9 research outputs found
COVID19 pandemic is a Β«pandemicΒ» of antimicrobial therapy
The article presents a critical analysis of antibiotic usage tactics in the treatment of patients with COVID-19 existing in Russian and foreign healthcare, and discusses the possible causes of unjustified antibiotic aggression in this category of patients. The potential negative consequences of the widespread use of antibiotics in patients carrying a new coronavirus infection are analyzed: life-threatening cardiotoxicity in patients with the simultaneous administration of such a "popular" candidate etiologic therapy as a combination of azithromycin and hydroxychloroquine, the potential development of other serious adverse drug reactions (in particular, the development of an antibiotic-associated pseudomembranous colitis, etc.), the expected dramatic increase in the secondary drug resistance of potentially pathogenic microorganisms to widely and often prescribed antibiotics
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
ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ : ΡΡΠΎ Π½Π°Ρ ΠΆΠ΄Π΅Ρ Π² 2019 Π³
Community-acquired pneumonia remains one of the main problems of modern medicine due to high incidence, mortality and costs for medical care. In 2019 a new version of clinical guidelines for diagnosis, treatment and prevention of community-acquired pneumonia in adults will be presented in Russia. The article is devoted to the most significant changes in new clinical guidelines.ΠΠ½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½Π°Ρ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΡ ΠΎΡΡΠ°Π΅ΡΡΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ, ΡΡΠΎ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½ΠΎ Π²ΡΡΠΎΠΊΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡΡ, ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ Π²ΠΊΠ»Π°Π΄ΠΎΠΌ Π² ΡΡΡΡΠΊΡΡΡΡ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ Π·Π°ΡΡΠ°ΡΠ°ΠΌΠΈ Π½Π° ΠΎΠΊΠ°Π·Π°Π½ΠΈΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ. Π 2019 Π³. Π² Π ΠΎΡΡΠΈΠΈ ΠΏΠΎΡΠ²ΠΈΡΡΡ Π½ΠΎΠ²Π°Ρ Π²Π΅ΡΡΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΠΏΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
. Π‘ΡΠ°ΡΡΡ ΠΏΠΎΡΠ²ΡΡΠ΅Π½Π° ΠΎΠ±Π·ΠΎΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π² Π½ΠΎΠ²ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
ΠΠΎΠ»Π΅Π·Π½ΠΈ ΠΎΡΠ³Π°Π½ΠΎΠ² Π΄ΡΡ Π°Π½ΠΈΡ
ΠΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½Π°Ρ Π°ΡΡΠΌΠ°(ΠΠ) - Π³Π΅ΡΠ΅ΡΠΎΠ³Π΅Π½Π½ΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠ΅Π΅ΡΡ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΠ΅ΠΌ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ, Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ², ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ ΡΠ²ΠΈΡΡΡΡΠΈΠ΅ Ρ
ΡΠΈΠΏΡ, ΠΎΠ΄ΡΡΠΊΠ°, Π·Π°Π»ΠΎΠΆΠ΅Π½Π½ΠΎΡΡΡ Π² Π³ΡΡΠ΄ΠΈ ΠΈ ΠΊΠ°ΡΠ΅Π»Ρ, ΠΊΠΎΡΠΎΡΡΠ΅ Π²Π°ΡΡΠΈΡΡΡΡΡΡ ΠΏΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ ΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ ΠΏΡΠΎΡΠ²Π»ΡΡΡΡΡ Π²ΠΌΠ΅ΡΡΠ΅ Ρ Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΠΉ ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ΅ΠΉ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ
ΠΠ½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ : Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄ΠΎΠ²
This paper presents mechanism of action and antimicrobial spectrum of macrolides as well as the known acquired resistance mechanisms in the common pathogens causing community-acquired pneumonia, such as Streptococcus pneumoniae and Mycoplasma pneumoniae. Non-antimicrobial (anti-inflammatory and immunomodulatory) effects of macrolides that have been found in experimental and clinical studies are described in detail. Results of clinical studies and current practice guidelines which determine potential benefits and a role of macrolides in the antibacterial therapy of severe community-acquired pneumonia in adults are reviewed.Π Π΄Π°Π½Π½ΠΎΠΉ ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΈ ΡΠΏΠ΅ΠΊΡΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄Π½ΡΡ
Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΠΈΠ·Π²Π΅ΡΡΠ½ΡΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΠΏΡΠΈΠΎΠ±ΡΠ΅ΡΠ΅Π½Π½ΠΎΠΉ ΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΡΡΠΈ ΠΊ Π½ΠΈΠΌ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ, ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ Streptococcus pneumoniae ΠΈ Mycoplasma pneumoniae. ΠΠΎΠ΄ΡΠΎΠ±Π½ΠΎ ΠΎΠΏΠΈΡΠ°Π½Ρ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠ΅ Π² ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
Π½Π΅Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΡΠ΅ (ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅, ΠΈΠΌΠΌΡΠ½ΠΎΠΌΠΎΠ΄ΡΠ»ΠΈΡΡΡΡΠΈΠ΅) ΡΡΡΠ΅ΠΊΡΡ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄ΠΎΠ². ΠΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠΈΠ΅ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π° ΠΈ ΠΌΠ΅ΡΡΠΎ ΠΌΠ°ΠΊΡΠΎΠ»ΠΈΠ΄ΠΎΠ² Π² Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
Etiology of severe community-acquired pneumonia in adults: Results of the first Russian multicenter study [ΠΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ : ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠ΅ΡΠ²ΠΎΠ³ΠΎ ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠ³ΠΎ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ]
Aim: to study the etiology of severe community-acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio-economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. Materials and methods. A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi-word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real-time PCR for identification of βatypicalβ bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. Results. Altogether 109 patients (60.6% male; mean age 50.8Β±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co-infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. Conclusion. S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono-infection should be taken into account. Β© 2020 Consilium Medikum. All rights reserved
ΠΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ : ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠ΅ΡΠ²ΠΎΠ³ΠΎ ΡΠΎΡΡΠΈΠΉΡΠΊΠΎΠ³ΠΎ ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
Aim: to study the etiology of severe community - acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio - economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. Materials and methods. A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi - word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real - time PCR for identification of βatypicalβ bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. Results. Altogether 109 patients (60.6% male; mean age 50.8Β±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co - infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. Conclusion. S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono - infection should be taken into account.Π¦Π΅Π»Ρ - ΠΈΠ·ΡΡΠΈΡΡ ΡΡΡΡΠΊΡΡΡΡ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ (Π’ΠΠ) Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ (Π Π€). Π’ΠΠ ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌ Ρ Π²ΡΡΠΎΠΊΠΎΠΉ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡΡ ΠΈ ΠΎΡΠ»ΠΈΡΠ°Π΅ΡΡΡ Π·Π½Π°ΡΠΈΠΌΡΠΌ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ - ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ Π±ΡΠ΅ΠΌΠ΅Π½Π΅ΠΌ Π΄Π»Ρ ΠΎΠ±ΡΠ΅ΡΡΠ²Π°. ΠΠ΄Π΅ΠΊΠ²Π°ΡΠ½Π°Ρ ΡΠΌΠΏΠΈΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π΄ΠΎΠ»ΠΆΠ½Π° ΠΎΡΠ½ΠΎΠ²ΡΠ²Π°ΡΡΡΡ Π½Π° Π·Π½Π°Π½ΠΈΠΈ ΡΠΏΠ΅ΠΊΡΡΠ° ΠΊΠ»ΡΡΠ΅Π²ΡΡ
Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ ΠΈ ΠΈΡ
ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΊ Π°Π½ΡΠΈΠΌΠΈΠΊΡΠΎΠ±Π½ΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, Π²ΡΠΏΠΎΠ»Π½ΡΠ²ΡΠ΅Π΅ΡΡ Π² ΠΌΠ½ΠΎΠ³ΠΎΠΏΡΠΎΡΠΈΠ»ΡΠ½ΡΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
6 Π³ΠΎΡΠΎΠ΄ΠΎΠ² Π Π€ Π² 2014-2018 Π³Π³., Π²ΠΊΠ»ΡΡΠ°Π»ΠΈΡΡ Π²Π·ΡΠΎΡΠ»ΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Ρ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Π’ΠΠ. ΠΠ»Ρ Π²Π΅ΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΊΡΠ»ΡΡΡΡΠ°Π»ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈΡΡ ΠΊΡΠΎΠ²Ρ, ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠ΅ ΠΎΠ±ΡΠ°Π·ΡΡ (ΠΌΠΎΠΊΡΠΎΡΠ°, ΡΠ½Π΄ΠΎΡΡΠ°Ρ
Π΅Π°Π»ΡΠ½ΡΠΉ Π°ΡΠΏΠΈΡΠ°Ρ, Π±ΡΠΎΠ½Ρ
ΠΎΠ°Π»ΡΠ²Π΅ΠΎΠ»ΡΡΠ½ΡΠΉ Π»Π°Π²Π°ΠΆ), Π°ΡΡΠΎΠΏΡΠΈΠΉΠ½ΡΠ΅ ΠΎΠ±ΡΠ°Π·ΡΡ Ρ ΡΠΌΠ΅ΡΡΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²; ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΡΡ ΡΠΊΡΠΏΡΠ΅ΡΡ - ΡΠ΅ΡΡΡ Π΄Π»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠ³Π΅Π½ΡΡΠΈΠΈ (L. pneumophila cΠ΅ΡΠΎΠ³ΡΡΠΏΠΏΠ° 1 ΠΈ S. pneumoniae). Β«AΡΠΈΠΏΠΈΡΠ½ΡΠ΅Β» Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Ρ (M. pneumoniae, C. pneumoniae, L. pneumophila) ΠΈ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠ΅ Π²ΠΈΡΡΡΡ (Π²ΠΈΡΡΡΡ Π³ΡΠΈΠΏΠΏΠ° Π ΠΈ Π, ΠΏΠ°ΡΠ°Π³ΡΠΈΠΏΠΏΠ°, ΡΠΈΠ½ΠΎΠ²ΠΈΡΡΡ, ΠΌΠ΅ΡΠ°ΠΏΠ½Π΅Π²ΠΌΠΎΠ²ΠΈΡΡΡ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° ΠΈ Π΄Ρ.) Π²ΡΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΠΎΠ»ΠΈΠΌΠ΅ΡΠ°Π·Π½ΠΎΠΉ ΡΠ΅ΠΏΠ½ΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ Π² ΡΠ΅ΠΆΠΈΠΌΠ΅ ΡΠ΅Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΡΡΠΎΠ². Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠ΅Π³ΠΎ Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 109 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (ΠΌΡΠΆΡΠΈΠ½ - 60,6%, ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ 50,8Β±18,0 Π»Π΅Ρ) Ρ Π’ΠΠ. ΠΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»ΠΈ Π’ΠΠ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ Π² 65,1% ΡΠ»ΡΡΠ°Π΅Π²; Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Π²ΡΡΠ²Π»ΡΠ»ΠΈΡΡ S. pneumoniae, ΡΠΈΠ½ΠΎΠ²ΠΈΡΡΡΡ, S. aureus ΠΈ K. pneumoniae (43,7, 15,5, 14,1 ΠΈ 11,3% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² c ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ). ΠΠ°ΠΊΡΠ΅ΡΠΈΠ΅ΠΌΠΈΡ Π²ΡΡΠ²Π»Π΅Π½Π° Π² 14,6% ΡΠ»ΡΡΠ°Π΅Π², S. pneumoniae ΡΠ²Π»ΡΠ»ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΠΌ ΠΏΠ°ΡΠΎΠ³Π΅Π½ΠΎΠΌ. ΠΠ²Π° ΠΈ Π±ΠΎΠ»Π΅Π΅ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Ρ Π’ΠΠ Π²ΡΡΠ²Π»Π΅Π½Ρ Π² 36,6% ΡΠ»ΡΡΠ°Π΅Π². Π‘ΡΠ΅Π΄ΠΈ ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΉ ΠΏΡΠ΅Π²Π°Π»ΠΈΡΠΎΠ²Π°Π»ΠΎ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠ΅ Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ (ΡΠ°ΡΠ΅ Π²ΡΠ΅Π³ΠΎ S. pneumoniae Ρ S. aureus ΠΈΠ»ΠΈ/ΠΈ Enterobacterales) - 57,7%; Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ ΠΈ Π²ΠΈΡΡΡΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½Ρ Ρ 38,5% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π² 1 ΡΠ»ΡΡΠ°Π΅ Π²ΡΡΠ²Π»Π΅Π½Π° ΠΊΠΎ - ΠΈΠ½ΡΠ΅ΠΊΡΠΈΡ Π΄Π²ΡΠΌΡ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΠΌΠΈ Π²ΠΈΡΡΡΠ°ΠΌΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π ΡΡΡΡΠΊΡΡΡΠ΅ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ Π’ΠΠ Ρ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
Π²Π·ΡΠΎΡΠ»ΡΡ
Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π» S. pneumoniae. Π‘Π»Π΅Π΄ΡΠ΅Ρ ΠΎΡΠΌΠ΅ΡΠΈΡΡ Π²ΡΡΠΎΠΊΡΡ ΡΠ°ΡΡΠΎΡΡ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΡΡ
Π²ΠΈΡΡΡΠΎΠ² (ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠΈΠ½ΠΎΠ²ΠΈΡΡΡ ΠΈ Π²ΠΈΡΡΡΡ Π³ΡΠΈΠΏΠΏΠ°) ΠΊΠ°ΠΊ Π² Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠΈ Ρ Π±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΠΌΠΈ Π²ΠΎΠ·Π±ΡΠ΄ΠΈΡΠ΅Π»ΡΠΌΠΈ, ΡΠ°ΠΊ ΠΈ Π² ΠΌΠΎΠ½ΠΎΠΊΡΠ»ΡΡΡΡΠ΅
ΠΠ°ΠΊΡΠΈΠ½ΠΎΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ . Π Π΅Π·ΠΎΠ»ΡΡΠΈΡ ΡΠΎΠ²Π΅ΡΠ° ΡΠΊΡΠΏΠ΅ΡΡΠΎΠ² (ΠΠΎΡΠΊΠ²Π°, 16 Π΄Π΅ΠΊΠ°Π±ΡΡ 2017 Π³.)
The following key issues of pneumococcal infection prophylaxis were discussed during the expert council: incidence rates of community-acquired pneumococcal pneumonia and other pneumococcal infections, local epidemiological data, increases in antimicrobial resistance and pneumococcal serotypes substitution, current international and Russian clinical guidelines, practical approaches, and pneumococcal vaccination coverage of adult population in the Russian Federation. The agreement between the experts about a need to distinguish the use of conjugate vaccines and polysaccharide vaccines in different subpopulations has been achieved.Π Ρ
ΠΎΠ΄Π΅ ΡΠΎΠ²Π΅ΡΠ° ΡΠΊΡΠΏΠ΅ΡΡΠΎΠ² ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½Ρ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ Π²ΠΎΠΏΡΠΎΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ (ΠΠ): ΡΠΈΡΡΠ°ΡΠΈΡ Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡΡ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ (ΠΠ) ΠΈ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΠ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΠΎΡΡΠ° ΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΡΡΠΈ ΠΈ Π·Π°ΠΌΠ΅ΡΠ΅Π½ΠΈΡ ΡΡΠ°ΠΌΠΌΠΎΠ² ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠ°, ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΠ΅ ΠΈ ΡΠΎΡΡΠΈΠΉΡΠΊΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ, ΡΠ΅ΠΊΡΡΠΈΠ΅ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ, ΠΎΡ
Π²Π°Ρ Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΠ΅ΠΉ Π²Π·ΡΠΎΡΠ»ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Π Π€. Π‘ΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½ΠΎ ΠΊΠΎΠ½ΡΠΎΠ»ΠΈΠ΄ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΌΠ½Π΅Π½ΠΈΠ΅ ΠΎ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΡΠ°Π·Π³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΠ³ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈ ΠΏΠΎΠ»ΠΈΡΠ°Ρ
Π°ΡΠΈΠ΄Π½ΡΡ
Π²Π°ΠΊΡΠΈΠ½ Π² ΡΠ°Π·Π½ΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ
ΠΠ°ΠΊΡΠΈΠ½ΠΎΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ . Π Π΅Π·ΠΎΠ»ΡΡΠΈΡ ΡΠΎΠ²Π΅ΡΠ° ΡΠΊΡΠΏΠ΅ΡΡΠΎΠ² (ΠΠΎΡΠΊΠ²Π°, 16 Π΄Π΅ΠΊΠ°Π±ΡΡ 2017 Π³.)
The following key issues of pneumococcal infection prophylaxis were discussed during the expert council: incidence rates of community-acquired pneumococcal pneumonia and other pneumococcal infections, local epidemiological data, increases in antimicrobial resistance and pneumococcal serotypes substitution, current international and Russian clinical guidelines, practical approaches, and pneumococcal vaccination coverage of adult population in the Russian Federation. The agreement between the experts about a need to distinguish the use of conjugate vaccines and polysaccharide vaccines in different subpopulations has been achieved.Π Ρ
ΠΎΠ΄Π΅ ΡΠΎΠ²Π΅ΡΠ° ΡΠΊΡΠΏΠ΅ΡΡΠΎΠ² ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½Ρ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ Π²ΠΎΠΏΡΠΎΡΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ (ΠΠ): ΡΠΈΡΡΠ°ΡΠΈΡ Ρ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡΡ Π²Π½Π΅Π±ΠΎΠ»ΡΠ½ΠΈΡΠ½ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠΎΠ²ΠΎΠΉ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ (ΠΠ) ΠΈ Π΄ΡΡΠ³ΠΈΠΌΠΈ ΠΠ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π»ΠΎΠΊΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΠΎΡΡΠ° ΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΠΎΡΡΠΈ ΠΈ Π·Π°ΠΌΠ΅ΡΠ΅Π½ΠΈΡ ΡΡΠ°ΠΌΠΌΠΎΠ² ΠΏΠ½Π΅Π²ΠΌΠΎΠΊΠΎΠΊΠΊΠ°, ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΠ΅ ΠΈ ΡΠΎΡΡΠΈΠΉΡΠΊΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ, ΡΠ΅ΠΊΡΡΠΈΠ΅ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ, ΠΎΡ
Π²Π°Ρ Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΠ΅ΠΉ Π²Π·ΡΠΎΡΠ»ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Π Π€. Π‘ΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°Π½ΠΎ ΠΊΠΎΠ½ΡΠΎΠ»ΠΈΠ΄ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΌΠ½Π΅Π½ΠΈΠ΅ ΠΎ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΡΠ°Π·Π³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠ½ΡΡΠ³ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈ ΠΏΠΎΠ»ΠΈΡΠ°Ρ
Π°ΡΠΈΠ΄Π½ΡΡ
Π²Π°ΠΊΡΠΈΠ½ Π² ΡΠ°Π·Π½ΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ