Брюшной тиф: современное состояние проблемы

Клиническая Микробиология и Антимикробная Химиотерапия. 2005; 7(1):47-67

​ Лобзин Ю.В., Волжанин В.М., Коваленко А.Н.
брюшной тиф Salmonella enterica серотип Typhi терапия профилактика антибиотикорезистентность
Раздел
Болезни и возбудители
Тип
Журнальная статья
Публикация
Клиническая Микробиология и Антимикробная Химиотерапия. 2005; 7(1):47-67

Аннотация

В России и других индустриально развитых странах брюшной тиф является спорадическим заболеванием, в то же время некоторые регионы в мире остаются эндемичными по брюшному тифу и служат источниками его распространения в другие страны. В последние годы отмечается распространение штаммов Salmonella enterica серотип Typhi, резистентных к большинству применявшихся ранее традиционных для лечения брюшного тифа антибиотиков. Растёт число сообщений о выявлении хинолонорезистентных штаммов сальмонелл и клинической неэффективности современных антимикробных препаратов при лечении брюшного тифа. В данном обзоре литературы представлены основные сведения, касающиеся этиологии, эпидемиологии, патогенеза брюшного тифа. Подробно рассмотрена динамика изменения резистентности S. Typhi к антимикробным препаратам и связанные с этим проблемы. Описаны клинические проявления брюшного тифа и его наиболее важных осложнений, методы его лабораторной диагностики. Особое внимание уделено выбору антибактериальной терапии с учётом изменившейся картины антибиотикорезистентности возбудителя и новых данных по эффективности и безопасности антибиотиков, особенно у детей и беременных. Рассмотрены вопросы лечения тяжёлого брюшного тифа и его осложнений. Приведены данные по существующим брюшнотифозным вакцинам и перспективы специфической профилактики.

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