Аннотация
В статье представлены основные подходы к антибиотикотерапии анаэробных инфекций, описаны наиболее типичные анаэробные патогены и механизмы их резистентности к антимикробным препаратам. Приведены данные исследований чувствительности к антибиотикам Bacteroides spp., Clostridium spp. и Fusobacterium spp., выделенных у госпитализированных пациентов в Швеции и Никарагуа, получавших антибактериальную терапию, а также у детей в возрасте до 2 лет в Никарагуа, получавших и неполучавших антибиотики. Наименее активными в отношении Bacteroides spp. были бензилпенициллин, цефалотин и пиперациллин, которые несколько превосходили клиндамицин и цефокситин. Обнаружены штаммы Fusobacterium spp., устойчивые к бензилпенициллину. Большинство штаммов Clostridium spp. были чувствительны к тестированным антибиотикам. Единственными анаэробами, устойчивыми к ампициллину и цефокситину, оказались Bacteroides spp., выделенные у детей, получавших антибиотики. Ни у детей, ни у взрослых не обнаружено штаммов, устойчивых к имипенему, метронидазолу и хлорамфениколу. Резистентность анаэробов, выделенных у 219 пациентов в Никарагуа, определялась к наиболее часто используемым в этой стране антибиотикам. Так, представители группы B.fragilis часто проявляли резистентность к ампициллину (56%), цефокситину (28%) и клиндамицину (25%). Обнаружены штаммы Fusobacterium spp., устойчивые к ампициллину (44%) и цефокситину (12%).
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