Антибактериальное действие оксида азота на возбудители госпитальной пневмонии (экспериментальное исследование)

Цель исследования: оценить антимикробное действие оксида азота (NO) in vitro при однократном и многократном воздействии на основные возбудители внутрибольничной пневмонии, выделенные из мокроты кардиохирургических пациентов.

Материалы и методы: Суточную культуру микроорганизмов из панрезистентных изолятов Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii и Klebsiella pneumoniae, выделенных из мокроты стационарных кардиохирургических пациентов с внутрибольничной пневмонией, а также музейные культуры P. aeruginosa и E. coli из Американской коллекции типовых культур подвергали воздействию NO в дозе 200 ppm в герметичной камере в течение 30 минут (экспериментальный образец) или медицинского воздуха (контрольный образец). После однократного либо 4-кратного с интервалом в 4 часа воздействия газов чашки Петри помещали в термостат при температуре 37°C, результаты оценивали через 24, 48 ч либо через 12, 24, 36 и 48 ч соответственно. Выращенные колонии подсчитывали с помощью автоматического счетчика колоний. Результаты выражали в КОЕ/мл.

Результаты: Через 24 и 48 часов после однократного воздействия NO ни в одном случае не наблюдали роста клинических изолятов P. aeruginosa и E. coli. Рост A. baumannii был меньше по сравнению с контролем через 24 часа, но его непрерывный рост отметили через 48 часов. Эффекта NO в дозе 200 ppm при однократном воздействии на другие микроорганизмы не обнаружили. После 4 воздействий NO рост музейной культуры E. coli так и не обнаружили, рост других экспериментальных штаммов был значительно снижен по сравнению с контролем (р<0,05).

Заключение. Представленные результаты могут служить предпосылкой начала применения многократной прерывистой ингаляционной NO-терапии в дозе 200 ppm при лечении пациентов с внутрибольничной бактериальной пневмонией.

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