vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2026-23-2-125-139vestim-1085Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEIn vitro анализ комбинированной фенотипической устойчивости клинических изолятов Escherichia coli и Klebsiella pneumoniae к антибиотикам и гуморальным факторам врожденного иммунитетаIn vitro analysis of combined phenotypic resistance of clinical isolates of Escherichia coli and Klebsiella pneumoniae to antibiotics and humoral factors of innate immunityhttps://orcid.org/0000-0003-2095-2378ЦиркуноваЖ. Ф.TsyrkunovaZh. F.

Циркунова Жанна Федоровна – канд. биол. наук, доцент, заведующий лабораторией

пр. Дзержинского, 83, 220083, г. Минск

Zhanna F. Tsyrkunova – Ph. D. (Biol.), Associate Professor, Head of the Laboratory 

83, Dzerzhinsky Ave., 220083, Minsk

tsyrkunova@list.ruhttps://orcid.org/0000-0002-6805-1782ПотапневМ. П.PotapnevM. P.

Потапнев Михаил Петрович – д-р мед. наук, профессор, гл. науч. сотрудник

пр. Дзержинского, 83, 220083, г. Минск

 

Michael P. Potapnev – D. Sc. (Med.), Professor, Chief Researcher

83, Dzerzhinsky Ave., 220083, Minsk

mpotapnev@yandex.byhttps://orcid.org/0000-0002-4150-282XКраськоО. B.KraskoO. V.

Красько Ольга Владимировна – канд. техн. наук, доцент, вед. науч. сотрудник

ул. Сурганова, 6, 220012, г. Минск

Olga V. Krasko – Ph. D. (Eng.), Associate Professor, Leading Researcher

6, Surganov Str., 220012, Minsk, 

krasko@newman.bas-net.byhttps://orcid.org/0009-0002-5617-6593ФилонюкВ. А.FilаnyukV. A.

Филонюк Василий Алексеевич – д-р мед. наук, профессор, гл. науч. сотрудник

ул. Казинца, 50, 220108, г. Минск

Vasily A. Filаnyuk – D. Sc. (Med.), Professor, Chief Researcher 

50, Kazintsa Str., 220108, Minsk

filonuk.vasiliy@gmail.comБелорусский государственный медицинский университетBelarusian State Medical UniversityОбъединенный институт проблем информатики Национальной академии наук БеларусиUnited Institute of Informatics Problems of the National Academy of Sciences of BelarusРеспубликанский центр гигиены, эпидемиологии и общественного здороRepublican Center for Hygiene, Epidemiology and Public Health202627052026232125139Copyright © Циркунова Ж.Ф., Потапнев М.П., Красько О.B., Филонюк В.А., 20262026Циркунова Ж.Ф., Потапнев М.П., Красько О.B., Филонюк В.А.Tsyrkunova Z.F., Potapnev M.P., Krasko O.V., Filаnyuk V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/1085

Одной из проблем современной медицины является формирование у бактерий комбинированной устойчивости к антимикробным средствам и гуморальным факторам врожденного иммунитета. Такой фенотип микроорганизмов не только сужает возможности антимикробной терапии, но и позволяет патогенам более эффективно преодолевать первую линию защиты организма человека, вызывая тяжелые диссеминированные процессы, трудно поддающиеся стандартным схемам лечения.

Цель данного исследования – изучение in vitro наличия комбинированной фенотипической устойчивости клинических изолятов энтеробактерий к антибиотикам и гуморальным факторам врожденного иммунитета, содержащимся в сыворотке и плазме крови.

В работе исследовано 59 клинических изолятов Escherichia coli (n = 30) и Klebsiella pneumoniae (n = 29), выделенных в различных стационарах г. Минска в 2021–2023 гг. Определение чувствительности бактерий к антибиотикам проводили на анализаторе Vitek 2 Compact (BioMerieux, Франция). Устойчивость к антимикробному действию нативной сыворотки, нативной плазмы и плазмы, обогащенной растворимыми факторами тромбоцитов (ПОРФТ/PRP), оценивали методом серийных разведений в жидкой питательной среде.

Установлена высокая частота комбинированной устойчивости грамотрицательных бактерий к экзогенным и эндогенным антимикробным веществам. Показано, что у клинических изолятов E. coli устойчивость к пенициллинам, цефалоспоринам, фторхинолонам и сульфаналамидам сочетается с устойчивостью к сыворотке крови в 60,0–66,7 % случаев. Изоляты K. pneumoniae продемонстрировали критически высокую резистентность к карбапенемам (72,4 %), защищенным пенициллинам (79,3 %), цефалоспоринам (82,1 %) и фторхинолонам (82,8 %), при этом большинство таких штаммов также было устойчиво и к плазме крови (69,2–81,8 %). ПОРФТ/PRP продемонстрировала выраженный бактериостатический эффект в отношении 88,9 % изолятов E. coli и 100 % K. pneumoniae.

One of the serious challenges in modern medicine is the development of combined resistance in bacteria to antimicrobial agents and humoral factors of innate immunity. This phenotype not only limits the options for antimicrobial therapy but also enables pathogens to more effectively overcome the body’s first line of defense, leading to severe disseminated processes that are difficult to manage with standard treatment regimens.

The aim of this study was to assess in vitro the presence of combined phenotypic resistance in clinical Enterobacteriaceae isolates to antibiotics and humoral factors of innate immunity present in blood serum and plasma.

A total of 59 clinical isolates of Escherichia coli (n = 30) and Klebsiella pneumoniae (n = 29), collected from various hospitals in Minsk between 2021 and 2023, were analyzed. The antibiotic susceptibility testing was performed using the VITEK 2

Compact system. The resistance to the antimicrobial action of native serum, native plasma, and platelet-rich plasma (PRP) was evaluated using the broth microdilution method.

A high prevalence of combined resistance to exogenous and endogenous antimicrobial agents was observed in Gramnegative bacteria. Among clinical isolates of E. coli, resistance to penicillins, cephalosporins, fluoroquinolones, and sulfonamides was associated with resistance to blood serum in 60.0–66.7 % of cases. In contrast, K. pneumoniae isolates exhibited critically high resistance to carbapenems (72.4 %), protected penicillins (79.3 %), cephalosporins (82.1 %), and fluoroquinolones (82.8 %), with the majority of these strains also resistant to blood plasma (69.2–81.8 %). The present study demonstrated a pronounced bacteriostatic effect of PRP against 88.9 % of multidrug-resistant E. coli isolates and 100 % of K. pneumoniae isolates.

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