{"id":10253,"date":"2020-04-23T05:00:59","date_gmt":"2020-04-23T02:00:59","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/cultura-secretie-col-uterin-cu-antibiograma-dupa-caz\/"},"modified":"2025-07-01T07:57:35","modified_gmt":"2025-07-01T04:57:35","slug":"cultura-secretie-col-uterin-cu-antibiograma-dupa-caz","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/cultura-secretie-col-uterin-cu-antibiograma-dupa-caz\/","title":{"rendered":"\u0411\u0430\u043a\u043f\u043e\u0441\u0435\u0432 \u0438\u0437 \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u043a\u0430\u043d\u0430\u043b\u0430 \u043d\u0430 \u043c\u0438\u043a\u0440\u043e\u0444\u043b\u043e\u0440\u0443 (\u0410\u043d\u0442\u0438\u0431\u0438\u043e\u0442\u0438\u043a\u043e\u0433\u0440\u0430\u043c\u043c\u0430 \u043f\u043e \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u0438)"},"content":{"rendered":"<p><strong><em>\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/em><\/strong><\/p>\n<p>Flora normala a tractului genital feminin variaza in functie de pH-ul si concentratia de estrogeni a mucoasei, aflate in stransa corelatie cu varsta, astfel:<\/p>\n<p style=\"padding-left: 30px;\">\u2013 prepubertar si postmenopauza flora este dominata de stafilococi si corinebacterii (aceeasi flora pe care o gasim pe suprafata epiteliului);<\/p>\n<p style=\"padding-left: 30px;\">\u2013 la femeile active sexual flora microbiana se modifica, fiind alcatuita din Enterobacteriaceae, streptococi, stafilococi, bacterii anaerobe (lactobacili, bacili anaerobi nesporulati, coci anaerobi). Lactobacilii reprezinta flora microbiana vaginala normala la aceste femei.<\/p>\n<p>Streptococul hemolitic grup B (Streptococcus agalactiae) este prezent in flora vaginala si poate fi transmis la nou \u2013 nascuti (cu aparitia de complicatii neonatale)<sup>1<\/sup>.<\/p>\n<p><strong><em>Clasificarea infec<\/em><\/strong><strong><em>tiilor de tract genital feminin<\/em><\/strong><\/p>\n<p>Infectiile genitale feminine reprezinta o cauza frecventa de consult ginecologic. Ele pot evolua ca:<\/p>\n<p style=\"padding-left: 30px;\">\u2022 infectii endogene, determinate de microorganisme din flora vaginala normala;<\/p>\n<p style=\"padding-left: 30px;\">\u2022 infectii exogene, cauzate in special de microorganisme cu transmitere sexuala:<\/p>\n<p style=\"padding-left: 60px;\">\u2013 bacterii (Neisseria gonorrhoeae, Chlamydia trachomatis \u2013 serotipurile D-K, Treponema pallidum)<\/p>\n<p style=\"padding-left: 60px;\">\u2013 virusuri (Herpes simplex \u2013 tip 2, Papillomavirus)<\/p>\n<p style=\"padding-left: 60px;\">\u2013 protozoare (Trichomonas vaginalis).<\/p>\n<p>O alta clasificare imparte infectiile de tract genital feminin in:<\/p>\n<ul>\n<li>infectii genitale joase \u2013 afecteaza vulva, vaginul si cervixul \u2013 apar, de obicei, ca urmare a unui contact sexual infectant sau ca urmare a unui dezechilibru al florei genitale normale.<\/li>\n<li>infectii genitale inalte \u2013 intereseaza uterul, trompele uterine, ovarele \u2013 apar frecvent ca extindere a infectiilor genitale joase. Se considera ca microorganismele existente in vagin si cervix patrund in cavitatea uterina si pot ajunge prin endometru la nivelul trompelor si al ovarelor<sup>1;2<\/sup>.<\/li>\n<\/ul>\n<p><strong>Infectiile genitale joase<\/strong><\/p>\n<p>Infectiile vulvare pot fi bacteriene, virale, micotice sau parazitare si se pot manifesta fie izolat, fie asociate cu vaginite. Pot fi:<\/p>\n<p style=\"padding-left: 30px;\">\u2013 infectii comune: foliculite, furuncule, piodermite;<\/p>\n<p style=\"padding-left: 30px;\">\u2013 infectii specifice: Trichomonas vaginalis, infectii micotice, Treponema pallidum, Herpes simplex \u2013 tip 2, Papillomavirus (mai ales 6 si 11);<\/p>\n<p style=\"padding-left: 30px;\">\u2013 mai rar Sarcoptes scabiae.<\/p>\n<p>Bartholinita (inflamatia glandelor Bartholin, situate la jonctiunea dintre vulva si vagin), poate fi determinata de Neisseria gonorrhoeae, C. trachomatis sau prin exacerbarea florei genitale locale. Blocarea conductului glandular prin procesul inflamator poate determina un abces din care se pot izola germeni aerobi si anaerobi.<\/p>\n<p>Vaginita (descrisa de cele mai multe ori ca vulvovaginita) poate fi:<\/p>\n<p style=\"padding-left: 30px;\">\u2013 specifica: produsa de fungi, Trichomonas vaginalis, Treponema pallidum, Papilomavirus;<\/p>\n<p style=\"padding-left: 30px;\">\u2013 nespecifica: \u2013 produsa prin multiplicarea florei vaginale normale;<\/p>\n<p style=\"padding-left: 30px;\">\u2013 produsa de corpi straini \u2013 in cazul prezentei de dispozitive contraceptive sau, la fetite, prin introducerea accidentala a corpilor straini in vagin.<\/p>\n<p>Staphylococcus aureus, prezent in vagin la 5-10% dintre femeile sanatoase, poate cauza scurgeri purulente si soc toxic in conditiile utilizarii de tampoane hiperabsorbante in perioada menstruala.<\/p>\n<p>La fetite sunt posibile vulvovaginite cu N. gonorrhoeae, C. trachomatis sau Streptococcus pyogenes. In cazurile cu igiena precara sunt posibile cazuri de vulvovaginite cu Enterobius vermicularis, prin migrarea parazitului in vagin.<\/p>\n<p>Vaginoza \u2013 sindrom infectios neinflamator \u2013 consta in inlocuirea florei lactobacilare normale cu specii bacteriene anaerobe (Bacteroides spp, Prevotella spp, Porphyromonas spp, Peptostreptococcus spp, Mobiluncus spp) asociate cu Gardnerella vaginalis. Aceste specii bacteriene fac parte din flora normala a vaginului, dar in cazul vaginozelor multiplicarea lor este de pana la 1000 ori mai mare. Desi infectia evolueaza cu precadare in perioada de activitate sexuala, ea poate aparea si la adolescente si preadolescente.<\/p>\n<p><strong>Cervicita<\/strong><\/p>\n<p>Exocolul uterin poate fi afectat de:<\/p>\n<p style=\"padding-left: 30px;\">-T. vaginalis, Candida albicans \u2013 infectii ce evolueaza ca cervico-vaginite;<\/p>\n<p style=\"padding-left: 30px;\">-Papillomavirus (mai ales tipurile 16 si 18) \u2013 implicat in etiologia neoplaziilor cervicale intraepiteliale;<\/p>\n<p style=\"padding-left: 30px;\">-Herpes simplex tip 2 \u2013 evolueaza cu leziuni ulcerative endo si exocervicale.<\/p>\n<p>Endocolul uterin poate fi sediul infectiilor cu:<\/p>\n<p style=\"padding-left: 30px;\">-N. gonorrhoeae \u2013 poate evolua asimptomatic la aproximativ 30% dintre femeile infectate. Contaminarea mucoasei uretrale si rectale poate determina localizari concomitente la aceste nivele, cu manifestari clinice de uretrita sau proctita;<\/p>\n<p style=\"padding-left: 30px;\">-C. trachomatis (serotipurile D-K) \u2013 nu determina vaginita. Deseori, pacientele au infectie cu etiologie dubla (gonococ cu Chlamydia). In laboratoarele Synevo se poate diagnostica infectia cu C.trachomatis prin depistarea antigenului in secretia recoltata de la nivelul endocolului. Nu se recomanda recoltarea din fundul de sac posterior (pot aparea <a title=\"rezultate\" href=\"\/ru\/rezultate\/\">rezultate<\/a> fals negative)<sup>1,2,3<\/sup>.<\/p>\n<p><strong><em>Diagnosticul infectiilor genitale joase<\/em><\/strong><\/p>\n<p>Recoltarea produselor patologice se efectueaza in cabinetele de ginecologie, cu instrumentar adecvat, de obicei din fundul de sac vaginal posterior.<\/p>\n<p>In momentul recoltarii este bine a se efectua (chiar in cabinetul de consultatie) doua teste rapide care pot orienta diagnosticul:<\/p>\n<p style=\"padding-left: 30px;\">-determinarea pH-ului secretiei vaginale cu ajutorul hartiei indicator (un pH&gt;5 poate indica infectie cu T. vaginalis sau prezenta vaginozei);<\/p>\n<p style=\"padding-left: 30px;\">-testul aminelor volatile (\u201cwhiff test\u201d) \u2013 prin adaugarea catorva picaturi de solutie KOH 10% peste secretia vaginala recoltata pe valva. Degajarea unui miros dezagreabil de peste alterat conduce la suspiciunea de vaginoza<sup>2<\/sup>.<\/p>\n<p>In cadrul laboratoarelor Synevo, secretia vaginala se recolteaza pe doua tampoane si doua lame de microscopie:<\/p>\n<p style=\"padding-left: 30px;\">-un tampon se introduce in recipientul Vagicult (un mediu special de imbogatire si depistare a Trichomonas vaginalis si levurilor) din care se va efectua preparat proaspat intre lama si lamela. Examinarea se face cu obiectiv de 10x si 40x si permite evidentierea parazitului T. vaginalis, a levurilor \u2013 inmugurite si hife \u2013 si a reactiei inflamatorii (intensa in trichomoniaza, discreta in candidoza si absenta in vaginoza);<\/p>\n<p style=\"padding-left: 30px;\">-cel de-al doilea tampon recoltat pe mediu de transport (Amies sau Stuart) va fi utilizat pentru insamantare pe medii de cultura;<\/p>\n<p style=\"padding-left: 30px;\">-lamele de microscopie vor fi colorate Gram (pentru aprecierea florei vaginale) si Giemsa (pentru aprecierea reactiei inflamatorii)<sup>3<\/sup>.<\/p>\n<p>In conditii normale, pe frotiul colorat Gram se observa bacili Gram pozitivi, drepti sau usor incurbati cu laturile paralele, cu grosimea si lungimea variabile pana la polimorfism, uneori filamentosi, care reprezinta flora lactobacilara (bacili D\u00f6derlein, vezi figura <em>21.5.5.1<\/em>)<sup>2<\/sup>. In vaginoze, flora lactobacilara este inlocuita cu bacili Gram variabili (G. vaginalis, Bacteroides spp.) si bacili Gram negativi incurbati (Mobiluncus) \u2013 <em>vezi figura 21.5.5.2<\/em>. Vaginoza se caracterizeaza prin prezenta de\u00a0 \u201cclue cells\u201d \u2013 celule vaginale superficiale ce prezinta pe suprafata lor abundenta flora bacteriana (<em>vezi figura 21.5.5.3<\/em>). Prezenta formatiunilor rotund-ovalare Gram pozitive este sugestiva pentru candidoza vaginala (vezi figura 21.5.5.4<sup>1;2<\/sup>.<em><a href=\"\/ru\/cultura-secretie-vaginala\/lactobacillus\/\" rel=\"attachment wp-att-9279\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/lactobacillus.jpg\" alt=\"-\" width=\"406\" height=\"408\"><\/a><\/em><\/p>\n<p><em><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/lactobacillus\/\" rel=\"attachment wp-att-9279 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/lactobacillus.jpg\" alt=\"-\" width=\"406\" height=\"408\"><\/a><\/em><\/p>\n<p><em>Fig. 21.5.5.1: \u00a0<\/em><em>Lactobacillus spp.\u00a0<\/em><em>(coloratie Gram, x1000,\u00a0<\/em><em>imagine din colectia proprie a laboratorului<\/em><em>)<\/em><em>\u00a0<\/em><\/p>\n<p><em>Aspect normal al unui prelevat vaginal: prezenta a numeroase celule epiteliale pavimentoase, polimorfonucleare putine, bacili Doderlein<\/em><em>\u00a0<\/em><\/p>\n<p><em><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/gradnerella-vaginalis\/\" rel=\"attachment wp-att-9280 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/Gradnerella-vaginalis.bmp\" alt=\"-\"><\/a><\/em><\/p>\n<p><em>\u00a0<\/em><\/p>\n<p><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/vaginoza\/\" rel=\"attachment wp-att-9281 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/vaginoza.jpg\" alt=\"-\" width=\"405\" height=\"410\"><\/a><\/p>\n<p><em>Fig. 21.5.5.3:\u00a0\u00a0<\/em><em>Frotiu sugestiv pentru vaginoza bacteriana:\u00a0<\/em><em>\u00a0<\/em><em>(<\/em><em>coloratie Gram, x1000,\u00a0<\/em><em>ima<\/em><em>gine din colectia proprie a laboratorului)<\/em><\/p>\n<p><em>\u00a0<\/em><em><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/levuri\/\" rel=\"attachment wp-att-9282 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/levuri.jpg\" alt=\"-\" width=\"460\" height=\"346\"><\/a><\/em><\/p>\n<p><em>Fig. 21.5.5.4 Levuri prezente in secretia vaginala<\/em>\u00a0<em>(<\/em><em>coloratie Gram, x1000,\u00a0<\/em><em>imagine din colectia proprie a laboratorului)<\/em><\/p>\n<p>Vizualizarea cocilor Gram negativi \u201cin diplo\u201d cu aspect de boabe de cafea localizati predominant intraleucocitar indica foarte probabil infectia cu Neisseria \u00a0gonorrhoeae (<em>vezi figura 21.5.5.5)<\/em>.<\/p>\n<p>Trichomonas vaginalis se observa cel mai bine pe preparatul nativ. Are forma rotund-ovalara cu dimensiuni de 7-23\/5-15 \u03bcm. Prezinta in mod normal 4 flageli anteriori si unul posterior care ii confera o motilitate rapida. De asemenea se mai pot observa membrana ondulanta si un axostil care se misca in lungul celulei. Parazitul mai poate vizualizat si pe frotiul Gram (<em>vezi figura 21.5.5.6)<\/em>.<\/p>\n<p><em><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/gonococi\/\" rel=\"attachment wp-att-9283 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/gonococi.jpg\" alt=\"-\" width=\"406\" height=\"411\"><\/a><\/em><\/p>\n<p><em>Fig. 21.5.5.5\u00a0<\/em>\u00a0<em>Neisseria\u00a0<\/em><em>\u00a0<\/em><em>gonorrhoeae<\/em>\u00a0<em>(<\/em><em>coloratie Gram, x1000,\u00a0<\/em><em>imagine din colectia proprie a laboratorului)<\/em><\/p>\n<p><em>\u00a0<\/em><em><a href=\"https:\/\/www.synevo.md\/cultura-secretie-vaginala\/tricomonas\/\" rel=\"attachment wp-att-9284 nofollow noopener\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/tricomonas.jpg\" alt=\"-\" width=\"486\" height=\"364\"><\/a><\/em><\/p>\n<p><em>Fig. 21.5.5.6 Trichomonas vaginalis (<\/em><em>coloratie Gram, x1000,\u00a0<\/em><em>imagine din colectia proprie a laboratorului)<\/em>.<\/p>\n<p>Insamantarea secretiei recoltata pe tamponul cu mediu de transport se face pe mediul agar Columbia cu 5% sange de berbec si un mediu lactozat cu incubare in atmosfera obisnuita 18 \u2013 24 de ore la 35\u201337\u00baC. Microorganismele izolate se identifica pana la nivel de specie si se efectueaza . antibiograma doar la germenii a caror prezenta a fost regasita si pe frotiul colorat Gram, alaturi de reactia inflamatorie. Se urmareste, de asemenea, prezenta Streptococcus agalactiae la femeile gravide in ultimul trimestru de sarcina<sup>3<\/sup>.<\/p>\n<p>Daca exista suspiciunea de infectie cu N. gonorrhoeae, incubarea se face in atmosfera cu 5% CO<sub>2<\/sub>.<\/p>\n<p>In cazul suspiciunii de candidoza, proba se va insamanta pe mediul Sabouraud cu Cloramfenicol<sup>3<\/sup>. Candida albicans este normal prezenta in vaginul a 15 \u2013 20% din femei, ajungand la 30% in trimestrul al III-lea de sarcina. Prin urmare, este semnificativa pentru o infectie cu Candida spp. colonizarea masiva a vaginului<sup>2<\/sup>. Dupa izolarea in cultura a levurilor se va trece la identificarea si efectuarea antifungigramei<sup>3<\/sup>.<\/p>\n<p>La fetite, recoltarea se va face de la nivelul orificiului de deschidere a vaginului sau se poate recolta endovaginal, daca exista instrumentar adecvat; se urmareste in special diagnosticarea vulvo-vaginitelor cu S. pyogenes si N. gonorrhoeae<sup>2<\/sup>.<\/p>\n<p>Diagnosticul bartolinitei se face prin colectarea exsudatului purulent cu ajutorul a doua tampoane: unul pentru microscopie si unul pentru insamantare pe medii de cultura. Incubarea trebuie facuta atat in conditii de aerobioza cat si anaerobioza; se urmareste in special prezenta N. gonorrhoeae. In cazul unui puroi \u201csteril\u201d se suspicioneaza infectia cu C. trachomatis sau Ureaplasma <em>urealyticum<sup>1,2<\/sup>.<\/em><\/p>\n<p><strong>Infectiile genitale inalte<\/strong><\/p>\n<p>In functie de localizare:<\/p>\n<p style=\"padding-left: 30px;\">\u2013 la nivelul mucoasei uterine: endometrite;<\/p>\n<p style=\"padding-left: 30px;\">\u2013 daca inflamatia cuprinde si muschiul uterin: endomiometrite.<\/p>\n<p><em>Infectia acuta<\/em> survine: \u2013 postpartum sau postabortum (vaginoza fiind factor de risc) si dupa explorari sau interventii endouterine (histerosalpingografie, implantare de sterilet).<\/p>\n<p>Etiologia lor este variata, fiind implicate bacterii aerobe si anaerobe ce fac parte din flora endogena vaginala: Streptococ grup B, enterococi, Enterobacteriaceae, Gardnerella vaginalis, bacili Gram negativi anaerobi, Mycoplasma hominis, Clostridium perfringens (in avort septic provocat), Streptococcus pyogenes etc<sup>2<\/sup>.<\/p>\n<p>In 10 \u2013 20% din cazuri, endometritele acute pot evolua cu bacteriemie.<\/p>\n<p><em>Endometritele cronice<\/em> (asociate cu endocervicite si salpingite) pot fi determinate de C. trachomatis (prin propagare ascendenta) sau Mycobacterium tuberculosis (pe cale hematogena).<\/p>\n<p><em>Inflamatia<\/em> epiteliului endotubar sau a trompei in general (salpingita) poate fi produsa de:<\/p>\n<p style=\"padding-left: 30px;\">\u2013 M. tuberculosis, N. gonorrhoeae, C.trachomatis \u2013 prin propagare intracanaliculara;<\/p>\n<p style=\"padding-left: 30px;\">\u2013 flora aero \u2013 anaeroba vaginala (in endometrite postabortum sau postpartum);<\/p>\n<p style=\"padding-left: 30px;\">\u2013 inflamatia mezosalpinxului si a peritoneului ce acopera ligamentul larg: anexita.<\/p>\n<p>Deoarece localizarea anatomica precisa a infectiei este greu de stabilit, se utilizeaza denumirea de boala inflamatorie pelvina (diagnostic laparoscopic)<sup>2<\/sup>.<\/p>\n<p><strong><em>Diagnosticul infectiilor genitale inalte<\/em><\/strong><\/p>\n<p>Recoltarea produsului patologic se realizeaza prin introducerea unui cateter sau a unei sonde sterile in cavitatea uterina, la care se adapteaza o seringa sterila si se aspira lichid endometrial; apoi se ataseaza la seringa un ac steril, se protejeaza varful acului cu un tampon de vata steril, se indeparteaza bulele de aer, se obtureaza varful acului cu un dop de cauciuc si se trimite la laborator in cel mai scurt timp.<\/p>\n<p>In endometritele postpartum sau postabortum se efectueaza si hemoculturi pe medii aerobe si anaerobe.<\/p>\n<p>In boala inflamatorie pelvina la care se suspecteaza infectia cu C. trachomatis se poate recurge la examen serologic.<\/p>\n<p>Pentru diagnosticul bacteriologic al tuberculozei genitale se recolteaza sange menstrual sau mucoasa uterina chiuretata in perioada premenstruala<sup>2<\/sup>. In cadrul laboratoarelor Synevo nu se prelucreaza produse patologice pentru depistare BK.<\/p>\n<p>Probele primite la laborator:<\/p>\n<p style=\"padding-left: 30px;\">\u2022 se examineaza microscopic pe frotiuri colorate Gram si Giemsa;<\/p>\n<p style=\"padding-left: 30px;\">\u2022 se insamanteaza pe medii de cultura: agar Columbia cu 5% sange de berbec (o placa pentru incubare aeroba si una pentru incubare anaeroba) si agar Mac Conkey<sup>2,3<\/sup>.<\/p>\n<p>Speciile bacteriene izolate se identifica pana la nivel de specie si se efectueaza antibiograma. Testarea sensibilitatii la antibiotice nu se efectueaza in cazul germenilor anaerobi<sup>3<\/sup>.<\/p>\n<p><span style=\"font-size: small;\">\u00a0<\/span><\/p>\n<p><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/p>\n<p><span style=\"font-size: small;\">1. Betty A.Forbes, Daniel F.Sahm, Alice S.Weissfeld. Genital tract infections. In Bailey and Scott\u2019s Diagnostic Microbiology. Mosby, USA, 11 ed. 2002, 939-953.<\/span><\/p>\n<p><span style=\"font-size: small;\">2. Dumitru Buiuc. Diagnosticul de laborator al infectiilor tractusului genital feminin. In Tratat de Microbiologie Clinica. Dumitru Buiuc, Marian Negut, Medicala, Romania,1 ed. 1999, 304-318, 672 \u2013 675.<\/span><\/p>\n<p><span style=\"font-size: small;\">3. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>\u0426\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u044b\u0439 \u043a\u0430\u043d\u0430\u043b \u043d\u0435 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0441\u0442\u0435\u0440\u0438\u043b\u044c\u043d\u044b\u043c. \u0412\u043d\u0443\u0442\u0440\u0438 \u043d\u0435\u0433\u043e \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u0435\u0442\u0441\u044f \u043c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u043e \u043c\u0438\u043a\u0440\u043e\u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u043e\u0432. \u0412 \u043e\u0441\u043d\u043e\u0432\u043d\u043e\u043c \u044d\u0442\u043e \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0438, \u0432 \u043c\u0435\u043d\u044c\u0448\u0438\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430\u0445 \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0443\u044e\u0442 \u0432\u0438\u0440\u0443\u0441\u044b \u0438 \u0433\u0440\u0438\u0431\u043a\u043e\u0432\u0430\u044f \u0444\u043b\u043e\u0440\u0430. \u0421\u043e\u0441\u0442\u0430\u0432 \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u0439 \u0438 \u0432\u043b\u0430\u0433\u0430\u043b\u0438\u0449\u043d\u043e\u0439 \u043c\u0438\u043a\u0440\u043e\u0444\u043b\u043e\u0440\u044b \u0432\u043e \u043c\u043d\u043e\u0433\u043e\u043c \u0441\u043e\u0432\u043f\u0430\u0434\u0430\u0435\u0442.<\/p>\n<p>\u0421\u0440\u0435\u0434\u0438 \u043c\u0438\u043a\u0440\u043e\u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u043e\u0432 \u0432\u044b\u0434\u0435\u043b\u044f\u044e\u0442 \u044d\u0443\u0431\u0438\u043e\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0432\u0438\u0434\u044b, \u0442\u043e \u0435\u0441\u0442\u044c \u043f\u0440\u0438\u043d\u043e\u0441\u044f\u0449\u0438\u0435 \u043f\u043e\u043b\u044c\u0437\u0443 \u0438 \u043f\u043e\u0434\u0434\u0435\u0440\u0436\u0438\u0432\u0430\u044e\u0449\u0438\u0435 \u0437\u0434\u043e\u0440\u043e\u0432\u044c\u0435 \u043e\u0440\u0433\u0430\u043d\u0430, \u0438 \u0443\u0441\u043b\u043e\u0432\u043d\u043e-\u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u044b\u0435, \u0432 \u043d\u0435\u0431\u043e\u043b\u044c\u0448\u043e\u043c \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0435 \u043d\u0435 \u0432\u044b\u0437\u044b\u0432\u0430\u044e\u0449\u0438\u0435 \u0432\u0440\u0435\u0434\u0430. \u0423\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u0447\u0438\u0441\u043b\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0443\u0441\u043b\u043e\u0432\u043d\u043e-\u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u043e\u0439 \u0444\u043b\u043e\u0440\u044b \u0438\u043b\u0438 \u043f\u0440\u0438\u0441\u043e\u0435\u0434\u0438\u043d\u0435\u043d\u0438\u0435 \u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u043e\u0439 \u043f\u0440\u0438\u0432\u043e\u0434\u0438\u0442 \u043a \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044e \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0439.<\/p>\n<p>\u0412 \u043d\u043e\u0440\u043c\u0435 \u043f\u0440\u0435\u043e\u0431\u043b\u0430\u0434\u0430\u044e\u0449\u0438\u043c \u0440\u043e\u0434\u043e\u043c \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0439, \u0436\u0438\u0432\u0443\u0449\u0438\u0445 \u0432\u043e \u0432\u043b\u0430\u0433\u0430\u043b\u0438\u0449\u0435, \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u043b\u0430\u043a\u0442\u043e\u0431\u0430\u0446\u0438\u043b\u043b\u044b, \u0438\u043b\u0438 \u043b\u0430\u043a\u0442\u043e\u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0438. \u041e\u043d\u0438 \u043e\u0442\u043d\u043e\u0441\u044f\u0442\u0441\u044f \u043a \u044d\u0443\u0431\u0438\u043e\u0442\u0430\u043c \u0438 \u0432\u044b\u043f\u043e\u043b\u043d\u044f\u044e\u0442 \u043c\u043d\u043e\u0433\u043e \u0432\u0430\u0436\u043d\u044b\u0445 \u0444\u0443\u043d\u043a\u0446\u0438\u0439: \u0441\u043e\u0437\u0434\u0430\u044e\u0442 \u043e\u043f\u0442\u0438\u043c\u0430\u043b\u044c\u043d\u0443\u044e \u043a\u0438\u0441\u043b\u043e\u0442\u043d\u043e\u0441\u0442\u044c \u0441\u0440\u0435\u0434\u044b, \u0432\u044b\u0434\u0435\u043b\u044f\u044e\u0442 \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u043c\u0438\u043a\u0440\u043e\u0431\u043d\u044b\u0435 \u0432\u0435\u0449\u0435\u0441\u0442\u0432\u0430, \u043f\u043e\u0434\u0430\u0432\u043b\u044f\u044e\u0442 \u0440\u043e\u0441\u0442 \u043d\u0435\u0436\u0435\u043b\u0430\u0442\u0435\u043b\u044c\u043d\u044b\u0445 \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0439, \u0441\u043f\u043e\u0441\u043e\u0431\u0441\u0442\u0432\u0443\u044e\u0442 \u0432\u044b\u0436\u0438\u0432\u0430\u043d\u0438\u044e \u0441\u043f\u0435\u0440\u043c\u0430\u0442\u043e\u0437\u043e\u0438\u0434\u043e\u0432 \u043d\u0430 \u043f\u0443\u0442\u0438 \u0432 \u043c\u0430\u0442\u043a\u0443. \u0412 \u043c\u0435\u043d\u044c\u0448\u0438\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430\u0445 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u044e\u0442\u0441\u044f \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u0438\u0442\u0435\u043b\u0438 \u0443\u0441\u043b\u043e\u0432\u043d\u043e-\u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u043e\u0439 \u0444\u043b\u043e\u0440\u044b: \u0433\u0430\u0440\u0434\u043d\u0435\u0440\u0435\u043b\u043b\u044b, \u0431\u0430\u043a\u0442\u0435\u0440\u043e\u0438\u0434\u044b, \u0441\u0442\u0440\u0435\u043f\u0442\u043e\u043a\u043e\u043a\u043a\u0438, \u044d\u043d\u0442\u0435\u0440\u043e\u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0438.<\/p>\n<p>\u0412 \u0441\u043b\u0443\u0447\u0430\u0435 \u043d\u0430\u0440\u0443\u0448\u0435\u043d\u0438\u044f \u0431\u0430\u043b\u0430\u043d\u0441\u0430 \u0432 \u0441\u0442\u0440\u0443\u043a\u0442\u0443\u0440\u0435 \u043c\u0438\u043a\u0440\u043e\u0444\u043b\u043e\u0440\u044b \u0432\u043b\u0430\u0433\u0430\u043b\u0438\u0449\u0430 \u0438 \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u043a\u0430\u043d\u0430\u043b\u0430 \u0432\u043e\u0437\u043d\u0438\u043a\u0430\u0435\u0442 \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u044b\u0439 \u0432\u0430\u0433\u0438\u043d\u043e\u0437. \u041e\u043d \u0432\u044b\u0437\u0432\u0430\u043d \u0433\u0438\u0431\u0435\u043b\u044c\u044e \u043b\u0430\u043a\u0442\u043e\u0431\u0430\u0446\u0438\u043b\u043b \u0438 \u0438\u0437\u0431\u044b\u0442\u043e\u0447\u043d\u044b\u043c \u0440\u043e\u0441\u0442\u043e\u043c \u0443\u0441\u043b\u043e\u0432\u043d\u043e-\u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u044b\u0445 \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0439. \u0416\u0435\u043d\u0449\u0438\u043d\u0430 \u043c\u043e\u0436\u0435\u0442 \u043e\u0442\u043c\u0435\u0447\u0430\u0442\u044c \u0434\u0438\u0441\u043a\u043e\u043c\u0444\u043e\u0440\u0442 \u0438 \u0437\u0443\u0434 \u0432\u043e \u0432\u043b\u0430\u0433\u0430\u043b\u0438\u0449\u0435, \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430 \u0432\u044b\u0434\u0435\u043b\u0435\u043d\u0438\u0439 \u0441 \u043d\u0435\u043f\u0440\u0438\u044f\u0442\u043d\u044b\u043c \u0437\u0430\u043f\u0430\u0445\u043e\u043c. \u0414\u0430\u043d\u043d\u043e\u0435 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0435 \u043e\u0441\u043e\u0431\u0435\u043d\u043d\u043e \u043d\u0435\u0436\u0435\u043b\u0430\u0442\u0435\u043b\u044c\u043d\u043e \u043f\u0440\u0438 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438, \u0442\u0430\u043a \u043a\u0430\u043a \u0441\u0432\u044f\u0437\u0430\u043d\u043e \u0441 \u0435\u0435 \u043d\u0435\u0431\u043b\u0430\u0433\u043e\u043f\u0440\u0438\u044f\u0442\u043d\u044b\u043c\u0438 \u0438\u0441\u0445\u043e\u0434\u0430\u043c\u0438. \u041f\u0440\u0438 \u043e\u0441\u043c\u043e\u0442\u0440\u0435 \u0432\u0440\u0430\u0447 \u043c\u043e\u0436\u0435\u0442 \u043e\u0442\u043c\u0435\u0442\u0438\u0442\u044c \u0432\u043e\u0441\u043f\u0430\u043b\u0435\u043d\u0438\u0435 \u0432 \u043e\u0431\u043b\u0430\u0441\u0442\u0438 \u0448\u0435\u0439\u043a\u0438 \u043c\u0430\u0442\u043a\u0438 \u0438 \u043d\u0430\u0440\u0443\u0436\u043d\u043e\u0433\u043e \u0437\u0435\u0432\u0430 \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u043a\u0430\u043d\u0430\u043b\u0430 \u0441 \u0443\u0432\u0435\u043b\u0438\u0447\u0435\u043d\u0438\u0435\u043c \u043e\u0431\u044a\u0435\u043c\u0430 \u0432\u044b\u0434\u0435\u043b\u044f\u0435\u043c\u043e\u0439 \u0441\u043b\u0438\u0437\u0438 \u0438\u0437 \u043d\u0435\u0433\u043e.<\/p>\n<p>\u041c\u0438\u043a\u0440\u043e\u0431\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 (\u0431\u0430\u043a.\u043f\u043e\u0441\u0435\u0432) \u043c\u0430\u0442\u0435\u0440\u0438\u0430\u043b\u0430, \u043f\u043e\u043b\u0443\u0447\u0435\u043d\u043d\u043e\u0433\u043e \u043f\u0440\u0438 \u0432\u0437\u044f\u0442\u0438\u0438 \u043c\u0430\u0437\u043a\u0430 \u0438\u0437 \u0446\u0435\u0440\u0432\u0438\u043a\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u043a\u0430\u043d\u0430\u043b\u0430, \u0447\u0430\u0441\u0442\u043e \u043d\u0430\u0437\u043d\u0430\u0447\u0430\u044e\u0442 \u043f\u0440\u0438 \u043f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0438 \u043d\u0430 \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u044b\u0439 \u0432\u0430\u0433\u0438\u043d\u043e\u0437. \u0412\u043e \u0432\u0440\u0435\u043c\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0442\u0430\u043a\u0436\u0435 \u0438\u043c\u0435\u0435\u0442 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u043d\u0430\u043b\u0438\u0447\u0438\u044f \u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0438 Streptococcus agalactiae, \u0442\u0430\u043a \u043a\u0430\u043a \u0435\u0435 \u043f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0435 \u0441\u0432\u044f\u0437\u0430\u043d\u043e \u0441 \u0440\u0438\u0441\u043a\u043e\u043c \u0440\u0430\u0437\u0432\u0438\u0442\u0438\u044f \u043f\u043d\u0435\u0432\u043c\u043e\u043d\u0438\u0438 \u0443 \u043d\u043e\u0432\u043e\u0440\u043e\u0436\u0434\u0435\u043d\u043d\u043e\u0433\u043e.<\/p>\n<p>\u041e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u0435 \u0443\u0441\u043b\u043e\u0432\u043d\u043e-\u043f\u0430\u0442\u043e\u0433\u0435\u043d\u043d\u043e\u0439 \u0444\u043b\u043e\u0440\u044b \u043c\u043e\u0436\u0435\u0442 \u043f\u043e\u0442\u0440\u0435\u0431\u043e\u0432\u0430\u0442\u044c \u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u0430\u043d\u0442\u0438\u0431\u0438\u043e\u0442\u0438\u043a\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u0438, \u043f\u043e\u044d\u0442\u043e\u043c\u0443 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043e\u0446\u0435\u043d\u043a\u0430 \u0435\u0435 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u043a \u0430\u043d\u0442\u0438\u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u044b\u043c \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u0430\u043c, \u0447\u0442\u043e \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u043f\u043e\u0434\u043e\u0431\u0440\u0430\u0442\u044c \u043d\u0430\u0438\u0431\u043e\u043b\u0435\u0435 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0435 \u043b\u0435\u0447\u0435\u043d\u0438\u0435.<\/p>\n<p><strong>\u041f\u043e\u0434\u0433\u043e\u0442\u043e\u0432\u043a\u0430 \u043a \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044e<\/strong><\/p>\n<ol>\n<li>\u041d\u0435 \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u0441\u0434\u0430\u0432\u0430\u0442\u044c \u0430\u043d\u0430\u043b\u0438\u0437 \u0432\u043e \u0432\u0440\u0435\u043c\u044f \u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u0446\u0438\u0438. \u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u0440\u043e\u0432\u043e\u0434\u044f\u0442 \u043d\u0435 \u043f\u043e\u0437\u0434\u043d\u0435\u0435 \u0447\u0435\u043c \u0437\u0430 5 \u0434\u043d\u0435\u0439 \u0434\u043e \u043d\u0430\u0447\u0430\u043b\u0430 \u043c\u0435\u0441\u044f\u0447\u043d\u044b\u0445 \u0438\u043b\u0438 \u0447\u0435\u0440\u0435\u0437 5 \u0434\u043d\u0435\u0439 \u043f\u043e\u0441\u043b\u0435 \u0438\u0445 \u043e\u043a\u043e\u043d\u0447\u0430\u043d\u0438\u044f.<\/li>\n<li>\u0417\u0430 2 \u043d\u0435\u0434\u0435\u043b\u0438 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u043f\u0440\u0435\u043a\u0440\u0430\u0442\u0438\u0442\u044c \u043f\u0440\u0438\u0451\u043c \u0430\u043d\u0442\u0438\u0431\u0430\u043a\u0442\u0435\u0440\u0438\u0430\u043b\u044c\u043d\u044b\u0445, \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u044b\u0445, \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u0433\u0440\u0438\u0431\u043a\u043e\u0432\u044b\u0445 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u043e\u0432.<\/li>\n<li>\u0417\u0430 3 \u0434\u043d\u044f \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u0438\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u0432\u043d\u0443\u0442\u0440\u0438\u0432\u0430\u0433\u0438\u043d\u0430\u043b\u044c\u043d\u0443\u044e \u0442\u0435\u0440\u0430\u043f\u0438\u044e (\u0441\u0432\u0435\u0447\u0438, \u0442\u0430\u043c\u043f\u043e\u043d\u044b).<\/li>\n<li>\u0417\u0430 1\u20132 \u0434\u043d\u044f \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0443\u0435\u0442\u0441\u044f \u043d\u0435 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u0442\u044c \u0441\u0440\u0435\u0434\u0441\u0442\u0432\u0430 \u0438\u043d\u0442\u0438\u043c\u043d\u043e\u0439 \u0433\u0438\u0433\u0438\u0435\u043d\u044b.<\/li>\n<li>\u0417\u0430 24 \u0447\u0430\u0441\u0430 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u0438\u0441\u043a\u043b\u044e\u0447\u0438\u0442\u044c \u043f\u043e\u043b\u043e\u0432\u044b\u0435 \u043a\u043e\u043d\u0442\u0430\u043a\u0442\u044b, \u0441\u043f\u0440\u0438\u043d\u0446\u0435\u0432\u0430\u043d\u0438\u0435.<\/li>\n<li>\u0417\u0430 2\u20133 \u0447\u0430\u0441\u0430 \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0441\u043b\u0435\u0434\u0443\u0435\u0442 \u0432\u043e\u0437\u0434\u0435\u0440\u0436\u0430\u0442\u044c\u0441\u044f \u043e\u0442 \u043c\u043e\u0447\u0435\u0438\u0441\u043f\u0443\u0441\u043a\u0430\u043d\u0438\u044f.<\/li>\n<li><strong>\u0412 \u0434\u0435\u043d\u044c \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0437\u0430\u043f\u0440\u0435\u0449\u0430\u0435\u0442\u0441\u044f \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u0442\u0443\u0430\u043b\u0435\u0442 \u043f\u043e\u043b\u043e\u0432\u044b\u0445 \u043e\u0440\u0433\u0430\u043d\u043e\u0432.<\/strong><\/li>\n<\/ol>\n<p>\u041b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0430 \u0438 \u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0441\u043a\u0438\u0435 \u043f\u0440\u043e\u0446\u0435\u0434\u0443\u0440\u044b \u043c\u043e\u0433\u0443\u0442 \u043f\u043e\u0432\u043b\u0438\u044f\u0442\u044c \u043d\u0430 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u0430\u043d\u0430\u043b\u0438\u0437\u0430.<\/p>\n<p>\u0422\u0440\u0430\u043d\u0441\u0432\u0430\u0433\u0438\u043d\u0430\u043b\u044c\u043d\u043e\u0435 \u0423\u0417\u0418 \u0438\u043b\u0438 \u043a\u043e\u043b\u044c\u043f\u043e\u0441\u043a\u043e\u043f\u0438\u044e \u043b\u0443\u0447\u0448\u0435 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u044c \u0437\u0430 2 \u0434\u043d\u044f \u0434\u043e \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0438\u043b\u0438 \u0447\u0435\u0440\u0435\u0437 2 \u0434\u043d\u044f \u043f\u043e\u0441\u043b\u0435 \u043d\u0435\u0433\u043e.<\/p>\n<p><strong>\u041a\u0430\u043a \u0441\u0434\u0430\u044e\u0442 \u0430\u043d\u0430\u043b\u0438\u0437 \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0435 \u0436\u0435\u043d\u0449\u0438\u043d\u044b:<\/strong><\/p>\n<ul>\n<li>\u043d\u0430 \u0441\u0440\u043e\u043a\u0435 \u0434\u043e 21 \u043d\u0435\u0434\u0435\u043b\u0438, \u0435\u0441\u043b\u0438 \u043d\u0435\u0442 \u0443\u0433\u0440\u043e\u0437\u044b \u043f\u0440\u0435\u0440\u044b\u0432\u0430\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438<\/li>\n<li>\u043d\u0430 \u0441\u0440\u043e\u043a\u0435 22\u201330 \u043d\u0435\u0434\u0435\u043b\u044c, \u0435\u0441\u043b\u0438 \u043d\u0435\u0442 \u0443\u0433\u0440\u043e\u0437\u044b \u043f\u0440\u0435\u0440\u044b\u0432\u0430\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438<\/li>\n<\/ul>\n<p>\u041f\u0440\u043e\u0442\u0438\u0432\u043e\u043f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u0438 \u043e\u0433\u0440\u0430\u043d\u0438\u0447\u0435\u043d\u0438\u044f<\/p>\n<p>\u041e\u0433\u0440\u0430\u043d\u0438\u0447\u0435\u043d\u0438\u044f \u043a \u0432\u0437\u044f\u0442\u0438\u044e \u043c\u0430\u0442\u0435\u0440\u0438\u0430\u043b\u0430:<\/p>\n<ul>\n<li>\u043c\u0435\u043d\u0441\u0442\u0440\u0443\u0430\u0446\u0438\u044f \u0438\u043b\u0438 \u043b\u044e\u0431\u044b\u0435 \u0438\u043d\u044b\u0435 \u043a\u0440\u043e\u0432\u044f\u043d\u0438\u0441\u0442\u044b\u0435 \u0432\u044b\u0434\u0435\u043b\u0435\u043d\u0438\u044f. \u0418\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u043f\u0440\u043e\u0432\u043e\u0434\u044f\u0442 \u043d\u0435 \u043f\u043e\u0437\u0434\u043d\u0435\u0435 \u0447\u0435\u043c \u0437\u0430 5 \u0434\u043d\u0435\u0439 \u0434\u043e \u043d\u0430\u0447\u0430\u043b\u0430 \u043c\u0435\u0441\u044f\u0447\u043d\u044b\u0445 \u0438\u043b\u0438 \u0447\u0435\u0440\u0435\u0437 5 \u0434\u043d\u0435\u0439 \u043f\u043e\u0441\u043b\u0435 \u0438\u0445 \u043e\u043a\u043e\u043d\u0447\u0430\u043d\u0438\u044f;<br \/>\n\u0432\u043e\u0437\u0440\u0430\u0441\u0442 \u043c\u043e\u043b\u043e\u0436\u0435 18 \u043b\u0435\u0442;<\/li>\n<li>\u0434\u0435\u0432\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0441\u0442\u044c (\u0432\u043d\u0435 \u0437\u0430\u0432\u0438\u0441\u0438\u043c\u043e\u0441\u0442\u0438 \u043e\u0442 \u0432\u043e\u0437\u0440\u0430\u0441\u0442\u0430);<\/li>\n<li>\u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u044c \u0441 31-\u0439 \u043d\u0435\u0434\u0435\u043b\u0438;<\/li>\n<li>\u0443\u0433\u0440\u043e\u0437\u0430 \u043f\u0440\u0435\u0440\u044b\u0432\u0430\u043d\u0438\u044f \u0431\u0435\u0440\u0435\u043c\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u043d\u0430 \u043b\u044e\u0431\u043e\u043c \u0441\u0440\u043e\u043a\u0435.<\/li>\n<\/ul>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[979],"product_tag":[],"class_list":{"0":"post-10253","1":"product","2":"type-product","3":"status-publish","5":"product_cat-tract-urogenital","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10253","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10253"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10253"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10253"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10253"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10253"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}