Supportive Therapy in OncologySupportive Therapy in OncologyПоддерживающая терапия в онкологии3034-24733034-3178Publishing House ABV Press6310.17650/3034-2473-2025-2-2-44-60REVIEWSОБЗОРНЫЕ СТАТЬИModern approaches to the treatment of infections caused by Pseudomonas aeruginosa with multiple antimicrobial resistance. What a practicing physician should knowСовременные подходы к лечению инфекций, вызванных Pseudomonas aeruginosa с множественной устойчивостью к антимикробным препаратам. Что должен знать практикующий врачhttps://orcid.org/0000-0001-8198-7131EpifanovaNatalia Yu.ЕпифановаН. Ю.
Russian Federation

Natalia Yuryevna Epifanova.

24, Kashirskoye Shosse, Moscow 115478.

Наталья Юрьевна Епифанова.

115478 Москва, Каширское шоссе, 24.

ne_nato2007@mail.ruN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России150720252244600107202501072025Copyright ©; 2025, Epifanova N.Y.Copyright ©; 2025, Епифанова Н.Ю.2025Epifanova N.Y.Епифанова Н.Ю.https://creativecommons.org/licenses/by/4.0https://stio.abvpress.ru/jour/article/view/63

The rise of antimicrobial resistance is a pressing problem worldwide. Oncology patients are at risk of developing infections caused by multidrug-resistant bacteria. This is associated with frequent visits of patients to hospitals for chemotherapy courses, long periods of neutropenia in oncohematologic patients and after hematopoietic stem cell transplantation, repeated courses of antibiotic therapy, surgical interventions, etc.

Aim of this work – to familiarize physicians with the mechanisms of antimicrobial resistance of Pseudomonas aeruginosa (P. aeruginosa), the possibilities and limitations of new antibiotics with antipseudomonal activity, and to help with the choice of antibiotic therapy for infections caused by multidrug-resistant P. aeruginosa and infections difficult to treat due to P. aeruginosa resistance.

The summarized data of the Russian online antimicrobial resistance research platform AMRmap on the sensitivity and resistance of P. aeruginosa in Russia for the period 2020–2022 is presented. Recommendations on treatment of infections caused by multidrug-resistant P. aeruginosa and infections difficult to treat due to P. aeruginosa resistance of the Infectious Diseases Society of America (2024), the European Society of Clinical Microbiology and Infectious Diseases (2022) and Russian guidelines on diagnosis and antimicrobial therapy of infections caused by multidrug-resistant microorganisms (2024) were analyzed. The possibilities of overcoming the mechanisms of P. aeruginosa resistance in new beta-lactams and selected antibiotics with antipseudomonal activity are considered.

Рост устойчивости к антимикробным препаратам – актуальная проблема во всем мире. Пациенты онкологического профиля относятся к группе риска развития инфекций, вызванных бактериями с множественной устойчивостью к антибиотикам, что связано с частыми обращениями пациентов в стационары для проведения курсов химиотерапии, длительными периодами нейтропении у пациентов онкогематологического профиля и перенесших трансплантацию гемопоэтических стволовых клеток, а также получением неоднократных курсов антибактериальной терапии, хирургическими вмешательствами и пр.

Цель работы – ознакомить врачей с механизмами устойчивости Pseudomonas aeruginosa (P. aeruginosa) к антимикробным препаратам, возможностями и ограничениями новых антибиотиков с антисинегнойной активностью и помочь с выбором антибактериальной терапии при инфекциях, вызванных мультирезистентными (multidrug-resistant) P. aeruginosa, и инфекциях, трудно поддающихся лечению в связи с резистентностью (difficult-to-treat resistance) P. aeruginosa.

В статье представлены  обобщенные данные российской онлайн-платформы по изучению резистентности к антимикробным препаратам AMRmap о чувствительности и резистентности P. aeruginosa в России за период 2020–2022 гг. Проанализированы рекомендации по лечению инфекций, вызванных  мультирезистентными P. aeruginosa, а также трудно поддающихся лечению в связи с резистентностью P. aeruginosa, Американского общества по инфекционным заболеваниям (2024 г.), Европейского общества по клинической микробиологии и инфекционным заболеваниям (2022 г.) и Российские методические рекомендации по диагностике и антимикробной терапии инфекций, вызванных полирезистентными микроорганизмами (2024 г.). Рассмотрены возможности преодоления механизмов устойчивости P. aeruginosa у новых β-лактамов и отдельных антибиотиков с антисинегнойной активностью.

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