sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20250209sibmed-2078Research ArticleМЕДИКО-БИОЛОГИЧЕСКИЕ НАУКИBIOMEDICINEВлияние микробиологических особенностей инфекций, вызванных Klebsiella pneumoniae, на антибиотикорезистентность и тяжесть инфекционного процессаInfluence of microbiological characteristics of infections caused by Klebsiella pneumoniae on antibiotic resistance and severity of the infection processhttps://orcid.org/0000-0002-6753-2074ЗемкоВ. Ю.ZemkoV. Yu.

 Земко Виктория Юрьевна, к.м.н.

 Республика Беларусь, 210009, г. Витебск, пр. Фрунзе, 27 

 Viktoryia Yu. Zemko, candidate of medical sciences 

 Republic of Belarus, 210009, Vitebsk, Frunze ave., 27 

viktoryiazia@gmail.comhttps://orcid.org/0000-0002-8226-6405ОкуличВ. К.OkulichV. K.

 Окулич Виталий Константинович, к.м.н. 

 Республика Беларусь, 210009, г. Витебск, пр. Фрунзе, 27 

 Vitaly K. Okulich, candidate of medical sciences 

 Republic of Belarus, 210009, Vitebsk, Frunze ave., 27 

vokul@mail.ruВитебский государственный ордена Дружбы народов медицинский университетБеларусьVitebsk State Order of Peoples’ Friendship Medical UniversityBelarus2025060520254528893Copyright © Земко В.Ю., Окулич В.К., 20252025Земко В.Ю., Окулич В.К.Zemko V.Y., Okulich V.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/2078

Цель исследования ‒ изучить влияние микробиологических особенностей инфекций, вызванных Klebsiella pneumonia, на формирование антибиотикорезистентности и тяжесть инфекционного процесса.Материал и методы. Проведен сравнительный анализ массы биопленки, толщины капсулы K. pneumonia, выделенной у 26 пациентов с сепсисом и у 8 больных хронической обструктивной болезнью легких. Исследовано влияние толщины капсулы на тяжесть инфекционного процесса и антибиотикорезистентность.Результаты и их обсуждение. Масса биопленки K. pneumoniae, выделенной у пациентов с сепсисом, составила 28,2 [16,5; 41,3] мкг/лунку (медиана [нижний квартиль; верхний квартиль]), отличалась устойчивостью к большинству используемых антибактериальных лекарственных средств и была больше массы биопленки, выделенной при хронической обструктивной болезни легких (24,3 [20,0; 28,2] мкг/лунку, p = 0,04), сохранявшей чувствительность к используемым препаратам. Проведена идентификация капсулы бактерий K. pneumoniae как видового признака или свойства патогенности по разработанному методу с использованием альцианового синего. Панрезистентные изоляты K. Pneumoniae имели наиболее толстую капсулу (0,44 [0,32; 0,53] мкм), карбапенемрезистентные изоляты, чувствительные к колистину и тигециклину, – более тонкую капсулу (0,38 [0,35; 0,41] мкм). Толщина капсулы клебсиеллы, сохранившей чувствительность к карбапенемам, была в 4 и 3,5 раза тоньше капсулы панрезистентных (p = 0,031) и карбапенемрезистентных, но чувствительных к колистину и тигециклину изолятов (p = 0,044) соответственно, и составила 0,11 [0,08; 0,16 мкм]. Выявлена положительная корреляция между толщиной бактериальной капсулы, массой микробной биопленки и общей длительностью пребывания в стационаре. Заключение. Патогенность бактерий и тяжесть заболевания объясняется толщиной капсулы K. pneumoniae, которая вносит определенный вклад в формирование антибиотикорезистентности микроорганизмов.

The aim of the study was to investigate influence of microbiological characteristics of infections caused by Klebsiella pneumonia on formation of antibiotic resistance and severity of infectious process.Material and methods. A comparative analysis of biofilm mass, thickness of capsule of K. pneumonia isolated from 26 patients with sepsis and from 8 patients with chronic obstructive pulmonary disease was carried out. The influence of capsule thickness on severity of infectious process and antibiotic resistance was studied.Results and discussion. The mass of K. pneumoniae biofilm isolated from patients with sepsis was 28.2 [16.5; 41.3] μg/well (median [lower quartile; upper quartile]), exhibited resistance to most of the antibacterial drugs used, and was greater than the biofilm mass isolated from patients with chronic obstructive pulmonary disease (24.3 [20.0; 28.2] μg/well, p = 0.04), which remained susceptible to the drugs used. K. pneumoniae bacterial capsule was identified as a species characteristic or pathogenicity property using developed method with alcian blue. Panresistant K. pneumoniae isolates had the thickest capsule (0,44 [0,32; 0,53] μm), carbapenem-resistant isolates sensitive to colistin and tigecycline had thinner capsule (0.38; 0.35–0.41 μm). Thickness of capsule of Klebsiella that retained sensitivity to carbapenems was 4 and 3.5 times thinner than thickness of panresistant (p = 0,031) and carbapenem-resistant isolates sensitive to colistin and tigecycline isolates (p = 0,044), respectively and was 0,11 [0,08; 0,16 мкм]. A positive correlation was revealed between thickness of capsule, mass of microbial biofilm and length of hospital stay.Conclusions. The pathogenicity of bacteria and severity of disease are explained by thickness of K. pneumoniae capsule that makes a certain contribution to formation of antibiotic resistance in microorganisms.

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