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HHH, a TaIOKe H3 p0T0rJl0TKH, H B 3Hat{HTeJibHOW CTeneHH y,n:aJUieTC.11pecHHt{ KaMH 3TIHTeJIH.11, CMbIBaeTC.11 CJIH3bl0, 3JIHMHHHpyeTC.11 ceKpeT0pHbIMH IgA, JIH30I.J;l'IM0M. Ilpen.lITCTByeT K0JfOHH3a[(HH TI0CT0p0HHHMH MHKpoopramn

MaMH, B TOM ti:HCJle H naToreHHbIMH, TI0KpbIBa10ma.11 CJIH3HCThie o6oJIOl{KH HOC0f'Jl0TKH 38lUHTHrul 6HoTIJieHKa.

AJJ;anee:

1. Bbl.lIBHTb H0CHTeJibCTBO rraToreHHhIX CTaq>HJIOKOKKOB.,lln.11 3Toro rrpocMoTpeTb qaIIIKH IlerpH c)KCA, Ha K0Top1,1e c.n;enaH1,1 rroceBbI CJIH3H C nepe,n:HHX H0C0BbIX X0)],0B, 0TMenITb ttaimqHe JieQHTHHa-

30II0JI0)KHTeJibHbIX KOJIOHHH, B0Kpyr K0T0pbIX HMeeTC.11 opeon (TaK

H83hIBaeMbIH «pa.ny:>KHbIH BeHt{HK»), npoBeCTH MHKp0CK0ITWleCK0e H3yqeHHe KOJIOHHH.

IloMHHTe, ti:TO Jiel.lHTHHa3HruI aKTIIBH0CTh CBOHCTBeHHa rraToreHHbIM CTaq>HJIOKOKKaM-Staphylococcus aureus. O,n:HaKo,.n;Jl.11 0K0ffl{aTeJibHoro 3aKJIIOl{eHH.11 06 HX rraTOreHH0CTH CT8B.IIT pH,n:)],0IT0JIHHTeJibHbIX n p o 6.

Mu1<poqmopa ypozeuumaJlbHozo mpa1<ma. MoqeBhIBO.ll.llllla.11cHcTe Ma, B TOM t{HCJie H MOti:eBOH rry3blpb, B H0pMe He co,n:ep)l(aT MHKpo6oB, 3a

HCKJilOt{eHHeM rrepe,n:HeH ypeTpbI, r)],e BCTpeqaIOTCH CTaq>MJIOKOKKH, Herra ToreHHhie HeifocepHH, KOpHHe6aKTepHH, MHK0TIJ1a3Mhl, Katt)],H)],bl H.llpyrue MHI<poopraI-IH3MbI.

Ha K0:JfCe u cmnucmblX Hapy.>ICHblX 120Jl06blX 0pi?G1'06 oforrruoT 83p06hI H amnpo61,1: 3ITH,nepMaJibHhle CTaq>HJIOKOKKH, 3eJieHHlllHe CTperrT0K0KKH,

KOpHHe6aKTepHH, 3HTepo6aKTep1m, 6uqm)],o6aKTepHH, cpy306aKTepm1, 8Ha3p06Hbie K0KKH.

Blla2aJluu,e. MHKpoqmopa BJiaramuua 3amttw:aeT penpo.nyKTHBHbie opraHbI)l(eHIJlHHbl B,neTOp0,UH0M rrepHo,ne OT rrpoHHI<H0Bemrn:IIOCTOpOHHeH MHKpOqmopbl (IIOJIOCTb M8TKH 3,U0p0BbIX)l(eHW:HH CTepHJibHa). KpoMe mro, C0CTQjJHHe MHKpoqmopbl BJiaraJIHW:a)l(eHW:HHbI-MaTepH BJIHjJeT Ha C0CTaB MHKpoqmopbI ee H0Bopo)l(,neHH0r0 pe6eHKa.

B pa3Hbie nepH0,Ubl)l(H3HH MHKpOq)Jlopa BJiaraJIHW:a HMeeT cyw:e CTBeHHbie 0TJIJ,fqffjJ. y,neBoqeK 0Ha MaJioqHcJieHHa H HMeeT CX0,UCTB0 C MHKpocpnopoH KO)l(H, ceKpeT BJiara.rm:w:a HdiTparreH (3HaqeHHe pH 7,0).

C HaCT)'TIJieHHeM IIOJIOBOH 3peJI0CTH rrpoHCX0,UHT pe3K0e H3MeHeHue

K0JIH1.JeCTBeHHoro H KaqecTBeHHoro C0CTaBa MHKpocpnopbI. Ilo.n BJIHjJHJfeM ropM0H0B - 3CTporeH0B B 3TilfreJIHH BJiaraJIHIJla B 6om,IIIOM K0JIH1.JeCTBe Ha KanmmaeTCjJ rJIHKoreH, 6Jiaro,napjJ qeMy C03,naJOTCjJ 0TITHMaJibHbie ycJI0BIDI

,nJijJ JiaKTo6aUHJIJI H HeK0T0pbIX.npymx MHKpo6oB. O6Jia,nM caxap0JIHTJ,fqe CKHMH CBOHCTBaMH, JiaKTo6auHJUihl MeTa60JIJi3HpyIOT rJIHKoreH, o6pa3YJOT M0J1oqey10 H.npyrHe KHCJI0TbI, II0Jiyl.JM npH 3T0M Heo6xo.nHMY10 3Heprnio.

Ce1<.peT BJiaranttw:a npHo6peTaeT I<.HcJioe 3Ha1.JeHHe (pH 4 - 5), qTo TaIOKe

6JiarorrpffjJTCTByeT)l(H3He,ne.11TeJihH0CTH JiaKTo6au;HJIJI, HX K0JmqecTB0,no CTHraeT l 08 KOE/Mn KpoMe,noMHHHpyIOW:HX naKTo6au;HJIJI, BO BJiaranmue

npeo6Jia,naJOT aHa3po61,I - 6aKTepoH,nhI, 6mpH,no6aKTepHH, rremoKoKKH; a3p06bI rrpe,ncTaBJieHbl CTaqJHJIOKOI<.KaMH, KOpHHe6aKTepH.11MH, 0,UHaK0

HX 1<.oJIH1.JecTB0 He rrpeBbIIIIaeT 103 - 104K O EI MJI Y HeKOTophIX)l(eHW:HH

BCTpeqaJOTCjJ CTpeIIT0K0KKH, rap,nHepeJIJibl, MHK0ilJia3Mhl, XJiaMH,nHH,

KaH,nH,UbI.

HaH60JihIIIee 3Ha1.feHHe HMeJOT JiaKTo6aummbI - naJiol.fKH J(o.nepneiiHa

(L. acidophylus). OHMHrpalOT 0CH0BHYJO pom, B K0JI0HH3aQHH CJIH3HCTOH o6oJI01.JKH BJiaraJIHW:a H o6pa30BaHHH 6HoIIJieHKH, o6Jia,naJOT Bblp8)l(eHHbIMH aHTHMHKp06HblMH CBOHCTBaMH 6naro.nap.s1 o6pa30BaHHIO MOJI01.JHOH KHC

JIOThl, nepeKHCH Bo,nopo.[{a, npo.nyKUHH aHTH6HOTHKono.no6HhIX Bew:ecTB. Bee 3TH <paKTopbl npeIDITCTBYJOT KOJI0HH3au;HH BJiararrHIJla npomncaK>ID:HMH H3BHe MHKpoopraHH3MaMH, B TOM 1.JHCJie naToreHHbIMH.

3. MuKpocl>Jiopa num;eeapuTeJibHoro TpaKTa

B muueBapHTeJibHOM TpaKTe cocpe,uoTO'-leHa OCH0BHag qaCTb H0p MaJibHOH MHKpOq>JIOpbl opraHH3Ma '-leJioBeKa. ITpH'-leM, pa3JJHqHbJe 0T,UeJibl IIHJUeBapHTem,HOH CHCTeMbl 3Ha'-IHTeJIE,HO OTJIH'-lalOTCj{ IIO Ka'-leCTBeHH0MY H K0JrnqecTBeHH0MY COCTaBY npHC}'TCTBYlOJUHX MHKpoopraHH3M0B.

KHllleqHHKa.

2. IlpoBeCTH KOppeKUHIO TIHTamu1 C y<leTOM B03pacTa 6oJibHOro, Hapyrne HHSI MOTOpHbIX H ceKpeTopHbIX c)>yttKUHH ero)KeJIY)lOqHO-KHllle"tJHOro

TpaKTa, C 3TOH ueJiblO:

- McnOJib30BaTI,)lHeTbl, CO,!lep)l(am:we KHCJIOMOJIOt{Hble npOJlYI<TbI, npOJlYKTb TIHTaHHSI paCTHTeJibHoro npoHCXO)l(JleHIDI. J:visr)leTeH paHHero B03pacTa npHMeIDIIOT a]lanTHpoBaHHbJe CMeCH, o6ora m:eHHble npe)lCTaBHTemIMH MHKpoc)>JiopbI - MaJIJOTKa, EHcpHJlOK, Ewc)>HJiaKT H Jlp.

- Ha3Ha"tJHTb q>yHKUHOHaJlbHOe TIHTami:e, npe)lcTaruunom:ee co6on roTOBble nnm:eBbie rrpOJlYKTbI, B KOTOpbie)l06aBJISIIOT 6wonpe napaTbI, aHTidOKCH)laHTbl, KapaTHHOH)lbl, nnm:eBbie BOJIOKHa (0Tpy6H, MOPCKYIO Karrycry, S16J10KH, MOpKOBb H.llpyrne OBOlll:H H q>pyKTbI)..l(enM BHeoHaTaJibHOM nepwo.n:e MO)KHO npHMeHHTb q>yHKUHOHaJibHoe TIHTaHHe B BHJle JIHOq>HJIH3HpoaaHHoro rpy.n: Horo MOJIOKa, o6oram:eHHoro B.bifidum.

- IlpH Heo6xo,L(HMOCTH Ha3HaqHTI, c)>epMeHTHble npenapaThI Ha

OCHOBe naHKpeaTHHa (so6eH3HM, cpnareH3HM H JJ.p.), 3HTepocop- 6eHTbl (CMeKTa, CYMC1, aJibmcop6, aKTHBHposaHHbIH yroni, H JJ.p.), TIOJlHBHTaMHHbl C MJrnepaJibHblMH)l06aBKaMH.

3. BocCTaHOBHTb HOpMarr.bttylO MHKpocjmopy KHUieqHHKa c TIOMOlll:blO 6nonperrapaTOB rrpo6HOTHKOB, npe6HOHiKOB, CHH6HOTHKOB.

Ta6mi:ua 4.

Pe1y11bmam ucC11e006aHua Mu«potjmopbl moncmow «ume'lnu«a ua ouc6a«mepuo1

<I>.M.O. Bo3pacT:

MHKpoopraHHJMLI

Hopr.ta (11e1 · u 110 1,5 JJeT -

L JJeT)

Hopr.ta (BlpOCJJl,IC)

--- Pe1yn1,nT

AHa)pofiHLIC

KOE /r tj,eKanuii

KOE /r tj,CKanuii

KOE /r tj,cKanuii

6Htl,Hlt06aKTepHH

10'" • IO"

10' - 10'"

JlaKT06au,Mnm, 1

10 -10

- 10•

Jiah.TCDOHAL I

10 • 10

10 · 10

'.}y6aKTCPHH

<I()

- IO"'

KnoCTPH.IJ.HH (o6mee KOflH4:Ct'TBO)

< IO·

<10

K'lOCTpH!tHH (neUHTHKalOTIO]HTHBHLIC)

< 10·

< IO

KnOCTPH.!\ffH (neuHTHHa]OHCraTHRHLIC)

< 10

-10

nemOCTOCOTOkOKKH

<10

10' -10'"

Alpo6n1,1e/ ljlaKyJJLT3THBH0-8118lpo6HLie

3trrcpo6arrepHH (o6utcc KORHSCCTBO)

10 • IO'

10' - 10

E. col i lJ1aKT01onolKTHBHLle/ reMOilHJHHHeraTHBHMC:)

10 -10'

10· -10

E coli (nan o1ono·rn TH BH1:Je / reMOilH3HffOOJHTH8IILJC)

< JO·

<10

E coli (n aKT010 Hcran1am, 1c/ reMomoHHHCraTHBHt,Je)

<W l

< IO

E. coli (nalCT030HCf3THBHLJe/ rt M Oil H1HH TT01HTH BHLIC)

<10'

<10

K; 1e6c HC.' Ula (o6u,,ce KO. 'lH'I C CTBO)

<IO

<10

Klebsiclla pneumoniae

<10

< 10

Klebsiclla oxvtoca

< 10·

<JO ·

Enterobacter cloacae

< JO·

< 10·

C1trobacter fr e und11

<10'

< 10·

Proteus vull(aris

<IO'

< 10·

Proteu s mirabil1 s

<10

< 10 1

Acinetobacter spp

< 10·

< IO

CTaq>HnOKOKKH (o 6meeKO:IHtteCTBO)

<10

<10'

Staohylococ cus aureus

< JO·

< 10

Staohylococcus SDD

< 10·

< 10

3HTCpOKOt.::KH

10'

- 10

• 10

JiallH!Jnl.J

<10

<10'

ll;pollC,r;eno.n.o6HLie rpn61.1 poua Candida

<IO

<10'

<t>HJiaMCHTOlKLlt n>H6bI

< IO

< 10 1

3aKJI10qem1e: CTeneHL:

4. IlpH TSl)KeJIOH <f>opMe.n:nc6aKTepH03a H36HpaTeJlbHO y.n:aJI.sIIOT H3- 6bJTO'l{H0 pa3MH0)KHBllJHXC.sI ycJI0BH0-naToreHHbIX npe.n:cTaBHTeJJeH HOpMo<f>rropbl C TT0M0ID:blO cpe.D.CTB, 06na.n:a10mHX cerreKTHBHOH aHTH-

6aKTepHaJU,HOH aKTHBH0CTblO:

- nposo,n:.sIT «ceneKTHBffYIO,n:eK0HTaMirnaumo» aHTHMHKp06Hbl MH npenapaTaMH, K0T0pbie He HapymalOT K0Jl0HH3HaUH0HHYIO pe3HCTeHTH0CTb KHIII e'l{Hl fKa: <pTOpXHHOJ10Hbl, MOHo6aKTaM, aMHHOrnHK03H.D.bI;

- npHMCH.silOT npenapaTbT 6aKTepHocj)aroB - CTaq>HJIOKOKKOBbIH, KJie6c:nerrrre3HbIH, nuo6aKTep1mqiar, mrrecn16aKTepHocpar n,n:p.

• KrrHHH'l{eCKH 3,n:opOBble.n:eTH,no 1,5-2-x neT npH o6Hapy)l(eHHH

-rpaH3HTOpHbIX MHKpoopraHlf3M0B (reMOJIHTJ,f'l{eCKHX E.coli, neunnrna30- Il03HTIIBHl,IX JCJIOCTpH,n:HH, KJie6cHeJIJI H.np:) H npH BbIC0K0M ypoBHe 6HcpH

,n:o6aKTepHH { l 010 l 011 KOE/r q>eKaJIHH) He Tpe6yJOT aKTHBHoro n e'-leHIDI.

Y1<a3aHHble MHKpoopraHlf3Mbl3JlHMMHHpyJOTC.sI K 1,5-2-M ro.naM)Klf3HH no.n: 803,UeikTBHCM C03peBaIOmero a;::i:anTHBH0ro HMMYHMTeTa.

5. BuonpenapaThI, npuMem1eMble,llJUI Koppe1m;uu HOpMaJILHOii MHKpocjmopbl KHWC'IJHHKa - npo6HOTHKH,

Npe6HOTHKH u CHH6HOTHKH

AKTHBHOCTh.

OKa3bIBa.sr 03.n:oposn.si:101:Qee,neikTBHe Ha)KI(T H 0611a.n:ru1 HMMYH0- CTHMyrrHpyww.eif aKntBH0CThlO, npo6HOTHKH cnoco6CTByJOT yrryqllleHHJO 3.n;OpOBJ:,.sI 'l{eJIOBe Ka.

TTpenapaTbI npo6HOTHKOB no,n:pa3)].emnoT Ha MOHOKOMTIOHeHTHbie, co

,JJ.ep)KaIIJHe MOHOKYJ1b1)'py O)].HOro BH)],a 6aKTepHH, H TIOJlHKOMllOHeHTHbie,

B COCTaB KOTOpbIX MOryT BXO.ll.lITb MHKpoopraHH3Mbl pa3JlH1-IHbIX BH)].0B J,fJlH HeCKOJlbKO IllTaMMOB O,[{Horo BH)].a, a TaIOKe BemecTBa, TIOBbIIllaIOIIJHe aKTHBHOCTb np enapaTa.

Eutj,U<)ocooepmaw,ue npenapamb1. Hx,neucrny10nmM Ha<1anoM SIB Jl.llIOTC.ll 6ttqm.uo6aKTepHH, o6na.uaromHe BhICOKOH aHTaroHHCTH'leCKOH aK THBHOCThlO nponrn rrrnpoKoro crreKTpa naToreHHhIX HycnoBHo-rraToreHHhIX 6aKTepHH. 3TH npenapaThl HOpManH3YIOT MHKpoqmopy KHilleqHHKa, ITOBhl IIIaJOT ero KOJTOHH3aU:HOHttyIO pe3HCTeHTHOCTh.

MOJlOKOMnoHeHlnHble npenapambl.

BHcj)H.n:yM6aKTepHH - co.n:ep)l(HT)l(HBhle JlHOq:>HJlbHO BhlcymeHHhle 6mpH.n:o6aKTepHH BHJJ.a B.bifidum, 11x KOHU:eHTpan:H.ll cocrnrurneT B O)],HOH,IJ,03e He Meuee 108)l(HBhIX 6aKTepHH.

TloilUKOMtlOHeHmHble, KOM6UHUpoeanHble u cop6upoeaHHble npenapambl: BmfmcpopM-co.n:ep)l(JIT 6ttqm.n:o6aKTepHH(B.bifidum) H3HTepoKOKKH (S. faecalis).

BmpHKOJl - co.uep)l(HT 611cj)HJJ.06a1<Tep1rn H 3IllepHXHH (B.bifidum, IllTaMM Escherichia coli M-17).

Bmptt.r1m (KoM6HHHpoBaHHhIM npenapaT) - co.n:ep)l(HT B.bifidum H J1H3OU:HM.

Em:pHJJ.YM6aKTepHH-cpoJ)Te H TTpo6mpop- co.uep)l(aT B.bifidum, a.n:cop- 611poBaHHbie Ha aKTHBHpOBaHHOM yrne (copfo1poBaHHbIH npenapaT).

<l>nopa.n:ocpttmoc - cMec1, nuoqnrnhHo BhicyweHHhIX B.bi fi dum, B.longum, L.acidophylis, L.bulgaricus H Streptococcus thermophylus (6HonornqecKH aKTHBHaSI.uo6aBKa K IlHIIJe - EA)]J

Da1<.mocooepmaw,ue npenapamb1. JJ:etrcTBYIOIIJee uaqano 3THX npenapaTOB -)l(HBbie naKT06au:HJ1m,1, 06J1a.ua10mHe IIIHpOKHM cneKTpOM aHTaroHHCTI,JtJeCKOH aKTHBHOCTH no OTHOilleHmo K naToreHHhIM J,f ycnOBHO naToreHHbIM 6aKTepH.llM 3a cqeT npOJJ.YKU:HH opraHWieCKMX KHCJlOT, nepe KHCH BOJlOpo.n:a H JlH3OU:HMa.

MoHOKOMnOHeHmHble npenapambl co.uep)l(aT)l<HBhie JlHO<pHJlhHO BhICYilleH Hhie naKT06au:mrn1,1pa3HhIX BH)].OB:

JlaKTo6aKTepHH- L.plantarum, bHo6aKToH - L.acidophilus. facTpo<papM - L.bulgaricus

Ilo.r1u1<0Mno11eHmHble npenapamb1:

A1.umaKT- co.nep)KHT nnoqm.11bHo BblcyrneHHbie:>KHBbie L.acidophilus

Tpex I.I.ITaMMOB.

nnHeKC - B C0CTaB npenapaTa BX0,[(.SIT)KHBble JIHOq>HJIH3HpOBaHHbie 6aKTepm.f an.nos L.acidiphilus, B.infanti s, S. faecalis.

Aunnon- co.nep)l(HT L.acidophilus Hrronncaxapn.n 1<eqmpHbIX rpn61<os

(HMMYHOCTHM)'JI.IITOp).

TipHMa,noqrnmoc - cMeCb)KHBblX JIHOq>HJibHO BblcyrneHHbIX L.acidophilus, L.rhamnosum, B.infantis, B.adolescentis Ha ocHose MaJibTO,[(eI<cTpHHa (EA). TipenapaT C0CTaBJieH C yqeT0M BH,nOBOro C0CTaBa 6Hqm.no- H JiaI<To6aunnn y mo,neH pa3JIH'IHblX B03paCTHbIX rpyrm.

Ko!lucooep:m:atl(Ue npenapambl (MOHOKOMflOHeHTHbie "IlOJlHKOMfl0- HeHTHbie) co.nep)KaT:>KHBbie JIHOq>HJTbHO BbicyrneHHble I.I.ITaMMbl KHllletJHOH nanoqKH - Escherichia coli, K HHM OTHOC.IITC.sl KonH6aKTepHH, EHq>HKOJT, Euoq>nop.

- KonH6aKTepHH - co,nep:>KHT 6aI<TepHH aHTaroHHCTHt.J:eCKHaKTHBH0ro IIITaMMa E.coli M-17. TiperrapaT Ha3Hat.JaIOT npH Bblpa)KeHHOM.neq>HUHTe E.coli. Konu6aKTepHH HOpMaJIH3yeT cl>H3Honornqec1<oe paBHOBec11e KH me,moH MHKpOq>JIOpbI, 803,[(eHCTBYSI Ha MHOrHe rraToreHHMe H ycJI0BH0- rraroreHHbie MHKpoopraHH3Mbl.

llpenapamb1, npuzomo6JleHHb1e u3 opyzux _6U006 6a1<.mepuu _UJlU

MUl<.J)OOHblX Mema60J1Umo6.

- Tipenapa-r1,1 Crropo6aKTep1rn,EaKTHcnopHH, EaKTHcy6THJI co,nep)KaT

)KHBble K}'Jibzyp1:,1 a3po6HbIX crroporeHHbIX rranot.JeK po,na Bacillus - B.cereus HJIH B.subt ili s. O6na.na.11 caxapoJIHTHt.JeCKHMH q>epMeHTaMH, 6aQHJIJibI o6- pa3YJOT KHCJTYIO cpe.ny, nperr.SITCTBy.s1 rrpoueccaM rn11emu1, cnoco6cTBYIOT CHHTe3y BHTaMHHOB rpynn1:,1 B H p B KHIIIet.JHHKe.

MHKpoopraHH3Mbl, COCTaB.JUIIOI.UJ.fe OCH0BY 3THX npenaparoB, He OTH0- C.IITCSI K xapaicrepm,IM rrpe,!lCTaBHTeJTSIMHOpMaJibHOH MHI<pocl>Jiop1:,1KHIIIe'IHHI<a. RxH3JIHIIJHee pa3MHO:>KeHHe Ha cpoHe CHIDKeHIDl KOJIH'leCTBa 0CHOBHblX npe.n CTaBHTeJieH o6mmrrao:i% MHKpoqmopbI MO>KeT 0TIIr0IIJJITb Tet.JeHHe,[(HC6aKTe pH03a, oco6eHHo y H0Bopm1<,nemn,rx H,nereii MJia,nmero B03pacrn. Tio3TOM)' rrpHMeHeHHe TaKHX rrperraparoB IlOI<a.3aHO TOJlbKO _,[(en(M CTapme 7 JleT. Qe

necoo6pa3HOCTh Ha3Hat.Jemu1 nperraparos, co.nep:>KalllHX B.subtili s-B.cereus,

.no.JDKHa ouemmaT1:,c.11B KIDK,ll,OM KOHKpernoM cnyqae 3a6011esaHID1.

- XIDiaK-<pOpTe - He co.nep)KHT)KHBl:,IX 6 aKTepHM, s ero COCTaB BXO

,[(.SIT TOJlbKO cy6cTpaThI rrpo,nyKTOB)KJi3He,!le.slTeJibH0CTH E.coli, S.faeca li s,

L.acidophilus, L.helveticus, a TaIOKe Ha6op coneii H MOJIOT.JHrur KHCJIOTa. IlpenapaT cnoco6cTByeT BOCCTaHOBJieHHIO HOpMaJibHOH MHKpoq,nopbI KHIIIeT.JmlKa, HOpMaJIH3YeT CHHTe3 BHTaMHHOB rpynnhI 8 H K, CTHMyJIH

pyeT pereHepa[(lflO CJilf3lfCTOH o60JIOT.JKH KHIIIeT.JHHKa, BOCCTaHaBJIHBaeT KHCJIOTHOCTb H HapymeHHbIH BO.IJ:H0-3JieKTpOJIHTHT.JeCKHH 6anaHc B npo

CBeTe KlfIIIKlf.

IlpenapaTbI-npo6HOTlfKlf, pa3pa6oTaHHbie Ha Kaq>e,z:i:pe MHKpo6Ho JIOrIUI PfMY.

I. Enq>n.nyM6aKTepHH attn 16n oTHKoycTonq lf BhIH.

2.)KJ]ECK (:>KHBOH neT.Je6HhIH cTpenToKOKK KHIIIeT.JHHKa), co,z:i:ep)l(HT

)l(HBbie JllfOq>lfJibHO BbICYIIIeHHbie 3HTepOKOKKH - S.fa ecali s, npe,z:i:Ha- 3HaT.JeH,[{JUI Koppe lflf MHKpOq>JIOpbI KHIII eT.JHHKa .

3.)IOIEM:HK ()l(eHCKHH rreqe6HbIH MHKpo6), co,z:i:ep)l(lfT)l(HBbie IIITaMMhI

L.fermentum, npe,nHa3HaT.JeH)J,ml KOppeK[(Hlf BarHHaJibHOH MHKpo q>nopbI.

Ilpe6HOTHKH H CHH6HOTHKH

Ilpe6uomu,<.u - npenapambl HeMu1<.po611020 npouexo;;,coe11UJ1., 11e ao eop6upy10me.H. 6 6epx11ux omoeJlax nuU{,e6apume.nb11020 mpaKma, enoeo611bl emUMyllupo6amb poem WlU Mema6oJlU'leeK)'10 aKmU61I0emb 110pMGllb1IOU MUKpO<pllOpbl KUUle'lHUKa. l/aU{,e 6ee 2 0 6eU{,eem6a, eoema6JlJl10U{,Ue 0CH06Y np e6uomu Ka,.H.6JIJl10mC.H. HU3K0M0JleK)'JlJlpHblMU y2lle600a.MU (0llU20eaxapu Obl, <ppyKmOOJlU20eaxapuiJbl), eooep;;,camc.H.6 2 py iJHOM M0Jl0Ke U 6 HeKomo pblX nUU{,e6blX npoiJyKmax.

- JlaKTYJI03a (.D:IOq>arraK)- co,nep)l(JIT cHHTeTHT.JecKHH.nncaxapH,n. JlaK ryno3a rn.npomi3yeTC.il MHKpoq>rropon TOJICTOro KlfIIIeT.JHHKa B OCHOBHOM.no MOJIOT.JH OH' KH CJIOTbI, KOToprur CTHMyJIHpyeT n epH CTaJibTHKY, cnoco6cTByeT CHH)l(eHlflO p H, ceJieKTIIBHO HCTIOJih3yeTC.il 6ltq>H,no6aKTepHRMH H rraKT0- 6 aKTepHRMH, cnoco6cTBy.i1 HX pocry Hpa3MHO)l(emno.

- IlaHTOTeHaT KaJib[(H.il - YTHJilf3HpyeTC.il 6Hq>H,z:i:o6aKTepHRMlf, CTHMYJIHpyeT HX pocT H pa3MHO)l(eHHe, yT.JaCTByeT B nponeccax OKHC JieHH.il B KJieTKax.

Cu116uomu,<. u - n p ena p am b z, npeoema6JlJl10U{,U e co6ou KoM6uHa'14uu npo6uomuKo6 u npe6uomuK06, oHu U36upamellb1IO emUMyllupy10m poem u Mema60Jtu'lee1<.y10 aKmU6Hoemb uHiJu 2 e1111ou MUKp O<pll Op bl, no6blUta10m

<paKmOpbl eemeem6eHHOU 3GU{,Umbl op 2 aHU3MG.

- EHoBecnmr-naKTo-co.nep)l(JIT 6mlm.noreHHbie cl>aKTOpbI H 6HoMaccy 6aKTepHH B.bifidum, B.adolescentis, L. plantarum.

6.ruoT06uonornH.IlpaKTnqecKoe3uaqeuue

I'Homo6mo11ozua - Hay1<.a (pa3oen 31<.cnepUMeHmaJlbHoii 6uo11ozuu U.MeOUU,UHbl), 3QHUMQIOU{llJlC.R no11y11enue,w U 6btpaU{U6QHUe.M:JICU60m

HblX, c6o6oonw.-c om Mu«.poopzaHU3M06 (znomo6uonmoB) u U3y11enue.M

UX:JICU3HeOeRmeJLbHOCmU.

Ee3MHKpo6HbIX)KHBOTHblX, HanpHMep MbIIlleH, nonyqaIOT nyTeM acenTl-fqCCKOro BCKpbITH.sI MaTKH 6epeMCHHOH MhlllIH H H3BJ1eqeHml H3 Hee MbIUiaT, KOTOpbIX BblpaIUHBaIOT B CTepHJibHbIX ycnOBH.sIX B cne:uuam,HOM rHOT06HOJIOrHqecKOM H30JI.sITOp e, KOpM.sIT CTepHJibHOH 1mmeii, TIOCTO.sIHHO

npOBOJl.sIT KOHTpOJib Ha OTCYTCTBHe MHKpocpnopbI. BpeMCHHOe IlOJIHOe YJ{aJieHHe HOpMaJibHOH MHKpoct>nopbl KHilleqHHKa B03MO)KHO H y MbllllCH, BbipameHHbIX B 06b1qHbIX ycnOBIDIX, nyTeM BBe.neHH.sI HM KOMTJneKca aH TH6HOTHKOB (CM. MCTO.IlHKY rHOT06HonoruqecKoro 3KCn ep HMeHT a).

Ha)KHBOTHbIX-rHOT06HOHTax1nyqaIOT MexaHH3Mbl H cpopMbl B3aHMO

.neHCTBIDI MHKpo6oB H MaKp oopr aHH3Ma. BbI.sICHCHO, 'ITO HOpMaJibHa.sI)KH3- He.neBTCJ1bHOCTb BbICillHX)KHBOTHbIX, B TOM qffcJie H qenoBeKa, B03MO:>KHa JIHillb rrpH coxpaHHOCTH B opraHH3Me ecTeCTBCHHOH MHKpocl>nopbI.

rttoT06HOJIOn1qecKHe 3KCrrepHMeHTbl rrp0Bo.n.s1T, rrpe)KJJ;e Bcero, B Me.nHUHHCKOH 1-1 BeTepHHapHOH MHKpo6HonorHH, HH<peK:UHOHHOH 1-1 He

HH<peKUHOHHOH HMMYHOJIOrHH H rraronorHH, npH H3yqeHHH cl>H3HOJIOrHH IlHJ.UCBapeHH.sI, B p a.n1-10 6HO JIOrH H.

rttOT061mnorHB Haxo.nHT npaKTHqeCKOe rrpHMeHeHHe B KJIHHWICCKOH Me.nHUHHe, B '-laCTHOCTH B XHpypnu1, OHKOJIOrHH, ne.nHaTpHH, OHa TCCHO CBB3aHa C KOCMHqecKOH 6HOJIOrHeH H Me.nHUHHOH.

CxeMa rnoT0611onoruqecKoro 3KcnepHMenTa no no 6opy pannoHaJILHOH aHTH6HOTHKOTepaDHII

1. TomOJlbHaJl iJeKoHmaMuHa1,fuJt (BpeMeHHOe yHJ,lqTO)KCHHe Bceii MHKpoqmopbI))Keny.no'-IHO-KHllle'-IHOro TpaKTa)KJ.IBOTHblX.,nn.11:noro MbllllaM B Te'-leHHe 5,n:HeH rrepopanbHO (qepe3 poT) BBOJl.sIT aHTH6HOTHKH

urnpoKoro cneKTpa.neHCTBH.sI: aMHKa:UHH (10 Mr/Mn)+ aMITHOKC (4 Mr/Mn)

+ HHCTanm (4 Mr/Mn).)l(HBOTHblM.naIOT CTepHJibHbIH KOpM H BO.ny, MOIOT B l% pacTBope xnopreKcH.nHHa.nn.11 CTepHJIH3aUHH KO)KHbIX IIOKpOBOB H

rrepeB0,LVIT B rHOT06HOJIOrJ,ftJeCKHM H30JHIT0p, rAe BB0,WIT aHni6HOTHKH

ern;e 0AHH cyTKH.

2. AoanmalJUH:JICUB0mHblX u rf>opMupoea11ue 1108020 MUKp06UOlJe H03a. OTMemIIOT aHTH6HOTHKH H BbIAep)KHBaIOT)KHB0THbIX B H30m1Tope 2 cyT0K, AeJialOT KOHTpOJihHbIH BhICeB cpeKaJIHH - MHKpocpnopa JJ:0JI)l(Ha 0TCYTCTB0BaTb. MHTparacTpaJibHO BB0AjJT)l(HB0THhlM 0,3 r.ri:eKaHTaTa cpeKaJIHH 60,'lhHoro mm paHeBoro 0TAengeMoro. Y MbillleM cpopMHpyercg

MHKpoq>Jiopa' KHlll etJHHKa , T0 ecTBeHHajJ MHKpocpnope 6oJibHOro.

3. H3yl/e11ue l/yecmeume'1b1Wcmu MUKporpllopbz K a11mu6uomuKGM in vivo. Mb1IIIaM lIHTparaCTpaJibH0 BB0,L{ITT pa3JIWIHbie a.HTI16HCYI"HI<H H BbUIBIDIIOT HaH6011ee aKrnBHbie rryTeM BbICeBa MHKpO<pJIOpbl Ha 3JieKTMBHbie IlHTme.Jil,Hble

cpeAbI. Ilocne aHaJIH3a nonyqeHHbIX pe3yJihTaTOB coCTaBJI.SllOT cxeMY Pa!OfO

HaJihHOM airrn:6HOTHI<OTepamrn,wui K0ppeKQHH Mm<poqmopbl 6oJibHOro.

3TOT MeT0A peKoMeH.l{yeTCH npHMeHjJTb AJI.11 6onee 3cpcpeKTHBHOM aHn16HOTHKOTepanm1 60JihHbIX (He no;ma10rn;HMHC.II o6bitJHbIM MeT0JJ:aM JietJeHH.11), B TOM tJHCJie.l{JijJ rreqemrn MHTeJibH0 Teeyrn;HX, xpoHHtJeCKHX rHOHHO-BOCilaJIHTeJibHhIX 3a6 on eaaHHH.

KouTpom.ui.1e eonpoci.1 no TeMe 1auHTHH

1. 3KOJIOrHtJeCKa'1 MHKpo6HOJIOrHH (MHKp03KOJIOrH.11); ynoTpe6rureMble Il0IDITHH: 6HOTOil, MHKpo6HOUeH03, nonyrru].H.11, 3K0CHCTeMa.

2. IlepetJHCJIHTb Fl oxapaKTepID0BaTb THITbl Me)l(BHJJ:0BhIX B3aHM00TH0Uie

HHH B 3K0CHCTeMe Me)l(.l{y nonyJI.sJUH.IIMH MHKpoopraHH3M0B B C0CTaBe 6HOUeH03a - HeHTpaJIH3M, CHM6H03, K0MMeHCaJIH3M, aHTar0HH3M,

napa3HTH3M.

3. Tio,n;pa3,n;eJJeHHe MHKpoqmopbl tJeJioBeKa B 38BHCHM0CTH OT ee Il0CT0- jJHCTBa H cpaKTOpbI, K0HTp0JIHpyiorn;He ee Il0CT0.IIHCTB0 a 6HOTOrrax.

4. 3Hat.JeHHe H0pMaJJI,HOH MHKpOq>JIOpbI JJ:JijJ opraHH3Ma qeJI0BeKa Fl

pa3BHTH.sl ero HMMYHHOH CHCTeMbl.

5. <l>yHKI.Um HOpMaJihHOH MHKpocpnopbI.

6. PoJib HOpMaJihHOH MHKpocpnopbI B o6ecneqemm KOJJOHH3aUHOHHOH pe3HCTeHTH0CTH K 3K30reHHbIM B036y,n;HTeJI.sIM, ee MexaHH3Mhl.

7. Ka11ecTBeHHhIH H KOJIHtJeCTBeHHhIH C0CTaB MHKpOq}JIOpbI pa3HbIX 06-

nacTeH (6HOTonoB) Tena 11enoBeKa - J<O)l(H, pecrrHpaTopnoro H yporeHH

TaJihHoro TpaKT0B. Ponh HOpMaJibHOH MHKpoqmopbI 3THX 6HOTOITOB.

8. MHKpoq)Jlopa ITHrn;eBapHTeJibH0ro Tp aKTa. Ka11ecTBeHHhIH Fl KOJIH'le CTBeHHhlH C0CTaB MHKpocpnopbI poTOBOH Il0JJ0CTH,)l(eJiy.l{Ka, T0HK0ro

H T0JICT0ro KHIII e'I HHKa. IloJIOCTHaH H MYK03HaH MHKp o q>n o p a.

9. TiepeqHCJllITb H oxapaI<Teptt30BaTb OCHOBHblX npe.ucTaBJ.nenew HOp MaJlbHOH MHKpocpnopbI TOJICTOro KHilleqHHKa.

10..[.(1rnaMHKa p83BHTmI MHKpo6HoQeH03a TOJICTOro KHmeqHnKa y rpy.u HOro pe6eHKa. Bo3MO)l(HOCTb KOppeKQHH.uaHHOro npoQecca.

11. TioH.IITHe «.n;Hc6aKTepH03». 3Haqem1e,UHC6HOTHqecKHX H3MeHeHHH

HOpManbHOH MHKpoqmopbl H, oco6eHHO, MHKpocpnopbl TOJlCTOro KH weqHHKa.un.11 opraHHJMa.

12. <l>aKTOpbI, IIpHBOJl.llW:He K pa3BHTHIO,[{HC6aI<TepH03a.

13. CTa,n:HH (cTeIIeHH),UHc6aI<TepH03a, HX xapaKTepHCTHKa.

14. MeTOJlbl na6opaTopHoH.UHarHOCTHKH.UHc6aI<TepHo3a. EaI<TepHono rnqecKHH (KOJIHqecTBeHHbIH) MeTO.U HCCJie,[{OBamrn HCIIpa)l(HeHHH C

QeJiblO BblSIBJieHH.11,UHC6aKTepH03a.

15. MeTO,Ubl 3KCIIpecc-,n:HarHOCTHKH m-rc6aKTepH03a, Ha '-leM OCHOBaHbl, IIpHMepbI, 3HaqeHHe.

16. IlpHHQHIIbl KoppeKJ..lHH MHKpocpnopbI TOJICTOro KHWeqHHKa npH,[{HC-

6aKTepH03e.

17. Ilpo6HOTHKH, IIpHMeIDieMbie,UJI.11 KOppeKQHH,[{HC6aKTepH03a KHmeq IDIKa, HX xapaKTepHCTHKa. IlpHMepbl 6nonpenapaTOB npo6HOTHKOB p83JIHqHbIX THIIOB.

18. Ilpe6HOTHKH n CHH6HOTHKH, HX xapaKTepHCTHKa, IIpHMepbI 6Honpe

napaTOB.

19. rHoT06HOJIOrH.11 H..e. e npaKTHqecKoe IIpHMeHeHHe B 6HOJIOrHH H Me-

.lUill.HHe.

20.)KHBOTHble-n-IOT06HOHTbl, cnoco6bl HXnonyqeHIDI H co,n:ep)l(aHIDI.

21. CxeMa rHOT06YfOJIOrnqecKOro 3KCIIepHMeHTa C uem,IO OITTHMaJibHOro Il0)],6opa aHTH6HOTHKOB)].JI.II JieqeHH51 6oJibHOro.

PaJ,ll,eJI 2: UncI,eKU:HH. cl>aKTOpbI naToreHHOCTH MHKpoopraHlf3MOB. IIHcl,eKD;HOHHhle JaooJieBaHHH, RX IlO,ll,pa3,!J,e.'leHHe

AHHTHe 11

IIJiau JaHHTHH:

1. HmpeKIIIUI H Hm}eKUHOHHblll npouecc. YcnoBml pa3BHTH.sI HHq>eKUH OHHOro rrp OL,ecc a.

2. Ponb MHKpoopraHH3Ma s HHq>eKUHOHHOM rrpou:ecce: rraToreHHOCTb H BHpyneHTHOCTb MHKpoopraHH3MOB, e,J:(l.fHHUbl H3MepeHH.sI BHpyneHT HOCTH.

3. <l>aKTOpbl rraToreHHOCTH MHKpoopraHH3MOB: q:>aKTOpbI a.ure3HH H

KOJIOHH3aU:m i, HHBa3HH H arpeCCHH, 3HTHcparOUHTapHble cpaKTOpbI. IlpHMepbI H MexaHH3Mbl.ueikTBml.

4. baKTepHaJibHbie TOKCHHbl, rro,np a3,nene1rne. Knaccmpm<aUIDI 6eJIKOBbIX

TOKCHHOB no MexaHH3MY.neHCTBIDI. XapaKTepHCTHKarpynn TOKCHHOB. 3H,UOTOKCHHbl.

5. <I>opMbl HH<peKUHOHHb!X 6one3HeH. 3JieMeHTbl:mH,UeMHOJIOfHH.

6. JKCnepHMeHTaJibHa..sI HHcpeKUHH. UerrH H MeTO)]J,I 3apIDKeHHH 3Kcne pHMeHTaJibHbIX)KHBOTHbI X.

7. CaMOCTO.sITeJihHa.sI rrpa.KTH'{eCKa.11 pa6oTa - yqeT OilbITOB no Bbl.sIBJie HHIO cpaKTopoB naToreHHOCTH 6aKTepHH:

a) BnI.sIBJieHHe KarrcyJihI y KarrcyJibHbIX 6aKTepHH B OKpaweHHblX Ma3Kax KJie6cHenn H 6au:1mn H Kop.n-cpaKrnpa y Mycobacterium tuberculusis B Ma3Kax, OKpaweHHblX no I.l;HJJIO-HHnbcetty.

6) Tecn1HaITJia3MOKoaryna3y, r11anypoHH.Ua3Y, neU:HTHHa3Y,.[{HK

a3y H reMOJIH3HHbl y CTa<pHJIOKOKKOB.

OEU.-Afl MIIKPOEHOJIOBUI

'IACTb2

MHKPO<l>JIOPA TEJIA 'IEJIOBEKA.

)IHC6AKTEPH03.

lIH<l>E IDl. <l>AKTOPLI IlATOr EHHOCTH MHKPOOPrAHH3MOB.

BPO)K)J,EHHLIH HMMYHHTET

Moc1<aa 2010

ROYBilO

POCCHHCKHH rocY,[(APCTBEHHI,IH ME,[(IIIOfllCKHH

YHIIBEPCHTET (PrMY) POC3.ll;PABA Pct>

OliIU;MI MHKPOliHOJIOrIDI

QACTb 2

MHKPO<l>JIOPA TEJIA 11EJIOBEKA. CliAKTEPH03.

HH<l>EK IDI.<l>AKTOPLIIlATOrEHHOCTH

MHKPOOPrAHH3MOB. BPOlK,[l;EHHLIH HMMYHHTET

YlIEEHO-METO,l.U1t.JECKOE IlOCOEHE

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