No 6 (2017)

Objective. To determine the clinical and laboratory features of acute respiratory infection (ARI) caused by coronaviruses in children. Subjects and methods. A total of 628 children aged 3 months to 6 years, who had been admitted to the Specialized Care Department of the Infectious Diseases Hospital with a diagnosis of ARI in January 2008 to December 2009 were examined. Polymerase chain reaction was used to diagnose coronavirus infection in 50 patients; of them 40 (80%) children were found to have viral monoinfection and 10 (20%) had viral co-infection. Results. Most children with coronavirus monoinfection had predominantly an acute onset of the disease that was mild or moderate. Rising body temperatures to fever at the onset of the disease were observed in 52.5% of children. In 72.5% of children, the duration of the febrile period was 1-2 days. Children were noted to have cough (100%), rhinitis (94.8%), laryngotracheitis with grade 1 laryngeal stenosis (52.5%), and harsh breath sounds on auscultation (65%). There were gastrointestinal disorders as vomiting in 7.5% of cases and liquid stool without pathological admixtures in 10%. No cardiovascular events were seen. Hematological parameters corresponded to the course of the infectious process and showed no characteristic features. Febrile fever, moderate catarrhal signs, and intoxication symptoms, cough, and phenomena of stenosing laryngotracheitis were observed in viral co-infection caused by a combination of coronaviruses and two viruses. Conclusion. In coronavirus infection (both mono- and co-infection) in children, catarrhal syndrome was dominant in most cases. The disease is commonly accompanied by cough, fever, and phenomena of stenosing laryngitis; there may be gastrointestinal dysfunction.

Objective. To present the main results of work of the Clinical Department of Infectious Diseases on viral hepatitides in children and pediatric hepatology. The Hepatitis Group was set up within the Department by Professor A.R. Reizis, MD, in 1980 and has been headed by him to the present time. The main aspects of researches have been the viral nature of hepatitides, their etiological diagnosis and epidemiology; recognition and the specific features of the course of viral hepatitides, their immuno- and pathogenesis; differential diagnosis with a wide range of diseases occurring with jaundice and/or liver involvement; both etiotropic and pathogenetic treatments for these diseases in children. At all work stages, the general issues of pediatric hepatology have also made a certain contribution to the problem of viral hepatitides in children, which has been embodied in 6 monographs, 13 guidelines and letters, 6 author certificates and patents for inventions and more than 350 printed publications.

In recent years, the relationship between infectious and allergic diseases has attracted the great attention of scientists. This literature review analyzes investigations of the role of a number of infectious agents as a trigger of allergic diseases (particularly, asthma and atopic dermatitis). Noteworthy are the data suggesting that some pathogens of bacterial and viral infections play a protective role in the manifestation of atopy. Despite many years of investigations, the clinical and pathogenetic aspects of the impact of allergic diseases on the course of bacterial and viral infections remain unstudied, which requires further investigations and elaboration of appropriate rehabilitation programs.

Objective. To evaluate the clinical and laboratory efficiency of using vitamin D in the combination therapy of acute intestinal infections (AIIs) of various etiologies in 1- to 6-year-old children with varying vitamin D status. Subjects and methods. A total of 215 hospitalized children were examined. Of them, 106 patients received standard therapy and 109 had vitamin D supplementation calculated with reference to the vitamin D [serum 25(OH)D] status for one month (the status was examined at 1, 8, and 30 days of therapy). General clinical indicators, gastrointestinal digestive function, severity of inflammation in the intestinal wall (fecal calprotectin (FCP) values), and serum 25(OH)D levels were assessed. Results. Patients even with deficiency in vitamin D after its supplementation were noted to have a shorter relief of the main clinical manifestations of the disease (p < 0.01), normalization of stool on discharge in all the patients (p < 0.01). In the early convalescence period after bacterial AIIs and intestinal infections of unknown etiology, the coli distal syndrome was completely relieved; elevated FCP levels were recorded only in 17.9% of cases; the 25 (OH) D levels did not decrease, but remained unchanged, and reached the optimum level of vitamin D at 30 days of its therapy. Conclusion. There is evidence that the use of vitamin D at the therapeutic doses is effective not only in treating Alls of various etiologies, but also in normalizing the vitamin D status.

Objective. To determine the current epidemiological features of the generalized form of meningococcal infection, pneumococcal meningitis, and Haemophilus meningitis during routine Haemophilus and pneumococcal vaccination and meningococcal vaccination, as epidemically indicated. Materials and methods. 170 reporting forms from 85 regions of the Russian Federation, which describe 2219 cases of purulent bacterial meningitis, were analyzed. Biomaterials from 370 patients were examined. Results. There was a vaccination-induced decrease in the incidence rates of pneumococcal and Haemophilus meningitis in children under 5 years of age. Conclusion. It is necessary to increase pneumococcal vaccination coverage in children and adults older than 60 years; to expand indications for vaccination against Haemophilus influenza, so that the vaccinated should include all children above 3 months of age, and not just risk-group children; to consider prospects for the national immunization calendar to include vaccination against meningococcal infection, by taking into account its heavy burden and poor prognosis due to that there may be a regular epidemic rise in morbidity rates.

The review gives data on the clinical efficacy and safety of SIVEXTRO® (tedizolid), a new oxazolidinone-class drug. Tedizolid is highly effective in treating gram-positive skin and soft tissue infections (erysipelas, acute cellulitis, skin abscess, wound infections with a lesion size area of at least 75 cm2) and, according to the 2013 FDA guidelines, are considered as acute bacterial infections of the skin and its structures. The ESTABLISH-1 has compared the efficacy and tolerability of a 6-day cycle of treatment with 200-mg once-per-day dose of tedizolid with a 10-day cycle with 600-mg twice-per-day dose of linezolid. The ESTABLISH-2 study has compared 200-mg once-per-day dose of intravenous/oral tedizolid for 6 days with 600-mg twice-per-day dose of intravenous/oral linezolid for 10 days. The investigation has revealed that the 6-day cycle of treatment with tedizolid is as effective as the 10-day cycle with linezolid and demonstrated the best tolerability.