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Ilpuroxenue 8rc Per.nauenry B3arrMoAeftcrsnq ytracrHIrKoBMOHr{TOpl{Hra pacnpocTpaHeHI|s pe3rrcTeHTHbrxK aHTr{MnKpodnrrpr [pe[aparaM ros6yAure.nefirocnrrraJrbHbrx nn$erqufi s CaHKT-flerep6ypre

Kpr,Irepnu Bbl6opa n3orqroB Bo36yAuTerefi rocrnraJrbHbrx lrHQeKrlr.rfi Arq Ha[paBJreHrrr B

rIoApa3AeJIeHI.Iq JIa6OpaToprru, BbrrroJrHflrorqefi pe+epeHTHbre r.tccJreAoBaHr.lfl

J\bnlfi

HaunrenosaHueAMII

Toqnu orceqeHlrfl IlogpargeneuuapeQepeHc-

raooparopuu BKoTopbre cJreAyer

HarrpaBHTb

I{30rqrbl

ArraMeTp3OHbI

3aAeplrcKrrpocra,

MM

MI,IHUMAflbHAq

noAaBJIflrorqaq

KoHqeHTparIuq(MrrK),MKf/MJI

t Xaparcrepucrrrna rr3oJrflToB Escherichia coli u Klebsiella spp. noApa3AeneHr4e Ne1 . 1 Meoonesevr < 2 5 > 0.125t . 2 .I[opunesevt < 2 7 > 0.1251 . 3 I,IunneHeu < 2 4 > 0 .5T,4 3praneseu < 2 9 > 0.0641 . 5 Tureulmlzn < 1 8 > 1 . 01 . 6 KonucruH > 2.01 . 7 floruruurcuu B > 4.07 Xapaxrepracrr{Ka rr3oJrsroB Pseadomonas aeruginosa u

Acinetobacter sDD.2 . 1 Korucr:un > 2.02.2 floruruuxcus B > 4.03 Xaparcrepucruna u3oJrfl ToB Stap hv lococctrs spp.3 . 1 Jllruegorua < 1 9 > 4.03.2 Basrolrnuun > 2 .0a aJ . J Tzreuurrun < 1 9 > 0.253.4 fianrorr,rnqnu > 1 . 04 XanaxrenncruKa rr3oJrflToB Enteroco cctrs spp.4 . 1 Jlunegomaa < 1 9 > 4.04.2 Banronuqun < 1 2 > 4.04.3 Turequrrnu < 1 8 > 0.254.4 [anrounquH > 4.0) XaparrepucruKa r.r3oJrffToB Strepto cocc us spp. ceporpyrn

A.B.C.F.GnoAprrAeneHr,re Ns 4Pe$epenc-ra6opa'ropuu(@fEHv r43M)

5 . 1 OEH3 H JINEHLIUI4JI JII,IH < 1 9 > 0.25

5.2 sPI,ITPOMI4III,IH < 2 1 > 0.255.3 TeTpauuKJI14H < 2 3 > l

5.4 KNI,{HIAM14III,IH < 1 7 > 0.55 .5 noptpnorcaqus (.qucr

l0 nnr)s12

5.6 resofrrorcaIIZH < 1 5 > 25.7 BAHKOM14III4H < 1 5 > 25.8 uerborancult < 2 5 > 2

J\}i l l i l

HaHDrenoeaHneAMtI

Toqxu orcerreHufl [oApasAefleHnspe$epenc-

ra6oparopuu e

KOTOpbre cJreAyerHarrpaBr.rTb

II3OJIgT[rI

AuaMeTp30HbI

3aAeplnKr{pocTa,

MM

MNHUMAJ|bHAq

NOAABTRIOI{Aq

KOHrleHTparIHq

(M[IK),urcr/u.n

6 Xaparcrepucr*rKa rl3ofl qroB Str ep to co cc us p ne umo niae noApa3AeJresue Jrlb(ofEv Hww4vr)6 . 1 Oxcaqurnun (lzcx

llrxr)< 1 9

6.2. Eesgulnenvrrr4nrvn > 0.066.3 . Spurpouuunn < 2 2 > 0.256.4. JleeodrorcaquH < 1 9 > 2 . 06.5 . Moxcn$roKcarIr4H < 2 2 > 0 .57 XaparcrepNcrrrKa rr3oJrfl ToB S almo nella spp.,

BKJrrcrrar S.tvphiroApinAeneHue Jrlb

Pe$epenc-ra6oparoprara((DByH HI4I4

Snr,IAeMr4onOrIlId Vl

naurpo6nororunr4MeHr4 llacrepa)

7 . 1 IIeSrasvluM < 2 2 > 1 . 07.2. Lletborarcnvt < 2 1 > 1 . 0

MepoueHepr < 2 5 > 0.1257.4. Haru.luxcoBafl K-Ta < 1 67 .5 . I-{unporf roKcauLIH < 3 0 > 0.067.6. fledroxcauun < 2 48 XapanrepucruKa u3orqroB Shigella n AlrapeereHHblx

Escherichia colirroApa3AeneHI,re Ns 3

Pe(pepenc-ra6oparopzr,r(oEyH HI{LI

3nI,IAeMnOJrOlvll4 14

uunpo6uororuuLrMeHr4 flacrepa)

8 . 1 UetbrasnllaNa < 2 2 > 1 . 08.2 I-[eSoraxcurr,t < 2 1 > 1 . 08.3 Meponeseu < 2 5 > 0.1258.4. I{unpot[noKcarrl4H < 2 2 > 0 .5

9 XapaxrepucruKa la3orqroB Enterobacteriacae(nnoue Escherichia coli u Klebsiello spp.l

rroApa3Aenesue JtlbPe$epenc-

ra6opa'ropun(@EyH HI,1I4

SrruAeMI,IOJIOrkrw pr

uurpo6uororuur4MeHr4 llacrepa)

9 . 1 Uedraszaprnr < 2 2 > 1 . 09.2. Lledoraxcuu < 2 1 > 1 . 09.3. Meponeueu < 2 5 > 0.t259.4. I{unpotpnoKcaqr.rH < 2 2 > 0.5

10 I4go rqrrr Bcex BI{AoB, yAo BJIerBopfl lolque o rIuAeMLIoJIo f pt.I ec KI4M

Kpr4Tepr4qM or6opa corJlacHo npl4noxeHl4to 13, 3a I,IcKJIIoqeHI4eMlI3oJItroB, orHeceHHbIX K poAy Streptococcus spp.

noApa3Aenenue J\l:2Pe(pepenc-

ra6oparopura (fEOYBIIO C3|MY

uwr.kI.I4. MeqHnKoea)

l l I4gorq'rn Bcex BI4AoB poga Streptococcus spp.,yAoBnerBoptrcque gnuAeMVoJIorI4qecKI4M KpI4TepI4.fl M or6opa

corJlacHo npuloNeuuro I 3

noApa3AeneHIae J\b 4Pe$epeuc-

na6oparopnu(ofEHv I43M)

* ,ftr HanpaoreH H, u3orsraMuKpoopraHu3Ma B noApa3aercur.rr Jr a6oparopuu, nnnolurtouef perpepeHtalte uccreAoBaHaf aocraro!rHblM tBrlercs co6lrAeuue

oAHoron3nepeqacIeHHbIXyclonuf(rranpr-rvep,HaIHqHepe3I,IcTeurHocruxlr6ol,ryt-rsatlrt6uoluMr.rKpoopmHIr3Ma)

flpunoxenue 9rc Per.uauenry sranNroAeftcrsus yqacrHl{KoBMOHr{ToprrHra pac[pocTpaHeHuq pe3ucreHTHblxK aHTr{Mr{Kpo6nuna [pe[aparaM nos6yAnrerefinocnl{TaJrbHbIx uu{erqnfi n Canrcr-flerep6ypre

Hanpanrerure rr3oJrfl Ta (conponogureJl bHoe n ucsuo)n radoparoprrm, BbIrlorHqrcIrryrc pe$epenruble rrccJleAoBaHIrfl

9. Haruquer{HBa3uBHbIXBMeIIrareJIbcrB(nyxnoe uo4ueprcuyrr)a. Karerepusalll{fl BeHb. Karerepusallu{ Mor{eBoro ny3blptc. I4BJI

1 .HaurueHosaHue vr{Dex{ nelc'ufr

2. flna BbrAereHu.s J___J_3" Jla6oparopHrrft uouep4. [rEarHos5. OI4O naqrreHra5. fiara [ocrynJreHut [aqrIeHra B cralll{oHap

_J___J_6. Horuep vcropufir 6onesHLI7. Or.4eresue8. Haluqpre on eparuBHof o BM ellareJlbcrBa fiaftletHanN,renoeaHr{e onepallun

Nsn/n

HauMeHogaHr.re

npenapara

arzaMeTp3OHbI

3aAepxK14DOCTA. MM

MUHI,IMAIbHAq

noaaBJItIoqat

KOHrleHTpaqut(MIIK).trmr/u:i

I Xaparrepucraxa usostsroe Escherichia coli u Klebsiellasnn

1 . 1 MeponeHev

1 . 2 .Ilopanenevl . J Hvnnegelr

1 4 3oranenevi . 5 Tuteusx-rlrrH1 . 6 Koluc'ruHt ; 7 lloruruurccns B2 Xapaxrepucrura u3olltroB Pseudomonas aeruginosa u

Acinetobacter s9p.2 . 1 Kolucrun2.2 flo,ruulrxclls B

l Xaparcrepncru ra tzotn-roe Staphyl o co c cu s spp

JlnsegorraaJ . L BaHxovulnn

TqreuuK"'ruH3.4 .IIantovuuuH.1 Xapaxrepucrura H3oJItroB Enterococcus spp.

JIriHesorrlaA A BanxovuquH4.3 Tureuux.nuH4.4 ,IIanrolruqrH5 Xaparrepucruxa u3orrroB Slreptococcus spp.

ceporDvnn A.B.C.F.GI l OEH3I,UtNEH I,IUI,IJIJII.IH

J . Z SDHTDOMI,IUIIH

5.3 TETpAUHKJIHH

5.4 KJII-IH,4AMI'IIHH

9. 3aseaFouluft na6oparopuefi

I0. FrzororuqecKllfi MarepnanI 1. Pesymrar HAeHrlI$I4KaIIHIrI 2. Meroa IIAeHTI{$I4KaqLILI13. Pesynrrar oIIeHKHaHTr46I4OTr,rKOqyBCTBr{Tetlb HOCTI,I :

5 .5 HopQrorcauuu(,uucx l0 trrxr)

5.6 resodrorccauhu) . / BAHKOMI-IUI4H

5 . 8 uedotaxcuv6 Xaparrepucruxa v3onflToB Sf eplo coccus pneumoniae

o . l Orcaqr.rlluu (Aucxl uxr)

o . z . .bEH3I,IJI NEH14IIHJIJI H H

6.3 3pnrpovuulru4

6.5 Moxcud:torcauun7 Xapaxrepucrura ugorffios Salmonella spp.

7 . 1 LIedra3u.[r4M

7.2 . Lledoraxcur,t7 . 3 . Meponesev7.4. HilHnuKcoBa.s K-Ta

7 . 5 . Llunpotblorcauus7.6 flerbroxcaquu8 Xaparrepucrura usonnon Shige lla u guapeeteuur'tx

Escherichia coli8 . 1 UedrasliaHra8.2 LIedoraKcfiM

8.3 MeooneHeu

8 .4 . Llunood,lorcaunu9 XaoanreDuctgxau3o rAToB En ter o b ac te r iac ae

9 . 1 LIe<bragr.r.ul.rv9.2 Uedoraxcl'tv9.3 Meponeneu9.4. LlHnoodroxcaIruH

Aara ___J__J lloAnucr

flpn;roxenue 10rc Per.nalrenry B3al{MoAeficrsuq yrracrHnKoBrHTOpr{Hra pacflpocTpaHeHuq pe3ucreHTHbIx K'uruurcpo6nurn.r [perraparaM no:6yAnrereiinHTaJIbHblx nuQenqufi s CaHlff-Ilerep6ypre

Ilepe.rexn SrrrrAeMrroJrorrrrrecnrrx KprrreprreB AJII HanpaBJreH[fl rr3oJrsroB

MrrKpoopraHlr3MoB B rroApa3AeJreHr{e Ne 2 (nce BrrAbI,3a l{cKJrrcqeHrreM Streptococcus spp.)

tr rroApa3AeJreHrre J\b 4 ra6oparopur, nrrno.nnnronlefi pe{epeHTHble uccfleAoBaHuq

(ro.nrrco Streptococcus spp.) AJrfl rrpoBeAeHrrfl MoJreKyJrflpHo-reHerrrqecKoro rrr[upoBaHIrfl

Bce ngAe.neHrrbre or rraq[euToB u3orqrbr exeMectrrHo rlepeAarorcs B [oApa3Aenesue ]lb 2

pe$epenc-na6oparoptrtr B cilyrraflx, Koropbre yAoBnerBop.slor xots 6rr oAHoMy LI3 cneA)'Iourl4x

Kpr,rTeplreB:Kpr.rrepr{ft L. B reqeHrae Mecrqa B MeAr4rIr4HcKoM frpexrAeHl4l4 npou3olrlJlo 5 u 6o.nee cryrraeB

[H$eKrlr.rft, BbBBaHHbx Bo36yAr,rreJreM oAuoro BLIAa y [aIII{eHToB, HaxoAtIrllxc-s B oAHoM

orAeneH[I,I MeAr,rq]IHcKoro ytlpexAe[r4fl r4ntr noABeprarcIuuxcs Aeficrsurc eA]IHoro rfar<ropa

prrcKa (o,4uorvI nuoft MeAkI Irldncxoft MaHLrlynqIInI4)

lrJlvlrcpurepnfi 2. B re.reHue Mecsqa B MeAr{III{HcKoM frpexAeHLII{ npou3oIIIJIo 3 u 6olee cflyqaeB

un(pexqnfi, BbBBaHHbx eos6yAureleu oAHofo Bugta y raUIreHToB, ecrrr [peAnonaraercfl

ruyrpH6onrnr.rHrrft xapaKTep uHQuqupo Banufl. naIIrIeHToB.BuyrpH6onbHr,rrrHoe un$uqupoBaH[e naqr{eHToB npeAnonaraercfl B cneAyloqux cnyqarlx: npl4

OTCyTCTBI{I,I IIOJIOXLITeJIbHOTO BbICeBa MIIKpOOpraHI,I3Ma I'I3 KJIIIHLIqeCKOIO MaTepVAna IJpId

rrepBoM rvrlrxpo6nonorrFrecKoM o6creAosaHI,II4 nauneHra (npu flocryrlJleHuu)uHurr4tlr4u BbIceBa

MHKpoopraHr,BMa y Toro )Ke narlueHTa rlpll nocneAyloq]Ix tvtuxpo6nolorl4qecKl'Ix

I4CCneAOBaHr{.gX Vtrrkl npu BbrceBe MI,IKpOOpraHI,I3Ma y IIaII}IeHTa, HaxoAtlllefoc.s Ha

craulaoHapHoM rerIeHI4I,I B TerreHIze 6onee 48 'racos

VTJTVIrcpnrepnfi 3. 3nuAeuuonor npeArroJraraer HaJrr,Iq[e rpynnoeofi sa6oreeaeNdocrz (ncurrmru)'VTJIUrcpurepuft 4.2 u 6otee cJryrraeB raH(percqufi, r{HTepnper}rpoBaHHbx KaK BHyrpl46omgu'{Hoe ran(puqrapoBaHl4e

vrrw 3a1oq Bbr3BaHHsx neo6rrqHbrM lrnn BnepBble I4AeHTl4(pnquponauublM B ueAuquncxofr

opraur43arlull BIzAoM nos6y.4urela

[pu;roxenue 11K Peuanenry e:a[N{oAeficrnnq yqacrHltKoB

MOHUTOpHHTa paCnpOCTpaHeHrIfl pe3HCTeHTHbIX

K aHTrrMuKpobnuru nperaparaM eor6yAurereft

rocrlr,rraJrbHrrx unQexqufi s CaHrfl-Ilerep6ypre

Coupono4rrreJrbHoe rrrrcbMo Ha KyJrbrypy MrrKpoopraHrr3Ma, [epeAaBaeMyro B rroApa3AeJreur.re J{b 2(sce nuArr, 3a rrcKJrrcqeHrreM Streptococcus spp.) rr rroApa3AeJrenr{e J\b 4 .ua6opar0pr{r, BbrrrorrHflrorqeft

peQepeHrnbre rrccJreAoBaHrrs (ro.nrro Streptococc us spp.)AJrs [poBeAeHus MoIeKyJrflpHo-reHeTlrrlecKoro Trr[upoBaHuq

YupexgenueJla6oparopurHorvrep KynbTypbr no )KypHany

Bospacr [_-l non M I )I{ QIIO (monuxo uttu4uanu)

.{ara nocry[tleHplt

Hanpanun(a) (o14o).{ara ornpaBKr{ Kynbrypbl

Bug vrurcpoopraHrr3M a (yrcas amu)

[ar a BbrAeJreHlrfl KyJlbrypbl

fiara or6opa MarepLIaJIa Ha rloceB

Ile;rs npoBeAeHrrn rrurpo6nororurlecKoro uccJIeAoBalrr.rfl(nodveprcuymu):I . rruHu.{ecKl{e rIoKa3aHI4t2 . cxpunuuf rr o gn LIAeMI,IoT o f uqeoKl{M tt oKa3 aHI,IsM

3.paccne4oBaHl4e BcrIbIIIrKI4

naHnrre o [aqrleHTe

Jt ucropnu 6oregHl.rOr.nerenue

Marepuar (omuemumu)

KpoBb

DAHA

MOqa

oTAeJrreMoe no ApeHaxy

acnrzpar BAJIMOKpOTa

CMxtoLIoIIclrt

KAJI

oTAenrreMoe noJIoBbIX opf aHoB

ceKper npe,{cTarenbHoll xeJIe3bI

avroncufinuft uarepuannDvroe (enuuume\

OcHosuofr .IIIaarHo3

IrIcxoA nbrnucKa nepeood cMepmb [araucxogaJlorcaJrusaqus IICMII (nocranrTe fanoqKy B coorBeTcTBylol[IeM uone)

nu(f er<qux s o6ractu xnpypruqecKofo BMellrarerlbcrea f---l

unserqrar HI,IxHHX AbrxareJlbnrx nyreft [---lzn$enqrar xpoeotoxa l-__luulperqnx MoqerloiloBoft cucrelmt [--l

nu$erqux 4pyroft noKanlr3alluu f--1 (uanuwume norcanuzaqun)focnura;rn3arluu B TeqeHnn roAa, rrpeArrrecrBoBaBlrrero roclrrraJlrr3allrrn fta/ueilseu3BecrHoEcn

Crpana, perlr oH, ropoA rrocrosnHoro rIpoxI{B ilrr*rs,

BrresArl3a npeAeJrbr perrroHa rrocTosHHoro IIpo]KIrBa,H.vs, B TeqeHIII{ roAa, IIpeAIUeCTBOBaBIIIeT0

roc[rrTaJrIr3aIIUUPeruou, HaceneHHblfr nynxr

focnnraru:aurs Ne 1

AaTAIIOCTYTIJIEHIIfl

AATA BbIIII{CKII fopoA, crpaHa craurroHap ,IIIIAfHO3

focnnrarr,rsauns l\b 2AaTaNOCTVTIJIEHIIS

,[ATA BbIIIIICKII fopoA, crpaHa cTarlr{oHap trr{arHo3

c -

r 9 :; F 3* b :

: (O

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g !

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7

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= .9 r i i= E ve t >

- - F =

: 9 6E c iF : I

6 Y Z: E f h

e p v, : 9 >

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= o 6! q - : !

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x A r

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2 v ZI <t x P .4 ! : >

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z

(.! 9

tv

o t . E i. ; A u

o E v F

; : n f ,i -g 9 E ' : \ JE E i 3 t r- r i V A

F S E g To I E -9 i x =E a iE r ' o aF E * E BE H E 5H r i :L x i E- = E Q: = e F! i * c FE F L ' :

, ! E,E io r o E -E ( E 9 c s

3 T E == - > , E; i o ! !

> q ) C 0 A

E ; > e 9g * F i FE S E . A Ej T E F B1 t = = g i

F AF F

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= l != 36 , FE :g t r{ F7 q )i t -

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EiFEE t 5 99 . 8 3 b

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t ! 0; i l x, E E .F : 5! q o

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x c r

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l " >E C <( ^ 9

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= 4

f >o >F !

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r : ac , = -= = r =E t - SF - I( , c ! g

$ s th r ;e i i= t xF i j

, 8 39 9 c5 i E> 9 i

; i y- t L

F 3 , Eo a . 0 i5 F FE I FE g Bn H Bv a m

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