7 research outputs found
In vitro activity of cefpodoxime against Russian clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes
Objective.
To determine in vitro activity of oral III generation cephalosporin cefpodoxime against clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes isolated from patients with community-acquired respiratory tract infections in different regions of the Russian Federation.
Materials and Methods.
The study included isolates of bacterial pathogens of community-acquired respiratory tract infections isolated from outpatients and hospitalized patients in different regions of the Russian Federation. A total of 558 isolates were included in the study, including 184 isolates of H. influenzae, 186 isolates of S. pneumoniae and 188 isolates of S. pyogenes. Species identification was performed using the MALDI-TOF mass spectrometry (Bruker Daltonics, Germany), for S. pneumoniae identification was also performed taking into account the morphology of colonies on blood agar, the presence of Ξ±-hemolysis, negative catalase reaction, sensitivity to optochin and positive results of latex-agglutination using DrySpot kit (OXOID, UK). Antimicrobial susceptibility to cefpodoxime and comparative antimicrobials was determined using broth microdilution method; interpretation of susceptibility testing results was performed in accordance with the recommendations of EUCAST, v.13.0. Data analysis and visualization were performed using the online platform AMRcloud.
Results.
Despite the generally low incidence of antibiotic resistance in the tested H. influenzae isolates, cefpodoxime, to which all tested isolates were susceptible, was superior to all other oral antibiotics in terms of in vitro activity: aminophenocillins (R β 8.7%), amoxicillin/clavulanate (R β 1.1%), co-trimoxazole (R β 31.5%), levofloxacin (R β 3.8%), moxifloxacin (R β 3.8%), tetracycline (R β 11%), cefixime (R β 2.2%), ceftibuten (R β 3.3%). Among the studied S. pneumoniae isolates, 81.7% were susceptible to cefpodoxime. All isolates resistant to penicillin, amoxicillin and ceftriaxone were also resistant to cefpodoxime. Cefpodoxime was inferior to levofloxacin (R β 0%), moxifloxacin (R β 0%), linezolid (R β 0%), vancomycin (R β 0%), ertapenem (R β 8.6%), ceftaroline (R β 2.3%), and chloramphenicol (R β 3.2%) in terms of in vitro activity against S. pneumoniae. However, all these drugs are either not available in oral form or have a less favorable safety profile compared to cefpodoxime. When compared with other III generation oral cephalosporins cefixime and ceftibuten, the activity of cefpodoxime against S. pneumoniae was significantly higher based on MIC50/90 values (cefixime β 0.125/8 mg/l, ceftibuten β 2/β₯ 128 mg/l, cefpodoxime β 0.06/4 mg/l) and MICs range (cefixime β 0.06/β₯ 128 mg/l, ceftibuten β 0.06/β₯ 128 mg/l, cefpodoxime β 0.03/32 mg/l). No strains resistant to Ξ²-lactam antibiotics were detected among the tested S. pyogenes isolates. Based on the MIC50/90 values and the range of MIC values, the in vitro activity of cefpodoxime was higher than that of ceftibuten and comparable to that of cefixime.
Conclusions.
According to the results of our study, as well as in view of its pharmacokinetic profile, high safety and compliance, cefpodoxime can be considered as one of the options for oral therapy of community-acquired bacterial upper and lower respiratory tract infections
In vitro activity of thiamphenicol against Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes clinical isolates
Objective.
To determine in vitro activity of thiamphenicol and other clinically available antimicrobials against clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes.
Materials and Methods.
We included in the study 875 clinical isolates from 20 Russian cities during 2018β2019. Among tested strains, 126 were H. influenzae, 389 β S. pneumoniae, 360 β S. pyogenes. Antimicrobial susceptibility testing was performed using broth microdilution method according to ISO 20776-1:2006. AST results were interpreted according to EUCAST v.11.0 clinical breakpoints.
Results.
The minimum inhibitory concentrations (MICs) of thiamphenicol did not exceed 2 mg/L for 94.4% of H. influenzae strains (MIC50 and MIC90 were 0.5 and 1 mg/L, respectively). Thiamphenicol was active against 76.9% of ampicillin-resistant H. influenzae strains (MIC of thiamphenicol 0.06 mg/L) did not exceed 2 mg/L. A total of 88.1% of S. pneumoniae strains resistant to erythromycin were highly susceptible to thiamphenicol (MIC < 2 mg/L). The MIC of thiamphenicol did not exceed 8 mg/L for 96.1% of S. pyogenes strains (MIC50 and MIC90 were 2 and 4 mg/L, respectively).
Conclusions.
Thiamphenicol was characterized by relatively high in vitro activity, comparable to that of chloramphenicol, against tested strains of H. influenzae, S. pneumoniae and S. pyogenes, including S. pneumoniae isolates with reduced susceptibility to penicillin
Cefpodoxime proxetil β new opportunities in antibacterial therapy of respiratory infections
The purpose of the expert council was to determine the place of cefpodoxime in the ABT algorithms for upper and lower respiratory tract infections and to form a consensus position on its use in clinical practice. Based on the available data, the possibility of including cefpodoxime in national guidelines for the treatment of rhinosinusitis, acute tonsillopharyngitis, community-acquired pneumonia (CAP), as well as infectious exacerbations of chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD) is being considered
Antimicrobial resistance of clinical isolates of Klebsiella pneumoniae and Escherichia coli in Russian hospitals: results of a multicenter epidemiological study
Objective.
To study the prevalence and mechanisms of antibiotic resistance, including carbapenemase production, in clinical isolates of Klebsiella pneumoniae and Escherichia coli isolated in different regions of Russia as part of the sentinel multicenter surveillance study in 2020β2021, and to explore the population structure of K. pneumoniae and the impact of βhigh-risk clonesβ on antibiotic resistance.
Materials and Methods.
Consecutive, non-duplicate isolates of K. pneumoniae (n = 2503) and E. coli (n = 2055) isolated from various specimens (blood, cerebrospinal fluid, respiratory samples, urine, wound secretions, etc.) of hospitalized patients with clinical signs of infection in 55 hospitals of 29 cities of Russia were studied. Species identification of isolates was performed by matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antibiotic susceptibilities were determined by serial broth microdilution or, in the case of fosfomycin, by agar dilution method, and results were interpreted according to EUCAST v13 MIC breakpoints. Carbapenemase production was determined phenotypically by carbapenem inactivation method (CIM), the presence of genes of the most common serine carbapenemases (KPC, OXA-48) and metallo-Ξ²-lactamases (VIM, IMP, NDM) was determined by real-time PCR. K. pneumoniae clinical isolates were genotyped and assigned to the known clonal complexes (CC) and sequence types (ST) using SNP typing and multilocus sequencing typing (MLST) methods. K- and O-serotypes, acquired resistance and virulence genes, and plasmids carrying these genes were characterized using whole-genome sequencing of selected isolates (n = 215).
Results.
The resistance rates of nosocomial/community-acquired isolates of K. pneumoniae were as follows: amoxicillin-clavulanate β 88.63/57.99%, piperacillin-tazobactam β 82.92/45.49%, cefotaxime β 87.74/56.97%, ceftazidime β 84.76/53.07%, cefepime β 81.43/49.18%, aztreonam β 1.63/53.28%, ceftazidime-avibactam β 30, 88/9.22%, ceftolozan-tazobactam β 70.06/31.35%, ertapenem β 72.10/28.69%, meropenem β 49.60/15.16%, imipenem β 44.54/13.73%, gentamicin β 60.82/30.33%, amikacin β 42.06/17.21%, ciprofloxacin β 85.10/49.39%; trimethoprimsulfamethoxazole β 74.38/48.16%, colistin β 5.96/2.25%. The resistance of nosocomial/outpatient isolates of E. coli were: ampicillin β 84.93/67.67%, amoxicillin-clavulanate β 57.37/39.73%, piperacillin-tazobactam β 19.48/8.70%, cefotaxime β 63.83/34.19%, ceftazidime β 45.32/20.34%, cefepime β 35.95/16.61%, aztreonam β 51.78/26.11%, ceftazidime-avibactam β 5.71/0.80%, ceftolozane-tazobactam β 11, 95/2.22%, ertapenem β 8.18/1.42%, meropenem β 5.17/0.53%, imipenem β 4.95/0.36%, gentamicin β 24.54/13.68%, amikacin β 5.49/1.42%, ciprofloxacin β 54, 14/32.50%, trimethoprim-sulfamethoxazole β 52.21/38.54%, fosfomycin β 2.48/1.43%, colistin β 1.60/1.07%, tigecycline β 6.35/3.11%. The frequency of carbapenemase production among K. pneumoniae nosocomial isolates was 65.32% (OXA-48 β 40.75%, NDM β 30.28%, KPC β 8.74%, OXA-48 + NDM β 10.62%, OXA-48 + KPC β 2.98%, NDM + KPC β 0.45%, OXA-48 + NDM + KPC β 0.20%). More than 70% of nosocomial isolates of K. pneumoniae belonged to only 7 major genetic lineages known as βhigh-risk international clonesβ: CC395 β 37.40%, CC23 β 9.59%, CC307 β 8.64%, CC147 β 7.61%, CC15 β 2.95%, CC258 β 2.92%, and CC11 β 2.41%. The population of community-acquired K. pneumoniae was characterized by significantly greater genetic diversity (Simpson diversity index: D = 0.919; 95% CI: 0.904 to 0.933) compared with the population of nosocomial strains (Simpson diversity index: D = 0.815; 95% CI: 0.802 to 0.827). Strains of the βhypervirulentβ genetic lineage of K. pneumoniae CC23 were more common in community-acquired infections.
Conclusions.
The extremely high frequency of resistance to cephalosporins in K. pneumoniae (> 80%) and E. coli (> 60%), as well as the high frequency of combined resistance to aminoglycosides and fluoroquinolones precludes their empirical use for the treatment of serious nosocomial infections caused by these pathogens. K. pneumoniae shows a rapid increase in resistance to carbapenems, mainly due to the spread of carbapenemases of three major groups: OXA-48, NDM and KPC. The overall increase in the frequency of carbapenemase production is accompanied by the growing diversity of carbapenemases, the increasing prevalence of strains producing NDM and KPC enzymes and those co-producing multiple carbapenemases simultaneously. In community-acquired infections, the high prevalence of resistance to cephalosporins in E. coli (> 30%) and K. pneumoniae (> 50%) remains the most important problem
ΠΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π½Π΅ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠΎΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ "ΠΡΡΠΎΡΠΈΠ°ΡΠΈΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ²-ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ²", ΠΠ΅ΠΆΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ "ΠΠ»ΡΡΠ½Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ Ρ ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΎΠ² ΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ²", ΠΠ΅ΠΆΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ ΠΏΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠΉ Ρ ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠΠΠΠΠ₯), ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ "Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ Π‘Π΅ΠΏΡΠΈΡ Π€ΠΎΡΡΠΌ" "ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ, Π²ΡΠ·Π²Π°Π½Π½ΡΡ ΠΏΠΎΠ»ΠΈΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΠΌΠΈ ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ"
Introduction. Strains of microorganisms resistant to antimicrobial agents are commonly found in medical units throughout most regions of the world, including Russia. This leads to lower antimicrobial therapy efficacy when treating nosocomial infections. In this regard, the timely implementation of adequate antibiotic therapy is of great importance. The objective of the guidelines: To provide summarized information on contemporary approaches to microbiological diagnostics and the assessment of results, as well as the principles of rational use of antimicrobial and antifungal agents, including treatment of infections caused by multiple drug-resistant strains of microorganisms. Subjects and methods. These guidelines are based on published data obtained in the course of randomized trials, as well as information presented in the provisions of international guidelines supported by high-level evidence. The guidelines were prepared by a working group of Russian experts with extensive experience in research and practical work in this area. On October 11, 2019, the final version of the guidelines was reviewed and approved at a joint meeting of the working group and representatives of the public organizations which initiated the development of these guidelines (Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), NGO Russian Sepsis Forum). Conclusion. The guidelines reflect an interdisciplinary consensus of approaches to the diagnostics and antibiotic therapy of infections caused by multiresistant microorganisms. The provisions set forth should be used to decide on the strategy of empirical and etiotropic therapy of the most severe infections.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π΅ ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ² ΠΌΠΈΡΠ°, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΈ Π² Π ΠΎΡΡΠΈΠΈ, ΠΏΠΎΠ»ΡΡΠ°ΡΡ ΡΠΈΡΠΎΠΊΠΎΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ ΡΡΠ°ΠΌΠΌΡ ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠΎΠ², Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠΈΠ΅ΡΡ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΡΡ ΠΊ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΡ
Π² ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡΡ
Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², ΡΡΠΎ Π·Π°ΠΊΠΎΠ½ΠΎΠΌΠ΅ΡΠ½ΠΎ Π²Π΅Π΄Π΅Ρ ΠΊ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π½ΠΎΠ·ΠΎΠΊΠΎΠΌΠΈΠ°Π»ΡΠ½ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ. Π ΡΡΠΎΠΉ ΡΠ²ΡΠ·ΠΈ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π°Π΄Π΅ΠΊΠ²Π°ΡΠ½ΠΎΠΉ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ°Π΅Ρ ΠΎΡΠ΅Π½Ρ Π±ΠΎΠ»ΡΡΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅. Π¦Π΅Π»Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ: ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ Π² ΠΎΠ±ΠΎΠ±ΡΠ΅Π½Π½ΠΎΠΌ Π²ΠΈΠ΄Π΅ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΎ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°Ρ
ΠΊ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ ΠΎΡΠ΅Π½ΠΊΠ΅ Π΅Π΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΠΎ ΠΏΡΠΈΠ½ΡΠΈΠΏΠ°Ρ
ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΡΡ
ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ³ΡΠΈΠ±ΠΊΠΎΠ²ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ², Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΏΡΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΡΡ
, Π²ΡΠ·Π²Π°Π½Π½ΡΡ
ΠΏΠΎΠ»ΠΈΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΠΌΠΈ ΡΡΠ°ΠΌΠΌΠ°ΠΌΠΈ ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠΎΠ². ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΎΡΠ½ΠΎΠ²Ρ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΈΠ· ΠΏΡΠ±Π»ΠΈΠΊΠ°ΡΠΈΠΉ, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ Π² Ρ
ΠΎΠ΄Π΅ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Π½ΡΠ΅ Π² ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
Π² Π²ΠΈΠ΄Π΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ, ΠΈΠΌΠ΅ΡΡΠΈΡ
Π²ΡΡΠΎΠΊΡΡ ΡΡΠ΅ΠΏΠ΅Π½Ρ Π΄ΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ. Π Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²Π»Π΅Π½Ρ ΡΠ°Π±ΠΎΡΠ΅ΠΉ Π³ΡΡΠΏΠΏΠΎΠΉ ΡΠΎΡΡΠΈΠΉΡΠΊΠΈΡ
ΡΠΊΡΠΏΠ΅ΡΡΠΎΠ², ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΡ
Π±ΠΎΠ»ΡΡΠΈΠΌ ΠΎΠΏΡΡΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΎΠΉ ΠΈ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ°Π±ΠΎΡΡ Π² ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΠΌΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ. ΠΠΊΠΎΠ½ΡΠ°ΡΠ΅Π»ΡΠ½ΡΠΉ Π²Π°ΡΠΈΠ°Π½Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ Π±ΡΠ» ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½ ΠΈ ΡΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ 11.10.2019 Π³. Π½Π° ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎΠΌ Π·Π°ΡΠ΅Π΄Π°Π½ΠΈΠΈ ΡΠ°Π±ΠΎΡΠ΅ΠΉ Π³ΡΡΠΏΠΏΡ ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΠ΅Π»Π΅ΠΉ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΉ - ΠΈΠ½ΠΈΡΠΈΠ°ΡΠΎΡΠΎΠ² ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ ΠΠ΅ΡΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ (Π ΠΎΡΡΠΈΠΉΡΠΊΠ°Ρ Π½Π΅ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Β«ΠΡΡΠΎΡΠΈΠ°ΡΠΈΡ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ²-ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ²Β», ΠΠ΅ΠΆΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½Π°Ρ ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Β«ΠΠ»ΡΡΠ½Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΎΠ² ΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΎΠ²Β», ΠΠ΅ΠΆΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½Π°Ρ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΡ ΠΏΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠΉ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠΠΠΠΠ₯), ΠΎΠ±ΡΠ΅ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ Β«Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ Π‘Π΅ΠΏΡΠΈΡ Π€ΠΎΡΡΠΌΒ»). ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΎΡΡΠ°ΠΆΠ°ΡΡ ΠΌΠ΅ΠΆΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΠΎΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΡΠ½ΠΎΠ΅ ΠΌΠ½Π΅Π½ΠΈΠ΅ ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π°Ρ
ΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ, Π²ΡΠ·Π²Π°Π½Π½ΡΡ
ΠΏΠΎΠ»ΠΈΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΠΌΠΈ ΠΌΠΈΠΊΡΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ. ΠΠ·Π»ΠΎΠΆΠ΅Π½Π½ΡΠ΅ Π² Π½ΠΈΡ
ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ ΠΏΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ ΡΠΌΠΏΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΡΡΠΈΠΎΡΡΠΎΠΏΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΡ
ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ