antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»antibiotics-617Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR PRACTITIONERSОбнаружение генетических маркеров резистентности к β-лактамным антибиотикам у грамотрицательных микроорганизмов с помощью ПЦР-диагностикиDiscovery of Genetic Markers of Resistance to β-Lactams in Gramnegative Microorganisms by PCR DiagnosisЛисицынаЕ. С.LisitsinaE. S.noemail@neicon.ruЧерненькаяТ. В.ChernenkayaT. V.noemail@neicon.ruИльинаЕ. Н.IlyinaE. N.noemail@neicon.ruЛазареваИ. В.LazarevaI. V.noemail@neicon.ruАгеевецВ. А.AgeevetsV. A.noemail@neicon.ruСидоренкоС. В.SidorenkoS. V.noemail@neicon.ruНПФ «Литех»РоссияLitekh CoRussian FederationНИИ скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency ServiceRussian FederationНИИ физико-химической медицины ФМБА РоссииРоссияResearch Institute of Physico-Chemical MedicineRussian FederationНИИ детских инфекций ФМБА РоссииРоссияResearch Institute of Children's Infections, Federal Medico-Biological AgencyRussian Federation201513052020609-101722Copyright © Лисицына Е.С., Черненькая Т.В., Ильина Е.Н., Лазарева И.В., Агеевец В.А., Сидоренко С.В., 20202020Лисицына Е.С., Черненькая Т.В., Ильина Е.Н., Лазарева И.В., Агеевец В.А., Сидоренко С.В.Lisitsina E.S., Chernenkaya T.V., Ilyina E.N., Lazareva I.V., Ageevets V.A., Sidorenko S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.antibiotics-chemotherapy.ru/jour/article/view/617

В исследование включены образцы биологического материала (15 образцов гемокультуры и 89 образцов бронхоальвеолярного лаважа), из которого были выделены монокультуры грамотрицательных бактерий устойчивых к цефотаксиму, цефепиму, имипенему, меропенему. В отобранных образцах методом ПЦР с детекцией результатов в режиме реального времени (ПЦР-тест систем ООО НПФ «Литех») были обнаружены гены бета-лактамаз: bla/CTX- M-like(72/104, 69,2%), blaNDM (6/104, 5,8%), blaVIM (49/104, 47,1%) и blaOXA48_like (59/104, 56,7%). Выявлена корреляция между фенотипом устойчивости Acinetobacter spp., Pseudomonas aeruginosa, Klebsiella pneumoniae и Escherichia coli к цефотаксиму и карбапенемным антибиотикам и выявлением генов blaCTX_M_like и blaNDM. В то же время до 70% K.pneumoniae, выделенных из биологических образцов, положительных на наличие генов карбапенемаз blaVIM и blaOXA48-like демонстрировали фенотипическую чувствительность к карбапенемам. Полученные результаты подтверждают прогностические возможности генетической диагностики для улучшения традиционного бактериологического исследования.

Fifteen specimens of the hemoculture and 89 specimens of the broncho-alveolar lavage were used in the study. Monocultures of gramnegative bacteria resistant to cefotaxime, cefepime, imipenem and meropenem were isolated from the specimens. The PCR method with detection of the results in the real time regimen (PCR test-system Litekh) provided detection of the beta-lactamase genes: bla/CTX- M-like (72/104, 69.2%), blaNDM (6/104, 5.8%), blaVIM (49/104, 47,1%) and blaOXA48_like (59/104, 56.7%). There was identified correlation between the phenotype of resistance of Acinetobacter spp., Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli to cefotaxime and carbopenems and detection of the blaCTX_M_like and blaNDM genes. At the same time, up to 70% of the K.pneumoniae isolates from the biological specimes positive with respect to the presence of the carbapenase blaVIM and blaOXA48-like genes demonstrated their phenotypic susceptibility to carbopenems. The results of the study confirmed the prognostic value of the genetic diagnosis for improvement of the routine bacteriological investigations.

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The authors declare that there are no conflicts of interest present.