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Роль Enterococcus faecalis при апикальном периодонтите

https://doi.org/10.33925/1683-3759-2021-26-4-275-283

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Аннотация

Актуальность. Апикальный периодонтит – одно из самых распространенных заболеваний периодонта. Enterococcus faecalis, естественным местообитанием которого является кишечник, относительно редко колонизирует слизистые полости рта здоровых лиц – в 1-20% случаев, однако его выявляют у 68% больных с инфекционными заболеваниями полости рта (кариесом, пульпитом, пародонтитом и др.) и особенно у пациентов с отягощенным соматическим анамнезом, например с сахарным диабетом (в 60% случаев). Это может изменить профиль риска прогрессирования воспалительных заболеваний пародонта, обусловленных появлением в полости рта нехарактерных представителей патогенной микробиоты. При развитии первичного апикального периодонтита микроорганизмы распространяются в пародонт, как правило, из некротизированных тканей пульпы зуба, при вторичном – из корневых каналов, уже подвергшихся эндодонтическому лечению. E. faecalis обладает уникальными свойствами – устойчивостью к физическим и химическим факторам, к дефициту питательных веществ, что приводит к селекции этого микроорганизма при развитии вторичного апикального периодонтита. Его обнаруживают в 30-90% проб из корневых каналов при этой патологии. Важно, что 33% случаев неудач при лечении вторичного апикального периодонтита связаны с инфекцией этим микроорганизмом. Для E. faecalis характерна природная и часто приобретенная резистентность к местным и системным антимикробным препаратам.

Таким образом, для успешной терапии апикального периодонтита крайне важным представляется идентификация микроорганизма и/или определение состава микробного сообщества, обусловившего его развитие с определением чувствительности к антимикробным препаратам, особенно в связи с высокой частотой ассоциации этого заболевания с инфицированием области поражения E. faecalis.

Об авторах

Н. Е. Баранцевич
Национальный медицинский исследовательский центр им. В. А. Алмазова
Россия

Баранцевич Наталья Евгеньевна, научный сотрудник

Санкт-Петербург



Л. Ю. Орехова
Первый Санкт-Петербургский государственный университет им. академика И.П. Павлова
Россия

Орехова Людмила Юрьевна, доктор медицинских наук, профессор, заведующая кафедрой стоматологии терапевтической и пародонтологии, президент Российской пародонтологической ассоциации

Санкт-Петербург



Е. П. Баранцевич
Национальный медицинский исследовательский центр им. В. А. Алмазова
Россия

Баранцевич Елена Петровна, доктор медицинских наук, заведующая научно-исследовательским отделом микробиологии и внутрибольничных инфекций

Санкт-Петербург



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Рецензия

Для цитирования:


Баранцевич Н.Е., Орехова Л.Ю., Баранцевич Е.П. Роль Enterococcus faecalis при апикальном периодонтите. Пародонтология. 2021;26(4):275-283. https://doi.org/10.33925/1683-3759-2021-26-4-275-283

For citation:


Barantsevitch N.E., Orekhova L.Yu., Barantsevitch E.P. The role of Enterococcus faecalis in apical periodontitis. Parodontologiya. 2021;26(4):275-283. (In Russ.) https://doi.org/10.33925/1683-3759-2021-26-4-275-283

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