[Monitoring of influenza and other respiratory diseases causative agents in children, hospitalized with community-acquired pneumonia in 2012-2013 epidemic season].

AIM: Study the circulation of respiratory viruses in children with community-acquired pneumonia (CAP) during the period from October 2012 to May 2013. MATERIALS AND METHODS: 136 children with CAP aged from 3 months to 16 years with ARI symptoms at the disease debut were studied. RNA/DNA of influenza A, B, parainfluenza (PI); adeno-, rhino-, RS-viruses, corona-, metapneumo- (MPV) and bocaviruses were detected in nasopharynx smears by PCR with hybridization-fluorescent detection in real time. Antibodies against influenza viruses A/H1N1/pdm09 California/07/09, epidemic reference strains of influenza viruses A/H1N1/Brisbane/59/07, A/ H3N2/Victoria/361/201 1, B/Wisconsin/1/10, against PI viruses type 1, 2, 3 were determined in paired sera by HAI. RESULTS: In February-March 2013 the number of children protected by antibodies against influenza decreased, and circulation of influenza viruses A/H3N2 and A/H1N1/ pdm09 was detected. Rhinoviruses and PI viruses were determined throughout the epidemic season, bocavirus and adenoviruses--during the autumn-winter period, RS-virus and MPV--during winter-spring. Coronaviruses were not detected. The peak of virus detection was established in February when the threshold of influenza and ARI morbidity was exceeded. The main pathogens of children of the first 3 years of life are rhinoviruses, RS-virus, PI viruses and bocavirus. RS-virus infection at the debut of CAP in children younger than 3 years in 55.5% of cases is associated with the development of broncho-obstructive syndrome. Bocavirus infection in 50% of cases progresses with laryngo-tracheitis and bronchiolitis. CONCLUSION: The fraction of viruses in etiologic structure ofARI in children varies depending on immune layer, season and age of children. Etiology of viral infection at the debut of CAP could only be proven using specialized laboratory studies.

[Colonization properties of opportunistic bacteria isolated from children with pneumonia].

AIM: Evaluation of phenotypes and pathogenicity factors of 476 opportunistic bacteria isolated from respiratory samples of 973 children with community-acquired pneumonia and 36 children without respiratory infection symptoms. MATERIALS AND METHODS: Quantitative method of tracheal aspirate and nasopharyngeal swab seeding into certified nutrient media was used, identification was carried out according to standard techniques. RESULTS: Adhesive, "anti-interferon", anti-lysozyme and inherent bactericidal activity of Escherichia coli and Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter spp. were established to ensure in combination with known aggression factors their colonization advantage compared with other pneumopathogens. Adhesion indexes of Gram-negative bacteria lower than 2.5 are shown as markers of invasive strains. Anti-lysozyme activity level lower than 2.14 microg/ml and lack of "anti-interferon" activity characterize non-invasive opportunistic bacteria strains. CONCLUSION: The detected phenotypic features of opportunistic bacteria may be used in clinical practice for evaluatio of etiologic importance of microorganisms isolated from tracheal aspirate in pneumonia patients.

[Rate of identification and characteristic of Streptococcus pneumoniae isolated from carriers and ill children in Khabarovsk region].

AIM: To assess the role of nasopharyngeal and clinical strains of Streptococcus pneumoniae in respiratory disease of children. MATERIALS AND METHODS: Two hundred and fifty-eight children attending and not-attending daycare as well as 1292 children with respiratory diseases admitted to clinic of Research Institute of Maternity and Childcare during 2001-2009 were studied. Materials for study were pharyngeal swabs and sputum. Identification was performed using optochin disks (bioMerieux), latex-agglutination (Slidex meningo-kit, bioMerieux) and agglutination on the glass. Fragment of S. pneumoniae genome was determined by PCR using diagnostic kits GenePac Spn (IsoGen Ltd., Moscow). RESULTS: Level of nasopharyngeal carriage of pneumococci is increased in children with recurrent respiratory illnesses as well as in children closed communities of children. Strains isolated from nasopharynx were typical on morphological and tinctorial characteristics and have increased level of resistance to macrolides and decreased level of resistance to penicillin compared to clinical strains of which 15-20% were optochin-resistant. CONCLUSION: Local serological spectrum of pneumococci circulating in Khabarovsk region was determined, which includes 13 serovariants with predominance of serotypes K1, K19, K6.

[Etiology of acute and chronic pyelonephritis in children in Khabarovsk region].

Microflora of urinary tract was studied in 419 children aged 1 - 17 years and hospitalized due to acute or chronic pyelonephritis. Etiology of inflammatory process was established in 57.8% of cases. According to our study, etiologic structure of causative agents of pyelonephritis did not differ from all-Russian data. The leading positions belonged to Gram-negative microorganisms from Enterobacteriaceae family: Escherichia coli, Proteus mirabilis, and Klebsiella spp. Results of the study point to high susceptibility of main causative agents of pyelonephritis to cephalosporins, aminoglycosides, and fluoroquinolones. High resistance to aminopenicillines was noted. In several isolates from Enterobacteriaceae family significant resistance to nalidixic acid and furazidin was observed.

[Etiology of pulmonary diseases in children in Khabarovsk Region].

Microflora of upper respiratory tract in 658 children aged 1 month - 17 years hospitalized with acute pneumonia (AP), acute bronchitis (AB), recurrent obstructive bronchitis (ROB), malformation of lungs (ML) and broncho-alveolar dysplasia (BALD) were studied. Carriage rates of Streptococcus pneumoniae (up to 95%) and Haemophilus influenzae (up to 89%) in 240 children attending daycare centers and schools were determined. Etiology of infectious process was ascertained in 40% of cases. S. pneumoniae was isolated in 45% of acute cases (AP and AB) and in 25% of chronic cases (BALD). H. influenzae was isolated in 8 - 12% of acute cases and in 32% of chronic cases. In 23 - 29% of all cases of pulmonary pathology in children persistence of Enterococcus faecium was determined. There were 13 different serotypes among isolated pneumococci. In patients with pneumonia the rate of detection of S. pneumoniae and H. influenzae DNA fragments by PCR was significantly higher compared with rate of their isolation from sputum.

[Etiology, clinical manifestations, and epidemiology in community-acquired respiratory infection in children in the Khabarovsk region]. / Etiologicheskaia kharakteristika, klinika i épidemiologiia gruppovogo zabolevaniia respiratornoi infektsiei u detei Khabarovskogo kraia.

Clinico-epidemiological analysis and etiological verification of the outbreak of respiratory infection among school children in a rural district of the Khabarovsk territory, registered in spring 1997, were made. According to clinical signs, one-third of the patients had whooping cough, while the rest of the children exhibited the signs of respiratory infection with the symptoms of longering bronchitis. A half of the children had not been vaccinated against whooping cough, as they had been given injections of adsorbed DT vaccine with reduced antigen content. Etiologically, the diagnosis of whooping cough was confirmed in 57% of the patients with 47.4% of them having Bordetella pertussis monoinfection and 52.6% having mixed infection, mainly in combination with chlamydiosis. Whooping cough took an abnormal course under these circumstances. Treatment with erythromycin produced a good effect.

[Changes in the buccal epithelium in certain diseases in children]. / Izmeneniia bukkal'nogo épiteliia pri nekotorykh zabolevaniiakh u detei.

Buccal epitheliocytes collected from healthy and sick children aged 1 to 5 years were examined. The maximal and minimal size of epitheliocytes was measured and their mean size estimated, as was the percent share of cell cytolysis. An integral index derived on the basis of these measurements reflects the degree of change in the quantitative parameters characterizing the buccal epitheliocytes and is in positive correlation with deviations of hematological parameters from the norm in children with bronchopulmonary and somatic disease.

[Comparative analysis of antibiotic sensitivity of Streptococcus pneumoniae strains isolated from patients and carriers]. / Sravnitel'nyi analiz chuvstvitel'nosti k antibiotikam shtammov Streptococcus pneumoniae, vydelennykh ot bol'nykh i nositelei.

The data on antibiotic sensitivity of 38 strains of S. pneumoniae isolated from children and 46 strains isolated from carriers are presented. The isolates from the carriers had significantly higher sensitivity to benzylpenicillin, ampicillin, methicillin, oxacillin, cefazolin, erythromycin, oleandomycin and lincomycin. Resistance to gentamicin was more frequent in the strains isolated from the carriers. Among the strains of S. pneumoniae isolated from the patients and carriers representatives of serovar K19 were more frequent. There were no statistically reliable difference in them by sensitivity to benzylpenicillin, ampicillin, cefazolin, lincomycin and rifampicin. Still, the isolates from the carriers were much more sensitive to methicillin, oxacillin, oleandomycin and erythromycin.