Ванкомицинорезистентные клинические штаммы Enterococcus spp. и Staphylococcus aureus

Ванкомицинорезистентные энтерококки (VRE) представляют серьёзную угрозу для общественного здравоохранения в связи с их высокой устойчивостью к антибиотикам, способностью вызывать тяжёлые инфекции и рост смертности в связи с ограничением терапевтических возможностей. В связи с этим изучение молекулярно-генетических характеристик ванкомицинорезистентных штаммов приобретает особую актуальность. Метициллинорезистентный золотистый стафилококк (MRSA) является основным полирезистентным внутрибольничным патогеном. Ванкомицин по-прежнему остаётся золотым стандартом терапии инвазивных инфекций, вызванных MRSA наряду с некоторыми другими анти-MRSA препаратами, такими как тейкопланин, линезолид и даптомицин. Ранее к ванкомицинорезистентным MRSA (VRSA) относили штаммы с МПК I 16 мкг/мл, однако у пациентов число случаев обусловленных такими штаммами всё ещё ограничено. С клинической точки зрения ванкомицин становится менее эффективным в отношении инфекций, вызванных штаммами MRSA с МПК к ванкомицину I 1,5– 2 мкг/мл. Выделяют категории штаммов S. aureus с промежуточной чувствительностью к ванкомицину (VISA) и гетерогенной чувствительностью к ванкомицину VISA (hVISA), как правило, относящиеся к HA-MRSA, часть из которых на сегодняшний день отнесены EUCAST к ванкомицинорезистентным.

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