Резюме. Изучали распространенность штаммов, устойчивых к цефалоспоринам расширенного спектра и карбапенемам, среди K. pneumoniae и E. coli, выделенных из клинического материала пациентов семи стационаров Санкт-Петербурга в период с января по май 2012 г. Доля штаммов, устойчивых к цефалоспоринам, колебалась в различных стационарах: E. coli-от 7,8 до 50%, K. pneumoniae-от 25,4 до 88,4%. Устойчивость была обусловлена продукцией бета-лактамаз расширенного спектра семейства СТХ-М, которые относились главным образом к группе СТХ-М-1, а также СТХ-М-2 и СТХ-М-9. В трех стационарах выявили 22 полирезистентных штамма K. pneumoniae, устойчивых к карбапенемам. Метод MАLDI-TOF MS показал, что резистентность к карбапенемам у всех штаммов была обусловлена продукцией карбапенемаз, которые согласно результатам тестов ROSCO Diagnostica относились к классу металлоβ-лактамаз. У всех изученных штаммов выявлен ген металло-β-лактамазы New Delhi metallo-β-lactamase (blaNDM-1). Результаты проведенных исследований показали, что в странах Балтийского региона (включая Россию, Санкт-Петербург) ведущим механизмом резистентности к цефалоспоринам штаммов E. coli и K. pneumoniae, выделенных в стационарах, является продукция СТХ-М-1. Впервые в России выделены штаммы K. pneumoniae, продуцирующие металло-β-лактамазу NDM-1, причем одновременно в нескольких стационарах Санкт-Петербурга.

The gut microbiota of healthy people, living in different regions, may vary considerably. The article presents the results of comparative qualitative and quantitative study of the intestine aerobic and anaerobic microbiota of residents of the Republic of Guinea (46) and Russia (60). The content of microorganisms (Enterobacteriaceae, Enterococcus spp., Lactobacillus spp., Bifidobacterium spp., Staphylococcus spp., Candida spp., non-fermentative gram-negative bacteria and others) in 1.0 gram of faeces was determined by bacteriological methods. Generic and species identification was performed using Vitek 2 Compact (bioMerieux, France), tube biochemical tests and MALDI-TОF mass spectrometry (Bruker Daltonics, Germany). Pearson χ 2 criterion, p < 0.05 and Fisher's exact test (medstatistica.ru) were used to assess the differences in the compared groups. 95% confidence intervals were calculated by the method of Wilson. Microbiological disorders were characterized by a decrease in the number of obligate microorganisms, an increase in the number of facultative (opportunistic) microorganisms (above 10 6 CFU/g) and the emergence of their associations. Dysbiotic disorders were identified in both compared groups: in 100% patients from Republic of Guinea (95% CI:92.3-100) and in 86.7% patients from St. Petersburg (95% CI:75.8-93.1). Severe degree of microbiota disorders in the residents of the Republic of Guinea was revealed at 19.6% (95% CI:10.7-33.2), in group of residents of St. Petersburg in 9.6% (95% CI:4.2-20.6). In both groups the microbiota disorders of third degree were detected less frequently, compared with the microbiota disorders of second degree. The study has found no significant differences in the content of obligate bacteria (Bifidobacterium spp. and Lactobacillus spp.), however, significant differences in the species composition of the facultative part of the microbiota were revealed. The residents of the Republic of Guinea had "atypical" E. coli (lactosonegative and hemolytic) and non-fermenting gram-negative bacteria Comamonas kerstersii more frequently. Opportunistic microorganism associations have been found in 30.4% of the residents of the Republic of Guinea (95% CI:19.1-44.8) and 18.3% of residents of St. Petersburg (95% CI:10.6-29.9). Opportunistic microorganism associations from the residents of the Republic of Guinea always contained Staphylococcus aureus. It is necessary to conduct further research on a bigger population to access the differences in the compared groups in Staphylococcus aureus and Hafnia alvei.

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The aim of this study was to compare the prevalence of different virulence factor (VF) genes in extended-spectrum beta-lactamase (ESBL) producing Escherichia coli strains isolated from the Baltic Sea region. A total of 432 strains of phenotypically ESBL positive E. coli were collected from 20 institutions located in Estonia, Latvia, Lithuania, and the region of St. Petersburg in Russia from January to May 2012 and analyzed for phylogenetic group and prevalence of 23 VF genes. The strains were collected from clinical material (urine, blood, wound, and respiratory tract). Bacterial isolates were compared according to phylogenetic group, clinical material, and geographical origin. Most of the VF genes were concentrated within phylogenetic group B2 and/or D. When comparing strains isolated from different countries, it was found that strains originating from Estonia and Latvia belonged mainly to group B2 and strains from Lithuania and Russia mainly to groups B2 and D. The P-fimbrial adhesin gene papEF was more prevalent in Russian strains, colicin gene cvaC in Lithuanian strains, and capsular gene kpsMTII in Latvian strains; serum resistant gene traT was less prevalent in Estonian strains. The regional differences of VF genes remained statistically significant after taking into account the phylogenetic distribution in the countries.

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