perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2016-61-4-49-54perinatology-352Research ArticleПЕРИНАТОЛОГИЯ И НЕОНАТОЛОГИЯPERINATOLOGY AND NEONATOLOGYКлебсиеллезный неонатальный сепсисNeonatal sepsis caused by KlebsiellaЦарегородцевА. Д.TsaregorodtsevA. D.

д.м.н., проф., советник ректора Российского национального медицинского университета им. Н. И. Пирогова 117997 Москва, ул. Островитянова, д.1

ХаертыновХ. С.KhaertynovKh. S.

к.м.н., доцент кафедры детских инфекций Казанского государственного медицинского университета

АнохинВ. А.AnokhinV. A.

д.м.н., проф., зав. той же кафедрой

НиколаеваИ. В.NikolaevaI. V.

д.м.н., доцент той же кафедры

СеменоваД. Р.SemenovaD. R.

аспирант той же кафедры 420012 Казань, ул. Бутлерова, 49

ЛюбинС. А.LyubinS. A.

зав. отдел. реанимации новорожденных городской детской больницы №1 г. Казани

АгаповаИ. В.AgapovaI. V.

зав. отдел. патологии новорожденных той же больницы 420034 Казань, ул. Декабристов, 125а

СкворцоваН. Н.SkvortsovaN. N.

врач-бактериолог Республиканской клинической инфекционной больницы 420140 Казань, пр. Победы, 83

ГБОУ ВПО «Российский национальный медицинский университ им. Н. И. Пирогова» Минздрава России, Москва; Казанский государственный медицинский университет, Казань; Городская детская больница №1, Казань; Республиканская клиническая инфекционная больница, КазаньРоссияN. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow; Kazan State Medical University, Kazan; City Children's Hospital One, Kazan; Republican Clinical Infectious Diseases Hospital, KazanRussian Federation2016060920166144954Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20162016Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/352

Клебсиеллы являются одной из наиболее распространенных причин развития неонатального сепсиса. Наибольшую актуальность представляют случаи заболевания, обусловленные штаммами клебсиелл, продуцирующими β-лактамазы расширенного спектра. Инфекции, вызванные этими штаммами бактерий, отличаются резистентностью возбудителя к большинству широко используемых в практике цефалоспоринов и значительной летальностью. Развитие манифестных, в том числе тяжелых форм клебсиеллеза, определяется наличием ряда факторов патогенности возбудителя, к числу которых относят капсульный антиген, липополисахарид, фимбрии и сидерофоры. Несмотря на то что вероятность развития сепсиса наибольшая у недоношенных детей, в ситуациях, связанных с инфицированием клебсиеллами-продуцентами β-лактамаз расширенного спектра, риску в равной мере подвергаются и доношенные дети. В результате проведенного нами изучения особенностей течения неонатального сепсиса, обусловленного клебсиеллами, установлено, что самым частым синдромом, развивающимся при клебсиеллезном сепсисе, определяющим тяжесть состояния пациента и влияющим на исход заболевания, является геморрагический, который развивается на фоне тромбоцитопении.

Klebsiella is one of the most common causes of neonatal sepsis. Cases caused by extended-spectrum β-lactamase-producing Klebsiella strains are of the most relevance. The infections caused by these bacterial strains are resistant to the majority of cephalosporins commonly used in practice and lead to significant mortality. The development of their clinical forms, including severe ones, is determined by a number of virulence factors that include capsular antigen, lipopolysaccharide, pili, and siderophores. Despite the fact that the probability of sepsis is highest in premature infants, full-term ones are equally at risk in the situations associated by the infection due to extended-spectrum β-lactamase-producing Klebsiella. Our investigation of the specific features of the course of neonatal sepsis caused by Klebsiella established that hemorrhagic syndrome evolving in the presence of thrombocytopenia is the most common condition developing in Klebsiella-induced sepsis that determines the severity of a patient’s condition and affects the outcome of the disease.

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