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

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.

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