BACTEROIDES FRAGILIS В РАЗВИТИИ АБДОМИНАЛЬНОЙ ХИРУРГИЧЕСКОЙ ИНФЕКЦИИ

The article presents the review of domestic and foreign literature and the authors’ own researches on the role of B. fragilis in the development of abdominal purulent-septic diseases and their postoperative complications (peritonitis, intra-abdominal abscesses, infected pancreatic necrosis, appendicitis, etc.). According to modern ideas, B. fragilis is one of the leading pathogens of human pathology.This review analyzes and summarizes information on the main factors of pathogenicity and virulence of toxigenic and nontoxigenic B. fragilis at the phenotypic, molecular-genetic level necessary for the survival of the bacteroid in pathophysiological conditions, the level of their antibiotic resistance. The role of aerotolerance of B. fragilis and complex of oxygen-detoxification enzymatic and non-enzymatic systems of antioxidant protection under oxidative stress (catalase, superoxide dismutase, fumarate reductase, thioredoxine-dependent peroxidase, alkylhydroperoxide reductase, gemm- ferritin, etc.) is discussed. New data on the known (capsular polysaccharides, proteases, neuraminidases, heparinase, hyaluronidase, fibrinolysin, enterotoxin frigilizin BFT-B. fragilis toxin, etc.) and less studied unique virulence factors (metalloproteinase BFT and IIMPII (BfPAI), bacterioprotein fragipainFpn protease, fibrinogen-binding protein BF-FBP, hemolysins (hlyA, hlyB, hlyC, hlyD, hlyE, hlyF, hlyG, hlyE, hlyF, hlyG and hlyIII, HlyBA), as well as the most probable way of secretion and extracellular delivery of toxins and B. fragilis vesicle. The authors draw attention to increasing resistance of B. fragilis to modern antimicrobial drugs, which must be taken into account when choosing adequate antimicrobial therapy.