Материалы XX юбилейного Конгресса детских инфекционистов России. «Актуальные вопросы инфекционной патологии и вакцинопрофилактики»

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Hemorrhagic colitis syndrome in children: the etiological structure in the infectious diseases clinic

The range of differential diagnostic search in the development of hemorrhagic colitis (hemocolitis) is wide enough and includes infectious and non-infectious factors. Purpose: clinical, laboratory and etiological analysis of bacterial diarrhea occurring with hemorrhagic colitis in the infectious diseases department.Materials and methods: a retrospective study of 141 case histories of those hospitalized in the infectious diseases department of the2 Children's City Clinical Hospital No. 9 named after G.N. Speransky of Moscow in 2019—2021 patients with clinical picture of hemocolitis. Hemocolitis was determined on the basis of macroscopic and microscopic signs (in scatology — mucus, leukocytes, erythrocytes) signs. All patients underwent routine laboratory examinations. The etiology was verified using modern methods of laboratory diagnostics (bacteriological analysis of feces, Latex test, ICA, ELISA, PCR, IHR).Results. There were 137 patients with infectious hemocolitis. Inflammatory bowel disease was diagnosed in 3 children, anus fissure — in 1 child. Young children under 3 years of age prevailed (77%). The etiology of infectious hemocolitis was deciphered in 47 patients (34%). Salmonellosis (36%) and shigellosis (36%) prevailed. Campylobacteriosis, clostridiosis-dificile and klebsiellosis accounted for 11%, 9% and 6% of cases, respectively. Yersiniosis was detected in 1 child at the age of 5 months. The severe form was found in 5.8% of cases, in most cases with shigellosis. Symptoms of intoxication and febrile fever were expressed in all patients, vomiting — in 28.5%, abdominal pain — in 94%, mesenteric adenitis on ultrasound — in 15%, diarrhea with a frequency of more than 5 times a day — in 84%, dehydration — in 64%, intercurrent diseases (ARVI, pneumonia) — in 41.3% of cases. Inflammatory changes in infectious hemocolitis were manifested by an increase in C-reactive protein in 71% (23.91 ± 24.17 mg/l), leukocytosis — in 69% (11.58 ± 3.52 х103 / μl), thrombocytosis — in 26%, an increase in the relative number of stab neutrophils in the general blood test in 78% of cases (10.95 ± 0.4%).Conclusions. Differential diagnostic search in the development of hemocolitis should include modern diagnostic methods, if necessary, additional instrumental studies and specialist consultations to exclude inflammatory bowel diseases.

Bacterial purulent meningitis in children: is there a light at the end of the tunnel?

Bacterial purulent meningitis is a life-threatening disease characterized by high mortality and severe consequences in survivors. Despite the modern possibilities of medicine, the disease continues to be a heavy burden on health care, the economy and society everywhere.Aim. To draw the attention of doctors to the problems associated with modern features of epidemiology, the consequences and possibilities of preventing bacterial purulent meningitis, especially in children, who constitute the main risk group for the development of this pathology.Literature review of Russian and foreign publications on the problem under consideration presented.Vaccination is recognized as one of the main tools for reducing morbidity and mortality from meningitis. Prophylactic vaccinations against N. meningitidis, Str.pneumoniae, H. influenzae, along with strict adherence to anti-epidemic measures in hospitals providing care to newborns, can help reduce the incidence of purulent meningitis in children and improve outcomes if they develop.

Congenital herpes simpleх: modern approach to prevention, diagnosis, and treatment

Among the classic pathogens of congenital infection, herpes simplex viruses type 1 and type 2 play important role. Neonatal herpes develops as a result of antenatal transmission of HSV. The greatest risk occurs with the primary infection of a woman in the late stages of pregnancy. In 85% of cases, genital and neonatal herpes is associated with HSV-2.The purpose of study: to identify the relationship between early manifestations of neonatal herpes and genital herpes during pregnancy for early diagnosis and etiological therapy of the newborn.Materials and methods. The analysis of current clinical recommendations and international consensuses of professional communities in Russia, the USA, and a number of European countries in the management of pregnant women was carried out. The five medical histories of newborn infants with a diagnosis of congenital herpetic infection were analyzed. In the clinical guidelines for the management of normal pregnancy, routine screening of pregnant women for HSV is omitted, however, examination is recommended for symptoms of genital herpes. For the prevention of neonatal herpes, antiviral drugs and caesarean section are used. Congenital herpes develops rarely, proceeds severely with significant residual manifestations in children. Antiviral therapy (Acyclovir) is used for herpetic infection in newborns: with systemic and local infection (eye damage). The analysis showed: despite the recurrent course of genital herpes in 4 out of 5 women during pregnancy, none of the pregnant women had a laboratory examination for HSV, pregnant women did not receive systemic etiological therapy and all deliveries were natural. The absence of preventive measures contributed to the early, during the first three days of life, the development of severe forms of neonatal herpes. In respect that the lack of significant clinical specificity and delayed manifestation, an antenatal anamnesis is important diagnostic criterion for neonatal herpes.

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Genetic variants identified in children with recurrent infections

Currently, the most effective way to diagnose hereditary defects of the immune system is molecular genetic research, the results of which are evaluated in conjunction with the data of clinical and laboratory studies.Aims of the sudy: to evaluate the frequency and spectrum of rare genetic variants associated with the development of primary immunodeficiency (PID) in children with recurrent infections.Materials and methods: DNA samples from 113 children with recurrent infections were analyzed by targeted multigene sequencing of 338 PID-associated genes. Results: Pathogenic variants appropriate to the potential diagnosis of PID were identified in 8% of patients. Interestingly, 47.8% of children had variants associated with auto-inflammatory disorders.

Teniases caused by Taenia asiatica, Taenia saginata, Taenia solium

The urgency of the problem of human teniases is due to the widespread prevalence of these parasitoses, which often infect humans.The aim and result of the work is to summarize the available information about the etiology, epidemiology, pathogenesis, clinical picture, diagnosis, etiotropic therapy and prevention of human teniases.Conclusion. Teniases are widespread, including on the territory of Russia. The clinic mainly includes symptoms of lesions of the gastrointestinal tract, allergic reactions. Diagnostics is carried out on the basis of the detection of eggs, proglottids, coproangigens of parasites in the feces, serological and molecular genetic tests. Praziquantel is an effective etiotropic therapy. Prevention takes into account the peculiarities of the epidemiology of teniases.

30 years of service for the health of children: we teach, we treat, we write, we create

The article, dedicated to the 30th anniversary of the founding of the Department of Infectious Diseases in Children of the Faculty of Postgraduate and Additional Professional Education of the St. Petersburg State Medical Pediatric University of the Ministry of Health of Russia, outlines the history of the creation and development of the department. The results of the comprehensive activities of the department are reflected: educational, research, organizational and methodological, treatment and diagnostic and advisory. The main directions and results of scientific work, their effectiveness when introduced into practical health care are described. The educational-methodical developments of the department, published in recent years, are presented, which are an important tool for improving the professional level of doctors. It is noted that by increasing the educational level of medical personnel, the department contributes to improving the quality of medical care for children, thereby not only taking part in improving the demographic situation in the country, but also in ensuring its national security.

Clinical, laboratory characteristics of a new Сoronavirus Infection in children in the Stavropol Territory

A new coronavirus infection in children is more often asymptomatic or in mild forms, however, more and more severe cases of the disease have been recorded recently, and single deaths in children have been recorded in the world.The aim of the study was a clinical and laboratory analysis of the features of the course of a new coronavirus infection in children in the Stavropol Territory.Based on a retrospective study, 86 medical records of inpatient children who were treated at the Regional Specialized Clinical Infectious Diseases Hospital of the Stavropol Territory were analyzed with a diagnosis of U07.1 New coronavirus infection for the period from April 2020 to April 2021.The majority of hospitalized patients suffered from COVID-19 in a moderate form 59.3%. Children are more likely to become infected in family foci of infection – 51.2%. In 60% of cases, children are hospitalized 4—7 days from the onset of the disease. In the clinical picture, the leading symptoms were: fever (76.7%), cough (55.8%), weakness (38.4%), rhinitis (20.9%), gastrointestinal symptoms (12.8%). Pneumonia was detected in 37.2% of children. All patients were discharged with clinical recovery.

Viral hepatitis in children: state and prospects for solving the problem

The problem of viral hepatitis (VH) today is an acute problem for the world healthcare system. Along with the COVID-19 pandemic, the VH pandemic claims up to 1.5 million lives annually. Since 2016, the Russian Federation has launched a WHO program aimed at combating VH. One of the first steps on the path of global elimination is getting rid of the virus in the small groups, among which micro-elimination in the child population is one of the promising areas.This review is devoted to the current state of the problem of VH in children in the Russian Federation today. The success of vaccine prevention (against viral hepatitis A and B) made it possible to achieve results in the form of a significant decrease in the incidence of children, minimizing the risk of perinatal infection. However, in recent years, there has been a progressive decline in vaccination coverage. This is mainly due to the growing popularity of anti-vaccination lobbies, a decrease in the awareness of patients and health workers about the need for timely vaccination, as well as the introduction of restrictive measures to prevent a new coronavirus infection. The emergence of mutant, "vaccine-eluting" strains, which are also resistant to available antiviral drugs, is another serious problem on the way to eliminating viral HBV. In the field of treating children with HBV, the possibilities are extremely limited, only 2 drugs are available, one of which (tenofovir alafenamide) is available only from the age of 12. Registration of direct antiviral drugs for the treatment of adolescents with chronic hepatitis C has made it possible to bring closer the goal of microelimination of the virus in children. However, the high cost of drugs poses a challenge for the state to introduce long-term benefit programs to ensure the availability of treatment. In addition, at the moment, the treatment of young children in our country remains a prospect for the future.Thus, despite significant advances in the strategy for the elimination of viral hepatitis, a number of problems remain relevant and present significant difficulties in achieving the global goal.