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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">lvrach</journal-id><journal-title-group><journal-title xml:lang="ru">Лечащий Врач</journal-title><trans-title-group xml:lang="en"><trans-title>Lechaschi Vrach</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-5175</issn><issn pub-type="epub">2687-1181</issn><publisher><publisher-name></publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51793/OS.2022.25.11.008</article-id><article-id custom-type="elpub" pub-id-type="custom">lvrach-987</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИНФЕКЦИИ. ВАКЦИНОПРОФИЛАКТИКА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>INFECTIONS. VACCINE PROPHYLAXIS</subject></subj-group></article-categories><title-group><article-title>Бактериальные осложнения гриппа  (обзор литературы)</article-title><trans-title-group xml:lang="en"><trans-title>Bacterial complications of influenza (literature review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2098-222X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скрябина</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Skryabina</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Скрябина Анна Александровна, ассистент кафедры инфекционных болезней и эпидемиологии лечебного факультета</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Anna A. Skryabina, Assistant of the Department of Infectious Diseases and Epidemiology</p><p>1 Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">anna.skryabina.85@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2205-9674</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никифоров</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikiforov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Никифоров Владимир Владимирович, д.м.н., профессор, заведующий кафедрой инфекционных болезней и эпидемиологии лечебного факультета </p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Vladimir V. Nikiforov, Dr. of Sci. (Med.), Professor, Head of the Department of Infectious Diseases and Epidemiology of the Medical Faculty </p><p>1 Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">v.v.nikiforov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3168-2169</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шахмарданов</surname><given-names>М. З.</given-names></name><name name-style="western" xml:lang="en"><surname>Shakhmardanov</surname><given-names>M. Z.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шахмарданов Мурад Зияудинович, д.м.н., профессор кафедры инфекционных болезней и эпидемиологии лечебного факультета </p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Murad Z. Shakhmardanov, Dr. of Sci. (Med.), Professor of the Department of Infectious Diseases and Epidemiology </p><p>1 Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">mur2025@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3964-9726</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Застрожин</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zastrozhin</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Застрожин Михаил Сергеевич, д.м.н., ведущий научный сотрудник; ассистент кафедры наркологии</p><p>109390, Москва, ул. Люблинская, 37/1</p><p> 125993, Москва, ул. Баррикадная, 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Mikhail S. Zastrozhin, Dr. of Sci. (Med.), Leading Researcher; Assistant of the Department of Narcology </p><p>37/1 Lublinskaya str., Moscow, 109390</p><p>2/1, p. 1 Barrikadnaya str., Moscow, 125993</p></bio><email xlink:type="simple">mszastrozhin@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное автономное образовательное учреждение высшего образования Российский национальный исследовательский медицинский университет имени Н. И. Пирогова Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Autonomous Educational Institution of Higher Education N. I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Государственное бюджетное учреждение здравоохранения Московский научно-практический центр наркологии Департамента здравоохранения города Москвы; Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования Российская медицинская академия непрерывного профессионального образования Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>State Budgetary Healthcare Institution Moscow Research and Practical Center of Addictions of the Department of Health of the City of Moscow; Federal State Budgetary Educational Institution of Additional Professional Education Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>29</day><month>11</month><year>2022</year></pub-date><volume>1</volume><issue>11</issue><fpage>48</fpage><lpage>54</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Скрябина А.А., Никифоров В.В., Шахмарданов М.З., Застрожин М.С., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Скрябина А.А., Никифоров В.В., Шахмарданов М.З., Застрожин М.С.</copyright-holder><copyright-holder xml:lang="en">Skryabina A.A., Nikiforov V.V., Shakhmardanov M.Z., Zastrozhin M.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.lvrach.ru/jour/article/view/987">https://journal.lvrach.ru/jour/article/view/987</self-uri><abstract><p>Эпидемии гриппа вызывают заболеваемость и смертность как вследствие прямого действия вируса в течение первых нескольких дней, так и по причине развития вторичных бактериальных осложнений, которые обычно проявляются после первой недели. По данным исследований, до 65% лабораторно подтвержденных случаев инфицирования гриппом сопровождаются вторичной бактериальной инфекцией, которая может иметь тяжелые последствия, особенно для пациентов из групп риска. Цель настоящей работы состояла в систематизации доступных научных данных о патогенезе бактериальных осложнений гриппа. По результатам обзора установлено, что грипп типа A наиболее часто осложняется присоединением вторичной бактериальной инфекции, причем инфицирование подтипами, содержащими в своем составе нейраминидазу N2, обычно сопряжено с более тяжелым течением инфекции. Возбудителями, наиболее часто осложняющими течение гриппа с конца 1800-х годов, являются S. pneumoniae, H. influenzae и S. aureus. Показано, что инфицирование вирусом гриппа приводит к возникновению многочисленных изменений эпителия респираторного тракта и нарушениям иммунных реакций, что предрасполагает к присоединению бактериальных осложнений. Вирус гриппа способен повреждать клетки эпителия дыхательных путей и ингибировать механизмы мукоцилиарного клиренса. После бактериальной колонизации развитие заболевания происходит благодаря специфическим характеристикам вирусной инфекции, которые облегчают адгезию и проникновение бактерий. Кроме того, показано, что в альвеолярных макрофагах, нейтрофилах, дендритных и NK-клетках изменяются цитокиновые профили, вследствие чего нарушаются функции указанных клеток. Это приводит к усилению воспалительной реакции и снижению эрадикации бактерий. Однако, несмотря на увеличивающееся количество работ, подробно описывающих различные аспекты патогенеза бактериальных осложнений гриппа, определение точного вклада каждого из описанных факторов представляет собой сложную задачу, решить которую могут помочь дальнейшие исследования.</p></abstract><trans-abstract xml:lang="en"><p>Influenza epidemics cause morbidity and mortality, both through the direct action of the virus during the first days of disease and through the development of secondary bacterial complications that usually occur after the first week. Studies show that up to 65% of laboratory-confirmed cases of influenza infection are accompanied by secondary bacterial infection, which may have severe consequences, especially for patients in risk groups. This study aimed to systematize the available scientific evidence on the pathogenesis of bacterial complications of influenza. The review showed that secondary bacterial infection occurs typically in patients with influenza A, and those infected with the neuraminidase N2 subtypes usually experience a more severe course of the disease. S. pneumoniae, H.influenzae and S. aureus have been the most frequent pathogens complicating the influenza since the late 1800s. Influenza virus infection has been shown to cause various changes to the respiratory tract epithelium and to alter the immune response, predisposing patients to bacterial complications. The influenza virus is able to damage respiratory epithelial cells and inhibit mucociliary clearance mechanisms. Following bacterial colonization, the development of the disease is due to the specific characteristics of the viral infection, which facilitates bacterial adhesion and penetration. In addition, cytokine profiles have been shown to change in alveolar macrophages, neutrophils, dendritic cells and NK cells, resulting in impaired function of these cells. This leads to an increased inflammatory response and decreased bacterial eradication. However, despite a growing body of work detailing different aspects of the pathogenesis of bacterial complications of influenza, determining the exact contribution of each of the factors described is a complex task to which further research may be helpful. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>грипп</kwd><kwd>острые респираторные вирусные инфекции</kwd><kwd>бактериальные осложнения</kwd><kwd>пандемии</kwd><kwd>эпидемический процесс</kwd><kwd>инфекционные болезни</kwd><kwd>эпидемиология</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Influenza</kwd><kwd>acute respiratory viral infections</kwd><kwd>bacterial complications</kwd><kwd>pandemics</kwd><kwd>epidemic process</kwd><kwd>infectious diseases</kwd><kwd>epidemiology</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Клинические рекомендации «Грипп у взрослых» (утв. 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