Clostridium perfringens – antibiotic-associated and sporadic diarrhea in children: age, anamnestic and clinical and laboratory features

Medical alphabet ◽

10.33667/2078-5631-2021-32-10-15 ◽

2021 ◽

pp. 10-15

Author(s):

A. S. Kvetnaya ◽

L. I. Zhelezova

Keyword(s):

Clostridium Perfringens ◽

Enzyme Analysis ◽

First Year ◽

Saint Petersburg ◽

Clinical Center ◽

Colony Forming Units ◽

Antibiotic Associated Diarrhea ◽

First Year Of Life ◽

Diarrhea Syndrome ◽

Klebsiella Spp

The article presents the data of the research on the problem of two clinical forms of enteroproducing Clostridium perfringens (C. perfringens) – associated infection in the children who are not connected with food – antibiotic-associated and sporadic forms. Within the period of 2019–2021 a retrospective analysis of the results of complex clinical and laboratory study of children aged from 2 months to 18 years with diarrhea (acute intestinal infection, n = 406 children) was carried out within the framework of the algorithm developed by Pediatric Research and Clinical Center for Infectious Diseases (Russia, Saint Petersburg). The material for the study included stool tests, coprofiltrates and strains of the microorganisms determinating microbiocoenosis of the intestines including enterotoxigenic strains of C. perfringens. The main group included children with diarrhea (n = 38 of 406 children with diarrhea) who at admission presented C. perfringens enterotoxin in coprofiltrates found by immune-enzyme analysis and there were identified the cultures of enterotoxigenic strains of C. perfringens by tests of intestinal contents. The first group included children (n = 30 of 406 children; 7 %) with antibiotic-associated diarrhea (AAD). The second group included children (n = 8 of 406 children; 2 %) with sporadic diarrhea. An overwhelming majority of patients with ААD (n = 20; 92.3 %) of the first 8 (100 %) years of life presented intensity of diarrhea syndrome in direct dependence on colonization activity of enterotoxigenic C perfringens (colony-forming units/g feces) (r = 0.78). The disease proceeded mainly with the syndromes of gastroenteritis, enterocolitis and hemorrhagic colitis. There was noted a reliable high frequency of severe forms of both ААD, and sporadic diarrhea (р < 0.05) caused by enterotoxigenic strains of C perfringens in children of the first year of life. Deep decompensated disorders of large intestine microbiota associated with Klebsiella spp., Staphylococcus aureus and Candida albicans, were characterized by severity and prolonged character of the course (р < 0.05). The received results determine the tactics of differential diagnosis and treatment of AAD and sporadic diarrhea caused by enteroproducing strains of C. perfringens.

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DETECTION OF GENETIC DETERMINANTS OF PATHOGENICITY OF STRAINS OF KLEBSIELLA SPP. ISOLATED FROM THE INTESTINAL BIOTOPE OF CHILDREN WITH FUNCTIONAL GASTROINTESTINAL DISORDERS

Acta biomedica scientifica ◽

10.29413/abs.2018-3.5.9 ◽

2018 ◽

Vol 3 (5) ◽

pp. 60-65

Author(s):

E. V. Grigorova ◽

L. V. Rychkova ◽

E. I. Ivanova ◽

U. M. Nemchenko ◽

M. V. Savelkaeva

Keyword(s):

Functional Gastrointestinal Disorders ◽

Gastrointestinal Disorders ◽

First Year ◽

Genetic Determinants ◽

Pathogenic Potential ◽

Bacteriological Study ◽

Industry Standard ◽

Comparison Groups ◽

First Year Of Life ◽

Klebsiella Spp

Functional gastrointestinal disorders (FGID) are one of the most common problems in children of the first year of life. The aim of the study was to assess the pathogenic potential of Klebsiella spp. strains, isolated from the colon in children of the first year of life with FGID. Material for the study included 61 coprological samples. The biological material was divided into comparison groups, depending on the type of Klebsiella excreted at a concentration of 105–108 CFU/g: 1st – with vegetation in the colon K. pneumoniae (n = 30); 2nd – with vegetation K. oxytoca (n = 31). Bacteriological study composition of the intestinal contents was carried out according to the Industry standard “Protocol of management of patients. Intestinal dysbiosis” (2003). Identification was carried out according to generally accepted schemes using commercial test systems for biochemical identification of bacteria. Statistical data processing was performed using licensed applications “MS Office Excel 2003 for Windows 7”. The data on the quantitative and qualitative changes in the composition microbiota in the comparison groups were obtained. The results of detection genetic determinants of pathogenicity in the samples of Klebsiella of two species show that among the strains of Klebsiella spp., vegetating in the intestines of children as a component of an allochthonous microbiota, a sufficiently high and virulent potential can be concentrated. Detection of pathogenicity genes in bacteria of the genus Klebsiella will expand and deepen the problem of finding the structures of adaptation of strains of bacteria that cause FGID in children of the first year of life.

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FEATURES OF LARGE INTESTINE MICROBIOCENOSIS IN INFANTS WITH FUNCTIONAL DISORDERS OF GASTROINTESTINAL TRACT AGAINST HIGH POPULATION DENSITY OF BACTERIA OF THE GENUS KLEBSIELLA

Bulletin physiology and pathology of respiration ◽

10.12737/article_5a24cd3713fea5.15038282 ◽

2017 ◽

Vol 1 (66) ◽

pp. 83-88 ◽

Cited By ~ 1

Author(s):

Екатерина Григорова ◽

Ekaterina Grigorova ◽

Ульяна Немченко ◽

Ulyana Nemchenko ◽

Елена Иванова ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Large Intestine ◽

High Titer ◽

Biochemical Properties ◽

Selective Decontamination ◽

First Year ◽

Functional Disorders ◽

Klebsiella Species ◽

First Year Of Life ◽

Klebsiella Spp

The aim of the research was to determine the features of large intestinal microbiocenosis during the vegetation of bacteria of the genus Klebsiella in children with functional disorders of the gastrointestinal tract in different age periods of the first year of life. The material for the study is based on 210 coprological samples isolated from infants of both sexes with functional disorders of the gastrointestinal tract and indication of Klebsiella spp. in the titer of 105-108 CFU/g. The children were grouped according to the age: 1st − children from 1 to 3 months old, 2nd − children from three to six months old, 3rd − children from 6 to 12 months old. All of them were divided into two groups for comparison, depending on the type of isolated Klebsiella species: K. pneumoniae (n=105) and K. oxytoca (n=105). The investigation of the intestinal microflora was performed in accordance with conventional methodology, and the assessment of the results was done according to Industry Standard. Identified bacteria were divided by their morphologic, tinctorial, cultural and biochemical properties. As a result of the study, dysbiotic disturbances of the 3rd degree were observed in children, complicated by the proliferation of bacteria of the genus Klebsiella, especially by its diagnostically important bacterial agent K. oxytoca. Most critical for the development of functional disorders of the gastrointestinal tract for the children of the first year of life is the age of 3-6 months. Long-term persistence of the Klebsiella spp. in high titer (105-108 CFU/g) in the large intestine of the children with functional disorders of the gastrointestinal tract dictates the need for selective decontamination of the Klebsiella from the gut microbiota.

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The Development of Swallowing Respiratory Coordination

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd18.1.19 ◽

2009 ◽

Vol 18 (1) ◽

pp. 19-24

Author(s):

Maggie-Lee Huckabee

Keyword(s):

Cortical Activation ◽

First Year ◽

Healthy Children ◽

Nasal Airflow ◽

Single Session ◽

Primary Finding ◽

Patterns Of Behavior ◽

Cortical Modulation ◽

First Year Of Life ◽

Swallowing Apnea

Abstract Research exists that evaluates the mechanics of swallowing respiratory coordination in healthy children and adults as well and individuals with swallowing impairment. The research program summarized in this article represents a systematic examination of swallowing respiratory coordination across the lifespan as a means of behaviorally investigating mechanisms of cortical modulation. Using time-locked recordings of submental surface electromyography, nasal airflow, and thyroid acoustics, three conditions of swallowing were evaluated in 20 adults in a single session and 10 infants in 10 sessions across the first year of life. The three swallowing conditions were selected to represent a continuum of volitional through nonvolitional swallowing control on the basis of a decreasing level of cortical activation. Our primary finding is that, across the lifespan, brainstem control strongly dictates the duration of swallowing apnea and is heavily involved in organizing the integration of swallowing and respiration, even in very early infancy. However, there is evidence that cortical modulation increases across the first 12 months of life to approximate more adult-like patterns of behavior. This modulation influences primarily conditions of volitional swallowing; sleep and naïve swallows appear to not be easily adapted by cortical regulation. Thus, it is attention, not arousal that engages cortical mechanisms.

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