References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2025-348

medsovet-9601

Research Article

ГАСТРОЭНТЕРОЛОГИЯ

GASTROENTEROLOGY

Особенности факторов патогенности представителей семейства Enterobacteriaceae, участвующих в развитии некротизирующего энтероколита

Features of virulence factors of the Enterobacteriaceae involved in the necrotizing enterocolitis development

https://orcid.org/0000-0002-9991-6750

Кокорев

Д. А.

Kokorev

D. A.

Кокорев Даниил Андреевич, младший научный сотрудник лаборатории генетических технологий в микробиологии Научно-образовательного профессионального центра генетических и лабораторных технологий, ассистент кафедры медицинской микробиологии и иммунологии

443099, Самара, ул. Чапаевская, д. 89

Daniil A. Kokorev, Junior Researcher of the Laboratory of Genetic Technologies in Microbiology, Professional Center for Education and Research in Genetic and Laboratory Technologies, Assistant Professor of the Department of Medical Microbiology and Immunology

89, Chapaevskaya St., Samara, 443099

d.a.kokorev@samsmu.ru

https://orcid.org/0009-0000-1954-9245

Стражина

Е. А.

Strazhina

E. A.

Стражина Екатерина Александровна, специалист лаборатории образовательных технологий в генетике, микробиологии и лабораторной диагностике Научно-образовательного профессионального центра генетических и лабораторных технологий

443099, Самара, ул. Чапаевская, д. 89

Ekaterina A. Strazhina, Specialist of the Laboratory of Educational Technologies in Genetics, Microbiology and Laboratory Diagnostics, Professional Center for Education and Research in Genetic and Laboratory Technologies

89, Chapaevskaya St., Samara, 443099

e.a.strazhina@samsmu.ru

https://orcid.org/0000-0001-9965-6568

Кабанова

Н. П.

Kabanova

N. P.

Кабанова Наталья Павловна, к.м.н., доцент, доцент кафедры педиатрии Института профессионального образования; заместитель главного врача по медицинской части

443099, Самара, ул. Чапаевская, д. 89

443029, Самара, ул. Шверника, д. 1

Natalya P. Kabanova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Pediatrics, Institute of Professional Education; Deputy Chief Medical Officer

89, Chapaevskaya St., Samara, 443099

1, Shvernik St., Samara, 443029

n.p.kabanova@samsmu.ru

https://orcid.org/0009-0009-3678-9465

Янковая

З. А.

Yankovaya

Z. A.

Янковая Зоя Александровна, студент Института педиатрии

443099, Самара, ул. Чапаевская, д. 89

Zoya A. Yankovaya, Student of the Institute of Pediatrics

89, Chapaevskaya St., Samara, 443099

yurinovaz@bk.ru

https://orcid.org/0000-0002-6177-8487

Константинов

Д. Ю.

Konstantinov

D. Yu.

Константинов Дмитрий Юрьевич, д.м.н., доцент, заведующий кафедрой инфекционных болезней с эпидемиологией, директор Института клинической медицины

443099, Самара, ул. Чапаевская, д. 89

Dmitrii Yu. Konstantinov, Dr. Sci. (Med.), Associate Professor, Head of the Department of Infectious Diseases and Epidemiology, Director of the Institute of Clinical Medicine

89, Chapaevskaya St., Samara, 443099

d.u.konstantinov@samsmu.ru

https://orcid.org/0000-0002-5905-1895

Лямин

А. В.

Lyamin

А. V.

Лямин Артем Викторович, д.м.н., доцент, директор Научно-образовательного профессионального центра генетических и лабораторных технологий, профессор кафедры медицинской микробиологии и иммунологии

443099, Самара, ул. Чапаевская, д. 89

Artem V. Lyamin, Dr. Sci. (Med.), Associate Professor, Director of the Professional Center for Education and Research in Genetic and Laboratory Technologies, Professor of the Department of Medical Microbiology and Immunology

89, Chapaevskaya St., Samara, 443099

a.v.lyamin@samsmu.ru

Самарский государственный медицинский университетРоссияSamara State Medical UniversityRussian Federation

Самарский государственный медицинский университет; Самарская областная детская инфекционная больницаРоссияSamara State Medical University; Samara Regional Children’s Infectious HospitalRussian Federation

2025

01122025

019

154–165

2025

Кокорев Д.А., Стражина Е.А., Кабанова Н.П., Янковая З.А., Константинов Д.Ю., Лямин А.В.

Kokorev D.A., Strazhina E.A., Kabanova N.P., Yankovaya Z.A., Konstantinov D.Y., Lyamin А.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.med-sovet.pro/jour/article/view/9601

Некротизирующий энтероколит – это полиэтиологическое тяжелое заболевание, характеризующееся возникновением трансмурального некроза стенки кишечника. Современные исследования предлагают новые концепции этиологии и патогенеза некротизирующего энтероколита. Существует множество факторов риска развития данной патологии: незрелость иммунной системы недоношенного новорожденного, нарушение адекватной колонизации микробиотой желудочно-кишечного тракта, несостоятельность барьерных функций кишечника, снижение толерантности к энтеральному питанию. В развитии данного заболевания равнозначную роль играют факторы риска и этиологический микробный агент. В качестве микроорганизмов, повреждающих кишечную стенку, наиболее часто у детей высевают бактерии: Еѕсһеrісһіа coli, Klebsіella рnеumоnіае, Cronobacter spp., Staphylococcus aureus, Enterococcus spp., Clostrіdіum perfringens, Pseudomonas аеrugіnоѕа, Proteus mіrabіlіs. У детей с иммунодефицитами различной этиологии в возрасте до 1 мес., получающих антибактериальную терапию, в качестве возбудителя обнаруживают грибы рода Candida. Развитию некротизирующего энтероколита способствуют вирусные агенты: коронавирусы, ротавирусы и вирусы Коксаки. Однако наиболее часто заболевание развивается в результате повреждающего действия бактериального агента. Каждый бактериальный штамм имеет свои генетические детерминанты, которые оказывают влияние на степень патогенности возбудителя, а также на тяжесть и длительность течения заболевания. В литературном обзоре обобщены данные отечественных и зарубежных публикаций, посвященных факторам патогенности представителей семейства Enterobacteriaceae, таких как Cronobacter spp., Klebsiella spp. и Enterobacter spp., как основных возбудителей некротизирующего энтероколита. Бактерии семейства Enterobacteriaceae обладают множеством факторов патогенности, среди которых ведущую роль играют адгезивная активность, способность к инвазии, выживаемость внутри макрофагов, продукция экзотоксинов, биопленкообразование.

Necrotizing enterocolitis is a severe, multifactorial disease manifests by transmural necrosis of the intestinal wall. Recent studies propose new concepts regarding the etiology and pathogenesis of necrotizing enterocolitis. There are numerous risk factors for the development of this condition, including the immaturity of the immune system in premature neonates, impaired colonization of the gut microbiota, underdeveloped intestinal barrier functions, and reduced tolerance to enteral nutrition. Both risk factors and the etiological microbial agent plays an equally important role in the development of this disease. The most commonly isolated bacteria that damage the intestinal wall in children include Escherichia coli, Klebsiella pneumoniae, Cronobacter spp., Staphylococcus aureus, Enterococcus spp., Clostridium perfringens, Pseudomonas aeruginosa, and Proteus mirabilis. In infants under one month of age with immunodeficiency of various etiologies who are receiving antimicrobial therapy, Candida species are identified as causative agents. Viral agents, such as Coronaviruses, Rotaviruses, and Coxsackieviruses, also play a role in the development of necrotizing enterocolitis. However, the disease most commonly results from the damaging action of bacterial agents. Each bacterial strain has its own genetic determinants, which influence the pathogenicity of the agent and the severity and duration of the disease. This review summarizes data from both domestic and international publications on the virulence factors of the Enterobacteriaceae, such as Cronobacter spp., Klebsiella spp., and Enterobacter spp., which are primary causative agents of necrotizing enterocolitis. Enterobacteriaceae bacteria possess a variety of virulence factors, including adhesive activity, invasiveness, survival within macrophages, exotoxin production, and biofilm formation.

некротизирующий энтероколитфакторы вирулентностифакторы патогенностиEnterobacteriaceaeCronobacter spp.Klebsiella spp.Enterobacter spp.

necrotizing enterocolitisvirulence factorspathogenicity factorsEnterobacteriaceaeCronobacter spp.Klebsiella spp.Enterobacter spp.

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