CHILDREN ACUTE ENTERIC INFECTIONS IN PAEDIATRICIAN PRACTICE: POSSIBILITIES OF DIAGNOSTICS AND THERAPY
https://doi.org/10.15690/vsp.v13i3.1023
Abstract
Acute Enteric Infections (AEI) occupy one of the leading places in structure of infectious pathology at children's age. A variety of etiological agents (bacteria, viruses and protozoa) causing infectious diarrhoea, the high frequency of mixed infections, frequent failures and uneven course prove the necessity of search of ways for optimization of diagnostic and therapeutic approaches according to modern scientific data. The principles of clinical and laboratory diagnostics of AEI are considered in the article. Criteria of the assessment of a disease severity, predictive criteria of development of the life-threatening states connected with the exicosis are presented. The principles of AEI treatment are presented from the modern positions, the necessity of an integrated approach and staging in therapy with the personified choice of preparations considering weight, phase and clinical form of a disease, age of a child and a macroorganism condition by the time of the disease beginning are introduced. The necessity of a strictly differentiated approach to prescription of antibiotics is emphasized. The data on expediency of inclusion of probiotics to starting AEI therapy of virus aetiology are separately presented taking into account strain-specific efficiency that provides the reliable reduction of degree of intensity and duration of the main symptoms of a disease, and also has beneficial impact on a condition of microflora of a gastrointestinal path.
About the Authors
D. V. Usenko
Central Research Institute of Epidemiology, Moscow
Russian Federation
Usenko Denis Valerievich, PhD, senior research scientist of Clinical Department of Infectious Pathology
Russian Federation
Usenko Denis Valerievich, PhD, senior research scientist of Clinical Department of Infectious Pathology
А. А. Ploskireva
Central Research Institute of Epidemiology, Moscow
Russian Federation
Russian Federation
A. V. Gorelov
Central Research Institute of Epidemiology, Moscow
Russian Federation
Russian Federation
References
1. Maleev V. V. Epidemiologiya i infektsionnye bolezni — Epidemiology and infectious diseases. 2006; 4: 1–4. 2. Mindlina A.Ya. Vestnik RAMN — Annals of RAMS. 2010; 11: 30–33.
2. Onishchenko G. G. Immunologiya — Immunology. 2008; 1: 18–23.
3. Grigorovich M. S. Iskhody ostrykh kishechnykh infektsii u detei, faktory ikh opredelyayushchie, i optimizatsiya putei reabilitatsii. Avtoref. dis. … dokt. med. nauk [Outcomes of Acute Intestinal Infections in Children, Factors of Progress and Optimization of Rehabilitation. Author’s abstract]. Moscow, 2012. 48 p.
4. Lobzin Yu. V., Skripchenko N. V., Volzhanin V. M. Zhurn. infektologii — Journal of infectology. 2012; 4 (4): 5–30.
5. Zhuparova M. E. Infektsionnye bolezni — Infectious diseases. 2009; 7 (2): 77–88.
6. Razd’yakonova I. V. Kliniko-immunologicheskaya kharakteristika kalitsivirusnoi infektsii u detei i taktika terapii. Avtoref. dis. … kand. med. nauk [Clinical and Immunological Characteristics of Caliciviral Infection in Children and Therapy Strategy. Author’s abstract]. St. Petersburg, 2009. 24 p.
7. Causes of child mortality for the year 2010. URL: http://www.who. int/gho/child_health/mortality/mortality_causes_text/en/index.html
8. Fischer T. K., Viboud C., Parashar U., Malek M., Steiner C., Glass R., Simonsen L. Hospitalizations and deaths from diarrhea and rotavirus among children < 5 years of age in the United States, 1993–2003. J. Infect. Dis. 2007; 195: 1117–1125.
9. MDG 4: Child mortality: Under-five mortality. URL: http://www.who. int/gho/child_health/mortality/mortality_under_five/en/index. html (дата обращения: 14.01.2013).
10. Podkolzin A. T., Veselova O. A., Yakovenko M. L., Konova lova T. A., Petukhov D. N., Yatsyshina S. B., Vorob’eva N. S., Shipulin G. A. Infektsionnye bolezni — Infectious diseases. 2013; 2: 38–44.
11. Bodnev A., Maleev V. V., Zhirokovskaya E. V., Nikiforova N. A., Korsakova T. G., Tikunov A.Yu., Netesov S. V., Tikunova N. V. Infektsion nye bolezni — Infectious diseases. 2008; 6 (1): 61–64.
12. Bulanova I. A., Titova L. V., Samodova O. V., Feklisova L. V. EpiNort — EpiNort. 2009; 10 (1): 18–24.
13. Podkolzin A. T., Fenske E. B., Abramycheva N.Yu., Shipulin G. A., Bitieva P. L., Sagalova O. I., Mazena V. N., Ivanova G. I., Semena A. V., Tagirova Z. G., Ivanova V. V., Molochnyi V. P., Ivolgina A. V., Maleev V. V., Pokrovskii V. I. Ter. arkhiv — Therapeutic Archive. 2007; 11: 10–16.
14. Glass R. I., Parashar U. D., Estes M. K. Norovirus gastroenteritis. N. Engl. J. Med. 2009; 361: 1776–1785.
15. Lyman W. H., Walsh J. F., Kotch J. B., Weber D. J., Gunn E., Vinje J. Prospective study of etiologic agents of acute gastroenteritis outbreaks in child care centers. J. Pediatr. 2009; 154: 253–257.
16. Gorelov A. V., Bondareva A. V. Epidemiologiya i infektsionnye bolezni. Aktual’nye voprosy — Epidemiology and infectious diseases. Current Items. 2013; 5: 46–50.
17. Akhmedova G. M. Etiologicheskaya rol’ kampilobakterov v strukture ostrykh bakterial’nykh kishechnykh infektsii u detei v Tadzhikistane. Avtoref. dis. … kand. med. nauk [Campylobacter’s Influence on Structure of Acute Microbial Enteric Infections in Children in Tadzhikistan. Author’s abstract]. Moscow, 2006. 24 p.
18. Gorelov A. V., Milyutina L. N., Usenko D. V. Klinicheskie rekomendatsii po diagnostike i lecheniyu ostrykh kishechnykh infektsii u detei. Prakt. ruk-vo dlya vrachei [Clinical Recommendations on Diagnosis and Treatment of Enteric Infections in Children. Guideline]. Moscow, 2005. 106 p.
19. Gorelick M. H., Shaw K. N., Murphy K. O. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. 1997; 99 (5): 6.
20. European Society for Pediatric Gastroenterology, Hepatology and Nutrition/European Society for Pediatric Infection Diseases. Evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J. Pediatric Gstroenter. Nutr. 2008; 46 (Suppl. 2): 81–122.
21. WGO practice guideline: acute diarrhea. Evidence-based care guideline for prevention and management of acute gastroenteritis (AGE) in children aged 2 months to 18 years. http://www.guideline.gov/
22. Naguze S. K. Sravnitel’naya kharakteristika ispol’zovaniya adaptirovannykh molochnykh smesei pri OKI u detei. Akt. vopr. infektsionnoi patologii u detei: Mat-ly tret’ego kongressa pediatrov-infektsionistov Rossii [Comparative Analysis of Infant Milk Formula Used in Feeding of Children Suffering from Acute Enteric Infections. Current Issues of Infectious Pathology in Children: Proceedings of the 3rd Congress of Pediatricians-Infectiologists of Russia]. Moscow, 2004. 159 p.
23. Netrebenko O. K. Vopr. sovr. pediatrii — Current pediatrics. 2004; 3 (1): 73–75.
24. Khavkin A. I. Vopr. sovr. pediatrii — Current pediatrics. 2003; 2 (1): 99–100.
25. Antonenko A. N. Laktaznaya nedostatochnost’ u detei rannego vozrasta, bol’nykh ostrymi kishechnymi infektsiyami, osnovnye metody ee korrektsii. Avtoref. dis. … kand. med. nauk [Lapp Lactase Deficiency in Infants Suffering from Acute Enteric Infections, Basic Methods of Correction. Author’s abstract]. Moscow, 2006. 21 p.
26. Simacahron N., Tongpenuai Y., Tongtan O. Randomized, double-blind clinical trial of a lacoste-free and a lacoste-containing formula in dietary management of acute childhood diarrhea. J. Med. Assoc. Thai. 2004; 6: 641–649.
27. O`Ryan M., Prado V., Pickering L. Millennium update on pediatric Diarrheal Illness in the Developing. World Semin. Pediatr. Infect. Dis. 2005; 16: 125–136.
28. EHEC/HUS O104-H4 — The outbreak is considered to be over. Berlin: Press Release of Robert Koch-Institute. 2011.
29. Ochoa T. J., Chen J., Walker C. M., Gonzales E., Cleary T. G. Rifaximin does not induce toxin production or phage-mediated lysis of Shiga toxin-producing Escherichia coli. Antimicrob. Agents Chemother. 2007; 51 (8): 2837–2841.
30. Bel’skii V. A., Kalutskii P. V., Kiseleva V. V. Geterogennost’ mikrobnykh populyatsii [Heterogeneity of Microbial Populations]. Moscow, MIA, 2008. 160 p.
31. Asseva G., Petrov P., Kantardjiev T. Surveillance of human salmonellosis in Bulgaria, 1999–2004: trends, shifts and resistance to antimicrobial agents. Euro Surveill. 2006; 11 (5): 624.
32. Milyutina L. N., Gur’eva O. V., Rozhnova S. Sh., Golovinova M. A. Epidemiologiya i infektsionnye bolezni — Epidemiology and infectious diseases. 2008; 2: 44–47.
33. Gorelov A. V., Trefilova I.Sh., Belova N. V. Epidemiologiya i infektsionnye bolezni — Epidemiology and infectious diseases. 1997; 6: 35–38.
34. Shcherbakov P. L., Petukhov V. A. Vopr. sovr. pediatrii — Current pediatrics. 2005; 4 (4): 86–90.
35. Szajewska H., Dziechciarz P., Mrukowicz J. Smectite in the treatment of acute infectious diarrhoea in children. Aliment. Pharmacol. Ther. 2006; 23 (2): 217.
36. Ploskireva A. A., Tkhakushinova N.Kh., Gorelov A. V. Infektsionnye bolezni — Infectious diseases. 2013; 11 (1): 50–55.
37. Marteau P. R., de Vrese M., Cellier C. J., Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. Am. J. Clin. Nutr. 2001; 73 (Suppl. 2): 430–436.
38. Szajewska H., Skorka A., Ruszczynski M., Gieruszczak-Bialek D. Meta-analysis: Lactobacillus GG for treating acute gastroenteritis in children — updated analysis of randomised controlled trials. Aliment. Pharmacol. Ther. 2013; 38 (5): 467–476.
39. Usenko D. V., Gorelova E. A. Infektsionnye bolezni — Infectious diseases. 2013; 11 (3): 27–35.
Review
For citations:
Usenko D.V., Ploskireva А.А., Gorelov A.V. CHILDREN ACUTE ENTERIC INFECTIONS IN PAEDIATRICIAN PRACTICE: POSSIBILITIES OF DIAGNOSTICS AND THERAPY. Current Pediatrics. 2014;13(3):12-20. (In Russ.) https://doi.org/10.15690/vsp.v13i3.1023
Views:
1900
Email this article 
