Распространённость условно-патогенных микроорганизмов, резистентных к антимикробным препаратам, у родильниц и факторы, влияющие на их выявление: обзор

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Аннотация

Резистентность условно-патогенных микроорганизмов к антимикробным препаратам представляет собой глобальную проблему здравоохранения. Несмотря на активное изучение, данные о распространённости устойчивых условно-патогенных микроорганизмов среди родильниц остаются ограниченными и характеризуются значительной гетерогенностью.

В статье систематизированы современные данные о частоте колонизации родовых путей родильниц резистентными штаммами условно-патогенных микроорганизмов и проанализированы факторы, которые определяют вероятность их обнаружения. Исследование включает анализ 45 научных работ за 2000–2025 гг. Поиск публикаций проводили в поисковых системах PubMed и Google Scholar, а также в научных электронных библиотеках eLibrary.ru и Национального центра биотехнологической информации (National Center for Biotechnology Information, NCBI) по ключевым словам: «условно-патогенные микроорганизмы», «резистентность к антимикробным препаратам», «родильницы», «колонизация родовых путей», «генетические детерминанты резистентности». Всего отобрали 7179 статей.

Согласно данным проанализированной литературы, среди резистентных условно-патогенных микроорганизмов, которые выявляли у родильниц, преобладали Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae и Enterococcus spp. Исследования отметили критические уровни резистентности к β-лактамам, включая цефалоспорины III поколения и карбапенемы, с выраженными межрегиональными различиями. Ключевыми факторами риска колонизации родовых путей родильниц резистентными условно-патогенными микроорганизмами стали инвазивные акушерские вмешательства, нерациональная антибиотикотерапия и длительная госпитализация. Клинически значимые последствия такой колонизации включают: повышенный риск послеродовых инфекционных осложнений, увеличение послеродовой летальности и риск вертикальной передачи резистентных условно-патогенных микроорганизмов новорождённым.

Результаты анализа литературы свидетельствуют о том, что необходимо разработать стратегию контроля колонизации родовых путей родильниц резистентными условно-патогенными микроорганизмами. Данная стратегия должна включать оптимизацию скрининга, тактики антибактериальной профилактики и лечения, а также внедрение методов эпидемиологического геномного надзора за послеродовыми гнойно-септическими инфекциями.

Об авторах

Светлана Сергеевна Смирнова

Федеральный научно-исследовательский институт вирусных инфекций «Виром»; Уральский государственный медицинский университет

Автор, ответственный за переписку.
Email: smirnova_ss69@mail.ru
ORCID iD: 0000-0002-9749-4611
SPIN-код: 3127-4296

д-р мед. наук, доцент

Россия, Екатеринбург; Екатеринбург

Юлия Сергеевна Стагильская

Федеральный научно-исследовательский институт вирусных инфекций «Виром»; Уральский государственный медицинский университет

Email: stagilskaya_ys@niivirom.ru
ORCID iD: 0009-0000-9261-5624
SPIN-код: 2923-4892

MD

Россия, Екатеринбург; Екатеринбург

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