SURUNKALI PIODERMIYALAR RIVOJLANISHIDA STAPHYLOCOCCUS AUREUS VA STREPTOCOCCUS PYOGENES ANTIBIOTIKOREZISTENTLIGINING ROLI
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Abstrak
Dolzarbligi. Surunkali piodermiyalar terining eng keng tarqalgan va klinik jihatdan muhim infeksion patologiyalaridan biri bo'lib qolmoqda; ular retsidivlarning yuqori chastotasi va standart terapiya samaradorligining pasayishi bilan kechadi. Eng jiddiy muammo — yetakchi qo'zg'atuvchilar Staphylococcus aureus va Streptococcus pyogenes ning antibiotikorezistentligi ortishi, jumladan MRSA va MLSB fenotiplarining tarqalishidir. Bu shtammlar yuqori virulentlik, bioplyonka hosil qilish qobiliyati va yaqqol yallig'lanish potensialiga ega bo'lib, kasallikning cho'zilgan va torpid kechishiga olib keladi. Rezistentlik ortib borayotgan sharoitda uning piodermiyalarni surunkalilashtirishdagi rolini o'rganish samarali va shaxsiylashtirilgan antibakterial terapiyani tanlash uchun alohida ahamiyat kasb etadi. Tadqiqot maqsadi. Staphylococcus aureus va Streptococcus pyogenes antibiotikorezistentligining kattalar va bolalarda surunkali piodermiyalar rivojlanishidagi rolini baholash. Materiallar va usullar. Tadqiqotga 2023–2025 yillarda kuzatilgan surunkali retsidivlanuvchi piodermiyali 168 bemor kiritildi. Bakteriologik tekshiruv, qo'zg'atuvchilarni MALDI-TOF MS usulida identifikatsiya qilish, antibiotiksezgirlikni aniqlash (EUCAST 2023), metitsillinrezistentlik genlarini (mecA, mecC) va MLSB rezistentlik fenotiplarini (ermA, ermB, ermC) aniqlash o'tkazildi. Statistik ishlov SPSS 26.0 yordamida bajarildi (χ², p<0,05). Natijalar. Surunkali piodermiyalarning yetakchi qo'zg'atuvchilari S. aureus (62,5 %) va S. pyogenes (27,4 %) ekanligi aniqlandi, aralash infeksiyalar esa kasallikning eng og'ir kechishini shakllantiradi (10,1 %). MRSA chastotasi 38,9 %, makrolidlarga chidamlilik — 41,3 %, tetratsiklinlarga — 27,5 % ni tashkil etdi. Bioplyonka hosil qilish S. aureus shtammlarining 52,4 % ida aniqlandi; bu davolash muddatining uzayishi va retsidivlar chastotasi (yiliga 6–7 marta) bilan bog'liq bo'ldi. S. pyogenes da cMLSB (29,6 %) va iMLSB (14,8 %) fenotiplari qayd etilib, ular makrolidlar va linkozamidlar samaradorligiga sezilarli ta'sir ko'rsatdi. MRSA va aralash infeksiyali bemorlarda yallig'lanish markerlari eng yuqori bo'ldi (CRP 25,6–27,3 mg/l; IL-6 21,8–23,1 pg/ml) va standart terapiyaga javob past bo'ldi. Davolashning o'rtacha davomiyligi 9–11 kundan (sezgir shtammlar) 19–23 kungacha (aralash infeksiyalar) o'zgardi. Xulosa. S. aureus va S. pyogenes antibiotikorezistentligi piodermiyalarni surunkalilashtiruvchi yetakchi omil bo'lib, retsidivlar chastotasini oshiradi, yallig'lanish javobini kuchaytiradi va standart terapiya samaradorligini pasaytiradi. Olingan ma'lumotlar majburiy mikrobiologik tekshiruv o'tkazish, rezistentlik mexanizmlarini aniqlash va antibakterial davolashni shaxsiylashtirilgan tarzda tanlash muhimligini ta'kidlaydi.
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