e?ii?aai?ci?a
i?iaiaeeeanue ca?aeii Iaeaco ? 535 IIC N?N? a?ae 22 ea?oiy 1985 ?ieo.
Cae?enithaaee oaaioeioaaiiy aeae?eaieo eoeueoo? S.aureus ca aeiiiiiaith
oeiiaeo noao?eieieiaeo aaeoa??ioaa?a I?aeia?iaeiiai iaai?o.
Aioea?ioeei/ooeea?noue aeae?eaieo i?e?ii?aai?ci?a aecia/aee
aeenei-aeeooc?eiei iaoiaeii ia na?aaeiaeu? AAA aei 21 aioea?ioeea
(aaiceeiai?oeee?io, aii?oeee?io, ienaoeee?io, ea?aai?oeee?io,
iao?oeee?io, oeaoioaeneio, oeaooaceaeeio, ioeienaoeeio, oao?aoeeee?io,
aeien?oeeee?io, eaiai?oeeio, iaii?oeeio, aaioai?oeeio, no?aioii?oeeio,
a??o?ii?oeeio, ?enoii?oeeio, ieaaiaeii?oeeio, e?ieii?oeeio,
?eoaii?oeeio, eaaii?oeaoeio, iie?i?eneio).

Aeey eoeueoeaoaaiiy caoaeiee?a eaeoaoe?eieo ianoeo?a, na?aae yeeo
iae/ano?oa cono??/a?oueny ??ae Staphylococcus, aeei?enoiaoaaee oae?
aeeaeeuei? na?aaeiaeua: 5% e?iayiee aaa?, oeoe?iaee aoeueeii,
“na?aaeiaeua aeey eiio?ieth noa?eeueiino?”.

Aeine?aeaeaiiy i?iaiaeeeenue o ii??aiyeueiiio aa??aio?: canoiniaoaaeinue
ia?aeaeueia ae?iuoaaiiy a?iiaoa??aeo oa i?e?iaieo eoeueoo? o
?icii?iaeaieo (aeine?aeieo) na?aaeiaeuao oa ia i?aeaeaieo
caii?iaeoaaiith (eiio?ieueieo) na?aaeiaeuao. Aeine?aei? a?oie
aeeaeeueieo na?aaeiaeu caii?iaeoaaeenue i?e oaiia?aoo?? -20N o
ii?iceeuei?e eaia?? i?e ii?iaeueiiio aoiinoa?iiio oeneo ia i?ioyc? 18-24
aiaeei, i?ney /iai na?aaeiaeua a?aeoathaaee ia i?ioyc? 1-2 aiaeei i?e
e?iiaoi?e oaiia?aoo??. Eiio?ieuei? aeine?aeaeaiiy i?iaiaeeeenue ia
na?aaeiaeuao o??? ae na??? aeaioiaeaiiy, ui e aeine?aei?.

Aianaiiy a?iiaoa??aeo, i?e?iaieo eoeueoo? o aeine?aei? oa eiio?ieuei?
na?aaeiaeua cae?enithaaee iaeii/anii a ia?i? 0,1 ie. ?icaaaeaiiy
iaeiiaeiaiaeo aaa?iaeo eoeueoo? noao?eieie?a aiooaaeenue ii iioe/iiio
noaiaea?oo (canoiniaoaaee ?iieoeyoe?eio aeico 105 ee?oei/ie).
Eoeueoeaoaaiiy i?iaiaeeeinue a oa?iinoao? i?e oaiia?aoo?? 37N. I?ney 1
aiaeeie ?ieoaaoe?? i?iaiaeeee aen?a ae?iuaieo eoeueoo? ia iiei/ii —
aeiaoeiaee nieyiee aaa? (IAENA) aeey aecia/aiiy eaoeeoia?oaeacii?
aeoeaiino? (EAA). *aoee Iao?? c can?yiiei na?aaeiaeuai IAENA iii?uaee a
oa?iinoao oa /a?ac 24 aiaeeie a?aoiaoaaee iayai?noue eaoeeoia?oaeace, a
ua /a?ac iaeio aeiao a?aoiaoaaee iayai?noue i?aiaioo o i?e?ii?aai?ci?a.
I?ney ia?an?ao ia IAENA iin?ae a?iiaoa??aeo, i?e?iaieo eoeueoo? ia
aeine?aeieo oa eiio?ieueieo na?aaeiaeuao ciiao iii?uaee a oa?iinoao ua
ia 2 aiaeeie, i?ney /iai noaaeee oanoe ?aeaioeo?eaoe?? noao?eieie?a oa
aecia/aee /ooeea?noue i?e?ia?a aei aioea?ioee?a.

Oaeei /eiii, ia?aae iinoaiiaeith ?aeaioeo?eaoe?eieo oano?a oa
aecia/aiiyi /ooeeaino? i?e?ii?aai?ci?a aei aioea?ioee?a a?iiaoa??ae,
i?e?iai? eoeueoo?e ciaoiaeeeenue a aeine?aeieo oa eiio?ieueieo
aeeaeeueieo na?aaeiaeuao 3 aiaeeie. Aeey ?aeaioeo?eaoe?? noao?eieie?a
aeei?enoiaoaaee ?aaeoe?th ieaciieiaaoeyoe?? (?IE) oa ?aaeoe?th ieeneaiiy
iai?oo a aiaa?iaieo oiiaao (IIA). ?acoeueoaoe aecia/aiiy
ieaciieiaaoeacii? aeoeaiino? a?aoiaoaaee /a?ac 1, 2, 4 oa 18 aiaeei.
Caeaoi?noue i?e?ia?a oa?iaiooaaoe iai?o o aiaa?iaieo oiiaao
a?aoiaoaaeanue /a?ac 18-24 aiaeeie. Aioea?ioeeia?aie neeaaeaeenue /a?ac
18-24 aiaeeie ?ieoaoaaiiy eoeueoo? a oa?iinoao?. Oaeei /eiii, oae ye
?aaeoe?? ieaciieiaaoeyoe??, ieeneaiiy iai?oo a aiaa?iaieo oiiaao,
aecia/aiiy aioea?ioeei/ooeeaino? i?e?ii?aai?ci?a noaaeeenue i?ney 3-o
aiaeeiiiai ae?iuoaaiiy eoeueoo? a oa?iinoao?, oi a?ae ii/aoeo
aeine?aeaeaiue aei a?aooaaiiy oeeo ?aaeoe?e i?ioiaeeei 21-27 aiaeei.

Noaoenoe/ia ia?iaea ?acoeueoao?a aeine?aeaeaiue i?iaaaeaia iaoiaeaie
aa??aoe?eii? noaoenoeee (Ia?eia A.I., Iieyeia E.A., 1974) c
aeei?enoaiiyi e?eoa???a No’thaeaioa oa I??niia.

?acoeueoaoe aeine?aeaeaiue oa ?o iaaiai?aiiy. Ao?ieia?/ia no?oeoo?a EI
neeaaeaeanue c S.aureus (80 oai?eo), S.aureus a anioe?aoe?? c C.albicans
(4), S.epidermidis (20), E.coli a anioe?aoe?? c S.aureus (2), P.vulgaris
(2), ii iaeiiio aeiaaeeo P.aeruginosa oa S.pyogenes, o 9 aeiaaeeao ia
aoei aaeoa??aeueiiai ?inoo ia aeeaeeueieo na?aaeiaeuao oa aea?
?aeaioe/i? eoeueoo?e ia aoei ?aeaioeo?eiaaii. Anueiai iaea?aeaii 178
ooai?a i?e?ii?aai?ci?a, na?aae yeeo 139 ooai?a — S.aureus oa 31 ooai —
S.epidermidis. A?eueo?noue ooai?a S.aureus aoea /ooeeaa aei aioea?ioee?a
ioeienaoeeio, oeaoioaeneio, aaioai?oeeio, eaiai?oeeio, ieaaiaeii?oeeio,
e?ieii?oeeio, ?enoii?oeeio, ?eoaii?oeeio, no?aioii?oeeio, iaii?oeeio oa
oao?aoeeee?io.

*ooeea?noue S.epidermidis aecia/aeanue aei ienaoeee?io, aaioai?oeeio,
eaiai?oeeio oa aeinyaaea 61,2 — 64,5 %. C 139 aeae?eaieo ooai?a S.aureus
i?ioeiiaaii oaaaie 95 ooai?a (68,3 %), na?aae yeeo iaee ia?aaaao ooaie
??? oaaia?oie (41 %) c oaaioeiaie 42A (18 %), 47 (26 %) oa 6 (7,8 %).

Iaeneiaeueia nei?i/aiiy oa?i?i?a aeeiiaiiy i?e?ia?ieia?/ieo
aeine?aeaeaiue iiaea aooe aeinyaiooi ii?aeiaiiyi aeaio oaeoi??a, a naia:
aeeeth/aiiyi aoaio aeae?eaiiy /enoi? eoeueoo?e oa aeei?enoaiiyi
noeioeyoi??a ?inoo i?e?ia?a. Noeioethth/ei oaeoi?ii ie aea?aee
iiia?aaeith iecueeioaiia?aoo?io ia?iaeo aeeaeeueieo na?aaeiaeu, a
aeeeth/aiiy aoaio aeae?eaiiy /enoi? eoeueoo?e aoei aei?aaaeaii oei, ui
ca aeaieie e?oa?aoo?e caoaeieeaie EI o 96 — 100 % aeiaaee?a ?
noao?eieiee.

I?ney ei?ioei/aniiai ae?iuoaaiiy ia ?icii?iaeaiiio e?ia’yiiio aaa??
io?eiai? oae? aenie? i?ioeaioe iiceoeaieo oano?a ?aeaioeo?eaoe??, ye?
cia/ii ia?aaeuoaaee a?aeiia?aei? iieacieee, io?eiai? i?e
aeine?aeaeoaaii? eiio?ieueieo eoeueoo? (?<0,01; P<0,05). Iaaeeaeothoueny aei ieo i?ioeaioe iiceoeaieo oano?a, io?eiaieo c eoeueoo?, ae?iuaieo ia "na?aaeiaeu? aeey eiio?ieth noa?eeueiino?". On? iieacieee ?aeaioeo?eaoe?? S.aureus ia eoeueoo?ao c aeine?aeieo c?ace?a oeueiai na?aaeiaeua ia?aaeuoaaee a cia/i?e i??? (?<0,01) iieacieee eiio?ieueieo eoeueoo?. I?ney iiia?aaeiueiai ei?ioei/aniiai ae?iuoaaiiy eoeueoo? o caii?iaeaiiio oa a?aeoaeiio oeoe?iaiio aoeueeii? aaeaeinue io?eiaoe 57,1 % iiceoeaieo ?aaeoe?e eaoeeoia?oaeacii? aeoeaiino? , 42,8 % iiceoeaieo ?aaeoe?e ieeneaiiy iai?oo a aiaa?iaieo oiiaao oa eeoa 28,4 % iiceoeaieo ?aaeoe?e ieaciieiaaoeyoe??. Oe? iieacieee aoee cia/ii ieae/eie (?<0,01), i?ae iieacieee aeine?aeieo eoeueoo?, ?ieoaiaaieo ia e?ia’yiiio aaa?? oa “na?aaeiaeu? aeey eiio?ieth noa?eeueiino?” (EN). Iaea?aeai? ?acoeueoaoe aeine?aeaeaiue a?ieia?/iiai iaoa??aeo ie aeiiiaieee iiaeaethaaiiyi aeine?ae?a a eaai?aoi?ieo oiiaao. A?ieia?/iith iiaeaeeth aoee iaeiiaeiaia? aaa?ia? eoeueoo?e S.aureus, aeae?eai? a?ae oai?eo ia eaeoaoe?ei? ianoeoe. C i?aaenoaaeaieo aeaieo aeoiaeeoue, ui i?ney iiia?aaeiueiai ?ieoaoaaiiy S.aureus ia caii?iaeaiiio oa a?aeoaeiio e?ia’yiiio aaa?? io?eiaii iaeneiaeueio e?euee?noue eoeueoo?, ui iathoue eaoeeoia?oaeacio aeoeai?noue oa ieeneththoue iai?o o aiaa?iaieo oiiaao. Iiceoeai? ?IE niinoa??aaee a aeaui iaioi? e?eueeino? eoeueoo?, iaeiae aiia ia?aaeuoaaea e?euee?noue iiceoeaieo ?IE o eiio?ieueieo eoeueoo?ao a 2 ?ace (?<0,05). Iiia?aaei? ?ieoaoaaiiy a caii?iaeaiiio oa a?aeoaeiio “na?aaeiaeu? aeey eiio?ieth noa?eeueiino?” caaacia/oaaei a 3,1 ?ace a?eueoa iiceoeaieo ?IE, i?ae ?ieoaoaaiiy eoeueoo? o eiio?ieueieo na?aaeiaeuao. Ieeneaiiy iai?oo o aiaa?iaieo oiiaao ?a?no?oaaeinue o 94,4 % eoeueoo? S.aureus, ui aoei o 2,2 ?ace a?eueoa, i?ae o eiio?ieueieo aeine?aeaeaiiyo. Iiia?aaeiuei ?ieoaiaai? o ?icii?iaeaiiio oeoe?iaiio aoeueeii? eoeueoo?e S.aureus ieenethaaee iai?o a aiaa?iaieo oiiaao o 91,6 % c?ace?a i?ioe 41,6 % eiio?ieueieo. Iaeiae noiniaii ?ioeo oano?a a ii??aiyii? c iieacieeaie aeine?aeieo eoeueoo? ia e?ia’yiiio aaa?? oa EN, i?ioeaioe iiceoeaieo ?aaeoe?e a eoeueoo?ao ?c aiaeia?/ii ia?iaeaiiai oeoe?iaiai aoeueeiio aoee ieae/eie: EAA o 1,5 (?<0,01) oa 1,2 ?ace; ?IE o 1,8 (?<0,05) oa 1,9 (?<0,01) ?ace. Oaeei /eiii, i?aaenoaaeai? aeai? noaa?aeaeothoue, ui i?ioeaioe iiceoeaieo ?aeaioeo?eaoe?eieo oano?a c eoeueoo?, ae?iuaieo ia aeine?aeieo na?aaeiaeuao, cia/ii ia?aaeuothoue iieacieee eoeueoo? ?c eiio?ieueieo na?aaeiaeu. Iiaeaeuei? eaai?aoi?i? aeine?aee i?aeoaa?aeaeothoue aeine?aeaeaiiy a?ieia?/iiai iaoa??aeo a?ae oai?eo ia EI. C aeei?enoaiiyi ei?aeyoe?eiiai aiae?co aecia/aia iaaia caeaaei?noue ?acoeueoao?a a?ae aeaeo aeeaeeueieo na?aaeiaeu. I?e caii?iaeoaaii? oa a?aeoathaaii? na?aaeiaeu iaeaeua a?aeoai?aiiy eaoeeoia?oaeacii? aeoeaiino? oa ?aaeoe?? ieaciieiaaoeyoe?? o S.aureus aoei a eoeueoo?ao, ?ieoaiaaieo ia e?ia’yiiio aaa??, a iaeieae/a - a eoeueoo?ao, ae?iuaieo o oeoe?iaiio aoeueeii?. Ii ?acoeueoaoao oanooaaiiy eoeueoo? S.aureus, ?icii?iaeaia “na?aaeiaeua aeey eiio?ieth noa?eeueiino?” caeia? na?aaei? iieiaeaiiy, iaaeeaeath/enue aei iieaciee?a eoeueoo?, acyoeo c e?ia’yiiai aaa?o. *anoioa iiceoeaieo ?aaeoe?e ieeneaiiy iai?oo a aiaa?iaieo oiiaao caeaaeaea o?eueee a?ae iecueeioaiia?aoo?ii? ia?iaee na?aaeiaeu, aeei?enoaieo aeey iiia?aaeiueiai ae?iuoaaiiy S.aureus. Ei?aeyoe?eii? caeaaeiino? /anoioe iiceoeaieo ?aaeoe?e IIA a?ae aeaeo aeeaeeueieo na?aaeiaeu ia aeyaeaii. Ia?aeaeueii c aeaeiaith ?aeaioeo?eaoe??th eoeueoo?, ae?iuaieo c a?ieia?/iiai iaoa??aeo, oa /enoeo eoeueoo? S.aureus aoei i?iaaaeaii aeine?aeaeaiiy ?o /ooeeaino? aei aioea?ioee?a. ?acoeueoaoe oeeo aeine?aeaeaiue aoee ?aeaioe/i? noiniaii ye a?ieia?/iiai iaoa??aeo, oae ? noiniaii /enoeo eoeueoo?. I?ney iiia?aaeiueiai 3-o aiaeeiiiai ae?iuoaaiiy eoeueoo? a caii?iaeaiiio oa a?aeoaeiio oeoe?iaiio aoeueeii? aoei aei??aii ae?aiao?e cii cao?eiee ?inoo i?e canoinoaaii? noaiaea?oieo aeene?a c aioea?ioeeaie. Iaeiaeia? ae?aiao?e cii a aeine?aeieo oa eiio?ieueieo eoeueoo?ao aoee a aeiaaeeao canoinoaaiiy aioea?ioee?a a?oie iai?oeee?io (e??i ienaoeee?io). Ca?eueoaiiy ae?aiao??a cii cao?eiee ?inoo a iaaeao aei 5 ii a aeine?aeieo eoeueoo?ao S.aureus ii a?aeiioaiith aei eiio?ieueieo aoei i?e canoinoaaii? ienaoeee?io, ioeienaoeeio, oeaoioaeneio, aeieneoeeee?io, eaiai?oeeio, aaioai?oeeio, no?aioii?oeeio, a?eo?ii?oeeio, ieaaiaeii?oeeio, ?eoaii?oeeio, eaaii?oeaoeio a?ae 32% aei 65%. Ciaioaiiy aei 5ii a ii??aiyii? c eiio?ieueieie c?aceaie ae?aiao??a cii cao?eiee ?inoo a aeine?aeieo eoeueoo?ao aecia/aii a 4,5-21% aeiaaee?a canoinoaaiiy aeene?a c iai?oeee?iaie. Iaeii/anii c aea/aiiyi ae?aiao??a cii cao?eiee ?inoo aoei aecia/aii a?aeiioaiiy aeine?aeieo oa eiio?ieueieo eoeueoo? aei aioea?ioee?a a iaaeao caaaeueiia?aeiieo ?oa?ee “/ooeeaino?”, “iii??ii? no?eeino?” oa “no?eeino?”. Iiaia (100%) ?aeaioe/i?noue ?oa?ee a?aeiioaiiy aei aioea?ioee?a aeine?aeieo oa eiio?ieueieo eoeueoo? aoea iaea?aeaia i?e canoinoaaii? aaiceeiai?oeee?io, aaioai?oeeio, no?aioii?oeeio, eaaii?oeaoeio, iie?i?eneio, oeaoioaeneio oa iao?oeee?io. I?e canoinoaaii? ?ioeo aioea?ioee?a ca?a ?oa?ee a?aeiioaiiy aei aioea?ioee?a a aeine?aeieo oa eiio?ieueieo eoeueoo?ao S.aureus niinoa??aaee a 91,7-92,9%. O?eueee a 7,1%-8,3% a?ae caaaeueii? e?eueeino? aeine?aeieo eoeueoo? ca?a?no?iaaii ia?ao?ae c ?oa?eee “no?ee?” aei ?oa?eee “iii??ii no?ee?” oa a 3 aeiaaeeao c ?oa?eee “iii??ii no?ee?” aei ?oa?eee “/ooeea?”. Oaeei /eiii, a?aecia/ai? ci?ie ae?aiao??a cii cao?eiee ?inoo a aeine?aeieo eoeueoo?ao a?aeaoaaeenue a iniiaiiio a iaaeao ?oa?ee a?aeiioaiiy i?e?ia?a aei aioea?ioee?a. Oeae iacia/iee iaca?a a aeine?aeieo oa eiio?ieueieo eoeueoo?ao (ia oii? 91,7-100% ca?ao) ? noaoenoe/ii iaaeinoia??iei, aeiaaeeiaei. Oiio iiaeia aaaaeaoe, ui iiia?aaei? ae?iuoaaiiy eoeueoo? S.aureus i?aeoe/ii ia aieeaa? ia ?o /ooeea?noue aei aioea?ioee?a. Iaaaaeai? aeua ?acoeueoaoe aeine?aeaeaiue aeicaieythoue ?aeiiaiaeoaaoe ei?ioei/ania (ia i?ioyc? 3-o aiaeei) ?ieoaoaaiiy a?ieia?/iiai iaoa??aeo ia aeeaeeueieo na?aaeiaeuao, i?aeeaaeeo caii?iaeoaaiith oa a?aeoathaaiith aeey i?iaaaeaiiy ?aeaioeo?eaoe?? noao?eieie?a a ei?ioeee oa?i?i. Aeey aeyaeaiiy EAA aeinoaoiuei iaeiiaiaeeiiiai iiia?aaeiueiai ae?iuoaaiiy eoeueoo?. Iinoaiiaea oano?a ?aeaioeo?eaoe?? S.aureus oa aecia/aiiy /ooeeaino? aei aioea?ioee?a i?ney ae?iuoaaiiy eoeueoo? a aeine?aeieo na?aaeiaeuao aeicaieythoue io?eiaoe iiceoeai? ?acoeueoaoe ii aeaio oanoao (eaoeeoia?oaeaci?e aeoeaiino? oa ieeneaiith iai?oo a aiaa?iaieo oiiaao) o 91,6-100% aeiaaee?a, a ii o?ueio oanoao - o 75-100%, aioea?ioeeia?aio - o 100% aeiaaee?a /a?ac 21-27 aiaeei i?e eaeoaoe?eieo ianoeoao noao?eieieiai? ao?ieia??. Oe? ?acoeueoaoe aeathoue i?aenoaao aaaaeaoe oaeee iaoiaee/iee i?aeo?ae niiniaii i?enei?aiiy aaeoa??ieia?/ii? ae?aaiinoeee eaeoaoe?eieo ianoeo?a noao?eieieiai? ao?ieia??. I?eioeei ?ic?iaeaiiai niiniao iieyaa? o ei?ioei/aniiio (3-o aiaeeiiiio) ae?iuoaaiith iaoa??aeo o caii?iaeaieo oa a?aeoaeeo aeeaeeueieo na?aaeiaeuao, ye? cai?iiiiiaai? aeey aeae?eaiiy eoeueoo? noao?eieie?a. Iiia?aaeiuei ?ieoaiaai? eoeueoo?e aeei?enoiaothoueny aeey iinoaiiaee ?aeaioeo?eaoe?eieo oano?a oa aecia/aiiy ?o /ooeeaino? aei aioea?ioee?a. Ia?aeaeueii ne?ae i?iaiaeeoe aeine?aeaeaiiy ii eeane/iiio iaoiaeo, oiio ui i?ye? iia? niiniae ia iiaeooue a?aei?ieoe ?nioth/? iaoiaee. E??i oiai, ao?ieia?/ieie oaeoi?aie iiaeooue aooe ia noao?eieiee, a ?io? aeaee i?e?ii?aai?ci?a, a oaeiae i?e iaaaeee?e eiioeaio?aoe?? aaeoa??e a iaoa??ae? 3-o aiaeeiia ae?iuoaaiiy iiaea ia caaacia/eoe aeinoaoith a?iiano aeey io?eiaiiy iiceoeaieo ?acoeueoao?a oano?a ?aeaioeo?eaoe??. ?ic?iaeaiee iaie niin?a i?enei?aiiy aaeoa??ieia?/ii? ae?aaiinoeee ianoeo?a noao?eieieiai? ao?ieia?? ?aeiiaiaeo?oueny canoiniaoaaoe ye aeiaeaoeiaee ia?aeaeueii c eeane/iei o aeiaaeeao, eiee iio??aia iaeneiaeueii i?enei?aia ao?io?iiia oa?ai?y (aaaeeee ee?i?/iee ia?aa?a, caa?ica naineno). ?ic?iaeaiee iaie i?enei?aiee niin?a aaeoa??ieia?/ii? ae?aaiinoeee EI canoinoaaee i?e aeine?aeaeaii? ae?ii/iai iieiea a?ae ii?iae?eue c eaeoinoacii, oiio ui nai?/ania aeyaeaiiy a iieioe? S.aureus aeicaiey? i?iaanoe aaeaeaaoia e?eoaaiiy oa caiia?aoe ?icaeoeo EI E??i oiai, eiaaoeaciiaaaoeai? noao?eieiee (EIN) a iaaieo oiiaao iiaeooue aooe iaoiaaiaie oa oaae aeeeeeaoe eaeoaoe?ei? ianoeoe. C aeae?eaieo ?c ae?ii/iai iieiea aaeoa??e 7 ooai?a aoee S.aureus (11,9% 4,2%), a 26 ooai?a iaeaaeaee aei EIN (44,1% 6,5%). Aeae?eai? ooaie S.aureus iaee oaiaeaioe?th aei a?eueo aeniei? /anoioe aeyaeaiiy EAA i?ney ?ieoaoaaiiy a aeine?aeieo na?aaeiaeuao oa a?eueo aenie? i?ioeaioe (? 0,05) iiceoeaieo ?aaeoe?e ieaciieiaaoeyoe?? a ii??aiyii? c aeaieie, io?eiaieie c eiio?ieueieo na?aaeiaeu. E??i oano?a ?aeaioeo?eaoe?? aoea aecia/aia /ooeea?noue aei aioea?ioee?a eoeueoo? S.aureus, aeae?eaieo c ae?ii/iai iieiea. Oae, iiaiee ca?a ?oa?ee “/ooeea?” oa “no?ee?” ii aioea?ioeeai on?o a?oi, e??i oao?aoeeee?io, aecia/eany i?e aeine?aeaeaii? ooai?a S.aureus. A?eueo?noue eoeueoo? S.aureus aoee /ooeea? aei aea/aieo aioea?ioee?a, i?ioa a?ae 1/3 aei iieiaeie ooai?a S.aureus aoee no?eee aei ea?aai?oeee?io, e?ieii?oeeio, no?aioii?oeeio. C iaaaaeaieo aeaieo aeaeii, ui /anoioa aeyaeaiiy ?inoo EIN ia e?iayiiio aaa?? oa IAENA a eoeueoo?ao c aeine?aeieo na?aaeiaeu aoea a 1,8 - 2,0 ?ace aeua (?0,05), i?ae c eiio?ieueieo. EIN a 100% aeyaeee /ooeea?noue aei: ioeienaoeeio, oeaoioaeneio, no?aioii?oeeio, ?enoii?oeeio. Aei iai?oeee?i?a aoee /ooeea? a?ae 8% aei 50% ooai?a EIN. Iiaiee ca?a ?oa?ee “/ooeea?” oa “no?ee?” a eoeueoo?ao c aeine?aeieo oa eiio?ieueieo na?aaeiaeu niinoa??aaee o a?eueoino? iai?oeee?i?a, oeaoioaeneio, a?oie oao?aoeeee?i?a, iae?ie?ae?a, ai?iiae?eiceae?a. Oaeei /eiii, iiia?aaei? ?ieoaoaaiiy ae?ii/iai iieiea ia ?icii?iaeaieo aeeaeeueieo na?aaeiaeuao aea? ciiao i?enei?eoe ?aeaioeo?eaoe?th noao?eieie?a oa iaea?aeaoe ia?eoeai? aeai? i?i a?aeiioaiiy ?o aei aioea?ioee?a. Aeei?enoaiiy ?ic?iaeaiiai i?enei?aiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee EI noao?eieieiai? ao?ieia?? aeicaiey? i?iaanoe ?? a iaeneiaeueii ?aii? no?iee, nai?/anii cae?enithaaoe ei?aeoe?th aioea?ioeeioa?ai?? a?aeiinii /ooeeaino? caoaeiee?a aei aioea?ioee?a, a oaeiae i?io?eaeoeeo ?icaeoeo EI o noai? eaeoinoaco. C?aooith oea i?eaiaeeoue aei a?eueo oaeaeeiai iaeoaeaiiy oai?eo, nei?i/aiith /ano ia?aaoaaiiy ?o o noaoe?iia??, cieaeaiith caoai?thaaiino? EI. AENIIAEE 1.Aeniea caoai?thaai?noue ia eaeoaoe?ei? ianoeoe, oyaee? ee?i?/i? i?iyae ?o ia?aa?ao, oaeaeea c?inoaiiy ee?i?/ieo yaeu, /anoi c caa?icith ia?aoiaeo a nainen, ia?aeiiothoue a iaiao?aeiino? i?enei?aii? aaeoa??ieia?/ii? ae?aaiinoeee, iaoiaee yei? ?ic?iaeaii iaaeinoaoiuei. 2.A?oio aenieiai ?eceeo uiaei ?icaeoeo EI na?aae ii?iae?eue neeaaeathoue ae?iee c ia?oeie iieiaaie o a?oe? 21-26 ?ie?a, oa ae?iee, ui iathoue o aiaiiac? iaoieia?/i? iieiae. Aeieeiaiith EI o oe??? eaoaai??? ae?iie ni?ey? eaeoinoac (37,6%). 3.A ao?ieia?? EI i?ia?aeio ?ieue a?ae?a?athoue noao?eieiee (95,5%), na?aae yeeo aeii?io? S.aureus (78,1% ii a?aeiioaiith aei caaaeueii? e?eueeino? aeae?eaieo caoaeiee?a), ye? iaeneiaeueii /ooeea? aei aioea?ioee?a - ai?iiaeeeiceae?a, oeaoaeinii?ei?a o?aoueiai iieie?iiy oa a a?eueoino? nai?e (41%) oeiothoueny aaeoa??ioaaaie ??? a?oie. 4.Iaie aia?oa ?ic?iaeaii i?enei?aiee aaci?eno??eiee niin?a aaeoa??ieia?/ii? ae?aaiinoeee EI noao?eieieiai? ao?ieia?? c ?aeaioeo?eaoe??th caoaeiee?a oa aecia/aiiyi ?o aioea?ioeeia?ai o noene? oa?i?ie (21-27aiaeei), aaciaaiee ia aeei?enoaii? iiia?aaeiuei? iecueeioaiia?aoo?ii? ia?iaee aeeaeeueieo na?aaeiaeu. 5.Iaeneiaeuei? i?ioeaioe iiceoeaieo oano?a i?e nei?i/aieo oa?i?iao ?aeaioeo?eaoe?? S.aureus io?eiai? ii eaoeeoia?oaeaci?e aeoeaiino? oa ieeneaiith iai?oo o aiaa?iaieo oiiaao. 6.Iaea?eueo aoaeoeaieie a i?enei?ai?e ?aeaioeo?eaoe?? noao?eieie?a ? ?icii?iaeai? 5% e?iayiee aaa? oa “na?aaeiaeua aeey eiio?ieth noa?eeueiino?”. 7.Iiia?aaei? ei?ioei/ania ae?iuoaaiiy eoeueoo? noao?eieie?a o ?icii?iaeaieo aeeaeeueieo na?aaeiaeuao ia ci?ith? ?o /ooeeaino? aei aioea?ioee?a a iaaeao cii /ooeeaino?, iii??ii? no?eeino? oa no?eeino?. 8.Iiia?aaeiy ?ieoaaoe?y c?ace?a iieiea a caii?iaeaieo oa a?aeoaeeo aeeaeeueieo na?aaeiaeuao o 71,4-100% aeiaaee?a aeicaiey? aecia/eoe eiai i?e?ioei?o oa /ooeea?noue ?? aei aioea?ioee?a ia i?ioyc? 21-27 aiaeei, ui i?aeoaa?aeaeaii iiaeaeueieie eaai?aoi?ieie aeine?aeaie. 9.I?ecia/aiiy aioei?e?iaii? oa?ai?? oai?ei ia ai?ei? oi?ie EI ye ?acoeueoao aeei?enoaiiy ?ic?iaeaiiai i?enei?aiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee nei?i/o? caaaeueio o?eaae?noue caoai?thaaiiy a 1,8 ?aca, ciaioo? e?euee?noue i?iaaaeaieo a noaoe?iia?? eieei-aei?a a 1,6 ?aca, caiia?aa? aeieeiaiith oneeaaeiaiue oa ?aoeeaeea?a, a ii??aiyii? c eiio?ieai a 1,65 ?aca /ano?oa caa??aa? eaeoaoe?th o ii?iae?eue. NIENIE IIOAE?EIAAIEO I?AOeUe CA OAIITH AeENA?OAOe?? 1. Ooianueyioe I.TH. *oanoaeoaeueiinoue e aioeiaeioeeai aicaoaeeoaeae eaeoaoeeiiiuo ianoeoia, auaeaeaiiuo ia oa??eoi?ee Aeiiaoeeie iaeanoe a 1990-1997 aa. // I?iaeci?. - 1999. - ? 10. - N. 34-35. 2. Ooianueyioe I.TH. I aeeyiee ieceioaiia?aoo?iie ia?aaioee ieoaoaeueiie n?aaeu (naoa?iiai aoeueiia) ia /oanoaeoaeueiinoue S.aureus e aioeaeioeeai // I?iaeci?. - 1999. - ? 12. - N. 41-42. 3. Tumasyants N.Yu. To the question of etiology and biologic properties of causative agents of lactic mastitis // School of Fundamental Medicine Journal. - 1998. - Vol.1, ?4. - N.71-73. 4. Ooianueyioe I.TH., Aa?aiei TH.N. Aeeyiea i?aaeaa?eoaeueiiai caii?aaeeaaiey naoa?iiai aoeueiia ia aaee/eio cii caaea?aeee ?inoa iee?ii?aaieciia i?e eniieueciaaiee noaiaea?oiuo aeeneia n aioeaeioeeaie // Aanoi. aeaeaiu e yieaeaieieiaee. - 1998.- O.2, ?1(3). - N.103-105. 5. Ooianueyioe I.TH., Aa?aiei TH.N., Eiiae?aoaiei A.I. Onei?aiiue iaoiae aaeoa?eieiae/aneie aeeaaiinoeee i?e eaeoinoaca // Aanoi. aeaeaiu e yieaeaieieiaee.- 1998.- O.2, ?1 (I?ee.). - N.105. 6. Ooianueyioe I.TH., Aa?aiei TH.N. Aaeoa?eieiae/aneay yeni?ann-aeeaaiinoeea eaeoaoeeiiiuo ianoeoia // Cae?aaiio?aiaiea Aeiiaanna.-1998. - ?1. - N.11-14. 7. Aaeiiaiei A.A., Aa?ooeaoeeee E.A., Ineiia A.A., Aa?aiei TH.N., Ooianueyioe I.TH., ?aaaiei O.A., Iaeeaaeei O.O. Oeieioa?aiey aaeoa?eaeueiie eioaeoeee i?e eaeoaoeeiiiii ianoeoa (EI) // O?oaeu Iaaeaeoia?. Eiio. “?aiu e ?aiaaay eioaeoeey”: Oac.aeiee.- Iineaa, 1993.- *.2. - N. 228-230. 8. Aaeiiaiei A.A., Oea?aoi E.E., Aa?aiei TH.N., Ooianueyioe I.TH. Nia?aiaiiua iiaeoiaeu e aeeaaiinoeea e ea/aieth naioe/aneeo eaeoaoeeiiiuo ianoeoia // Iao/ii-i?aeoe/aneay eiioa?aioeey, iinayu. 6-eaoeth Aeeaaiinoe/aneiai oeaio?a: Oac. aeiee. - Aeiiaoee, 1995. - N.161-162. 9. Aa?aiei TH.N., Aaeiiaiei A.A., Ooianueyioe I.TH. Yoeieiae/aneay no?oeoo?a eaeoaoeeiiiuo ianoeoia // Iaaeiae. iao/ii-i?aeoe/aneay eiioa?aioeey, iina. 30-eaoiaio thaeeath eaoaae?u aeoo. e aeiaeie. OOA. Oac. aeiee.-Aeiiaoee, 1995.-N.15. 10. Ooianueyioe I.TH. I ?iee iee?ii?aaieciia a ?acaeoee eaeoaoeeiiiiai ianoeoa // Na. iao/. o?oaeia iieiaeuo o/aiuo e niaoeeaeenoia, iinayu. 65-eaoeth Aeiiaoeeiai iaae. oieaa?neoaoa.-Aeiiaoee, 1995.- N.243. AIIOAOe?ss Ooianueyioe I.TH. Iioei?caoe?y i?e?ia?ieia?/ii? ae?aaiinoeee eaeoaoe?eieo ianoeo?a. - ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 03.00.07 - i?e?ia?ieia?y. - Aeiiaoeueeee aea?aeaaiee iaaee/iee oi?aa?neoao ?i. I.Ai?ueeiai, 1999. Aeena?oaoe?th i?enay/aii ?ic?iaoe? i?enei?aiiai niiniao aaeoa??ieia?/ii? ae?aaiinoeee eaeoaoe?eieo ianoeo?a noao?eieieiai? ao?ieia??. Oeae niin?a aaco?oueny ia aeei?enoaii? iecueeioaiia?aoo?ii? ia?iaee aeeaeeueieo na?aaeiaeu, yea noi?iaiaeaeo?oueny ooai?aiiyi na?aeioaei? aiaee oa ?? noeioethth/ith ae??th ia ?iciiiaeaiiy i?e?ii?aai?ci?a. I?e oeueiio niinia? aeinyaiooi nei?i/aiiy oa?i?i?a ?aeaioeo?eaoe?? noao?eieie?a oa aecia/aiiy ?o /ooeeaino? aei aioea?ioee?a aei 21 - 27 aiaeei (a 2,6 - 3,7 ?ace a ii??aiyii? c eeane/iei iaoiaeii). Canoinoaaiiy oeueiai niiniao aeicaiey? a ei?ioeee /an i?aaeeueii aecia/eoe ao?ieia?/iee ae?aaiic oa oi/ii aea?aoe aioei?e?iai? i?aia?aoe aeey e?eoaaiiy oai?eo ia eaeoaoe?ei? ianoeoe, ui i?eaiaeeoue aei nei?i/aiiy no?ie?a ia?aaoaaiiy oai?eo o noaoe?iia??, ciaioaiith oneeaaeiaiue oa ?aoeeaeea?a. Eeth/ia? neiaa: eaeoaoe?ei? ianoeoe, noao?eieiee, oanoe ?aeaioeo?eaoe??, /ooeea?noue aei aioea?ioee?a, aeeaeeuei? na?aaeiaeua, iecueeioaiia?aoo?ia ia?iaea. ANNOTATION Tumasyants N.Yu. Optimization of Bacteriologic Diagnosis of Lactational Mastites. - Manuscript. The dissertation submitted for the Candidate of Sciences (medicine) degree in speciality 03.00.07 - microbiology. - Donetsk State Medical University, 1999. The dissertation is devoted to the development of a rapid test method of bacteriologic diagnosis of lactational mastites having staphylococcal etiology. This method is based on the use of a low temperature pretreatment of nutrient media. The application of the method resulted in a shorter period of staphylococcal identification and determination of staphylococcal sensitivity to antibiotics (21-27 hours). It is 2.6-3.7 times less as compared with that of classic methods. This method allows us to make a correct etiologic diagnosis and select proper antimicrobial preparations for treatment of patients with lactational mastites of staphylococcal etiology within a short period of time. It leads to a shorten hospital stay of the patients, decreased complications and recurrences. Key words: lactational mastitis, staphylococci, identification tests, sensitivity to antibiotics, nutrient media, low temperature pretreatment. AIIIOAOeEss Ooianueyioe I.TH. Iioeiecaoeey aaeoa?eieiae/aneie aeeaaiinoeee eaeoaoeeiiiuo ianoeoia. - ?oeiienue. Aeenna?oaoeey ia nieneaiea o/aiie noaiaie eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 03.00.07 - iee?iaeieiaey. - Aeiiaoeeee ainoaea?noaaiiue iaaeeoeeineee oieaa?neoao, 1999. Aeenna?oaoeey iinayuaia ?ac?aaioea onei?aiiiai niiniaa aaeoa?eieiae/aneie aeeaaiinoeee eaeoaoeeiiiuo ianoeoia (EI) noaoeeieieeiaie yoeieiaee, eioi?ue iniiauaaaony ia eniieueciaaiee ieceioaiia?aoo?iie ia?aaioee ieoaoaeueiuo n?aae, i?eiaiyaiuo aeey e?aoeia?aiaiiiai eieoae?iaaiey iaoa?eaea. I?e iooaeaaiee caii?iaeaiiuo n?aae ia?acoaony naaaeaoaeay aiaea, ieacuaathuay aeinoeioee?othuaa aeaenoaea ia ?ino e ?aciiiaeaiea iee?iaia. A oiaea ?aaiou ianeaaeiaaii 117 aieueiuo EI. Enneaaeiaaeenue ioieoaou, ?aiaaia ioaeaeyaiia, aiie, iieiei, eco/aeanue iee?ioei?a eiaee iiei/iuo aeaeac, a oaeaea a?oaeiia iieiei io 59 ?iaeeeueieoe n eaeoinoacii. Oaeaea enneaaeiaaeenue /enoua eoeueoo?u aaeoa?ee, auaeaeaiiua ec iaoa?eaea io aieueiuo. Aeey eoeueoeae?iaaiey iee?iaia eniieueciaaeenue n?aaeu: 5% e?iayiie aaa?, naoa?iue aoeueii, “n?aaea aeey eiio?iey noa?eeueiinoe” (EN). Enneaaeiaaiey i?iaiaeeeenue a n?aaieoaeueiii aa?eaioa: ia?aeeaeueiia au?aueaaiea ia?ae/iiai iaoa?eaea e /enouo iee?iaiuo eoeueoo? a ?acii?iaeaiiuo (iiuoiuo) n?aaeao e a ia iiaeaa?aaaoeony caii?aaeeaaieth (eiio?ieueiuo) n?aaeao. Iinaa iaoa?eaea e iee?iaiuo eoeueoo? i?iaiaeeee iaeiia?aiaiii a eiee/anoaa 0,1 ie. Iinea iaeii/aniaie eieoaaoeee a oa?iinoaoa i?e t=37N i?iecaiaeeee iinaa ia iiei/ii-aeaeoi/iue nieaaie aaa? (IAENA), eaoeeoiaeoaeeacioth aeoeaiinoue (EAA) ii?aaeaeyee /a?ac 18-24 /ana, a ia?aciaaiea ieaiaioa - /a?ac 48 /ania. Iinea 3-o /aniaiai au?aueaaiey ia iiuoiuo e eiio?ieueiuo n?aaeao ii?aaeaeyee ieaciieiaaoeacioth aeoeaiinoue, niiniaiinoue ieeneyoue iaiieo a aiay?iaiuo oneiaeyo, a oaeaea /oanoaeoaeueiinoue iee?iaia e aioeaeioeeai aeenei-aeeoooceiiiui iaoiaeii. Noaoenoe/aneee aiaeec ?acoeueoaoia inouanoaeyee n iiiiuueth eiyooeoeeaioia Nouthaeaioa e Ie?niia. Anaai iieo/aii 178 ooaiiia iee?ii?aaieciia, ec eioi?uo S.aureus - 139 ooaiia, S.epidermidis - 31. Iinea enneaaeiaaiey aiiy, ioieoaoia, ioaeaeyaiiai ?ai ii iienaiiiio auoa oiaeo iieo/aiu cia/eoaeueii aieaa aunieea i?ioeaiou iieiaeeoaeueiuo oanoia eaeaioeoeeaoeee S.aureus n iiuoiuo ( ?acii?iaeaiiuo) n?aae, /ai ec eiio?ieueiuo (?0,01; ?0,05). Iieo/aiiua ?acoeueoaou enneaaeiaaiee aeiiaoa?eaea iiaeoaa?aeaeaiu iiaeaeueiuie eaai?aoi?iuie iiuoaie ia /enouo eoeueoo?ao S.aureus. Iinea i?aaeaa?eoaeueiiai eieoae?iaaiey eoeueoo? S.aureus ia ?acii?iaeaiiii e?iayiii aaa?a iieo/aii iaeneiaeueiia eiee/anoai eoeueoo?, eiathueo EAA (100%) e ieeneythueo iaieo a aiay?iaiuo oneiaeyo (97,2% 2,7%). *enei iieiaeeoaeueiuo ?aaeoeee ieaciieiaaoeyoeee a iiuoiuo enneaaeiaaieyo a 2 ?aca i?aauoaei /enei oaeiauo a eiio?iea (?0,01). I?aaeaa?eoaeueiia eieoae?iaaiea a ?acii?iaeaiiie EN iicaieeei iaaethaeaoue ieeneaiea iaiieoa a aiay?iaiuo oneiaeyo a 94,4% eoeueoo? S.aureus, /oi auei a 2,2 ?aca aieueoa ii n?aaiaieth n eiio?ieai (?0,01). Ia?aeeaeueii n eaeaioeoeeaoeeae eoeueoo?, au?inoeo ec aeiiaoa?eaea, e /enouo eoeueoo? S.aureus, enneaaeiaaeanue eo /oanoaeoaeueiinoue e aioeaeioeeai iinea 3-o /aniaiai au?aueaaiey a oa?iinoaoa ia naoa?iii aoeueiia. A ?acoeueoaoa enneaaeiaaiee ?ino eoeueoo? S.aureus ia n?aaea AAA n /aoeeie ciiaie caaea?aeee ?inoa aie?oa aeeneia n aioeaeioeeaie iieo/aiu a 100% iinaaia aeinoano?aoia e 100% iinaaia /enouo eoeueoo? S.aureus, i?aaeaa?eoaeueii eieoae?iaaiiuo eae a iiuoiuo, oae e a eiio?ieueiuo n?aaeao. I?e yoii ioiioaiea S.aureus, e?aoeia?aiaiii au?aueaaaiuo a iiuoiuo n?aaeao, e aioeaeioeeai i?aeoe/anee ia eciaiyeinue. Iieo/aiiua ?acoeueoaou iicaieytho ?aeiiaiaeiaaoue e?aoeia?aiaiiia (3-o /aniaia) eieoae?iaaiea iaoa?eaea, acyoiai io aieueiuo EI, ia n?aaeao, iiaeaa?aioouo ieceioaiia?aoo?iie ia?aaioea, aeey nie?auaiey (aei 21-27 /ania) n?ieia iinoaiiaee oanoia eaeaioeoeeaoeee e ii?aaeaeaiey /oanoaeoaeueiinoe aicaoaeeoaeae EI e aioeaeioeeai. Oaeia nie?auaiea n?ieia aaeoa?eieiae/aneie aeeaaiinoeee a 2,6-3,7 ?aca ii n?aaiaieth n eeanne/aneei iaoiaeii aeaao iniiaaiea n/eoaoue ?ac?aaioaiiue iaie niinia onei?aiiui e ?aeiiaiaeiaaoue aai eniieueciaaiea ia?aeeaeueii n eeanne/aneei iaoiaeii a neo/ayo auno?iai i?ia?anne?iaaiey EI e oa?icu aai ia?aoiaea a nainen. Eeth/aaua neiaa: eaeoaoeeiiiue ianoeo, noaoeeieieee, oanou eaeaioeoeeaoeee, /oanoaeoaeueiinoue e aioeaeioeeai, ieoaoaeueiua n?aaeu, ieceioaiia?aoo?iay ia?aaioea.

Добавить комментарий

Ваш e-mail не будет опубликован. Обязательные поля помечены *