[Norovirus infection in children hospitalized with acute gastroenteritis in northeastern Poland]. / Zakazenia norowirusowe u dzieci hospitalizowanych z ostra biegunka w pólnocno-wschodniej Polsce.

Noroviruses belonging to the family of Caliciviridae are a major cause of acute gastroenteritis in both children and adults. In the current study incidence of norovirus gastroenteritis was estimated in children hospitalized for acute gastroenteritis using commercially available ELISA tests. Epidemiological data were correlated with basic demographic findings. A hundred and forty nine children with acute gastroenteritis were enrolled in the study. Screening for common viruses causing gastroenteritis: rotavirus and adenovirus was performed and than stool samples were frozen and stored in <20 degrees C for future simultaneous testing with IDEIA Norovirus (Dakocytomation). Group I noroviruses were found in one child when 16 children were tested positive for Norowirus group two. In total noroviruses were found in 11.4% of children included in the study. Children with norovirus infection were 3 weeks to 15 years old (mean age 5.9 years). Seasonal peak of norovirus infection was seen in September through December. The infectious agent has not been identified in 43% of investigated children. Our results support important role of noroviruses as a causing agent of gastroenteritis in children in Northeastern Poland. The importance of noroviruses may grow as rotavirus infections are likely to be eliminated due to wide introduction of vaccine in the nearest future. Routine testing for noroviruses should be considered in clinical practice.

[Unusual clinical manifestation of Lyme disease--report of 2 cases]. / Rzadkie postacie kliniczne choroby z Lyme--opis 2 przypadków.

Unusual clinical manifestation of Lyme borreliosis in two children has been presented. We discuss patient from Borrelia-endemic area who presented with persistent headache, weakness and fever. The second patient experienced acute flu-like signs with associated neck pain and stiffness (probable diagnosis). After two weeks lasting antibiotic therapy (ceftriaxone, ampicillin) nonspecific symptoms and signs decreased.

[Burden of hospitalization of children with viral meningitis in Bialystok, 2003-2005]. / Hospitalizacje dzieci z wirusowym zapaleniem opon mózgowo-rdzeniowych (WZOMR) w Bialymstoku w latach 2003-2005.

OBJECTIVE: This study examined the burden of hospitalization of children with viral meningitis in Department of Pediatric Infectious Diseases, Medical University of Bialystok from 2003 to 2005. METHODS: Data were extracted from Children Teaching Hospital database. A hospitalization with viral meningitis was defined as any discharge with diagnoses of mumps meningitis (B26.1), enteroviral meningitis (A85.0), tick-born encephalitis (A84.1) and viral undifferentiated meningitis (A87.9) due to ICD-10. Outcome measures included number of hospitalizations in total and due to different etiology as well as their impact in the budget of the unit. RESULTS: 316 hospitalizations with viral meningitis were identified. Of these 246 (77.6%) were diagnosed with mumps etiology, 10 (3.2%) with enteroviral, 1 (0.3%) with tick-born virus and 59 (18.7%) with unknown viral etiology. Most cases of viral meningitis were hospitalized in 2003--132 (41.8%). Of these 93.9% were diagnosed with mumps meningitis. In 2005, of 78 hospitalizations associated with viral meningitis 10 (12.8%) were confirmed and further 38 (48.7%) were suspected enteroviral meningitis. The percentages of costs associated with viral meningitis in 2004 and 2005 (26% and 18.8%) were high in comparison to percentage of hospitalizations with viral meningitis (10.7% and 7.3%, respectively).

[Antibiotics use for acute gastroenteritis in ambulatory care of children before and after implementation the healthcare system reform in Poland]. / Stosowanie antybiotyków w leczeniu ambulatoryjnym ostrych biegunek u dzieci w okresie przed i po wprowadzeniu reformy systemu ochrony zdrowia w Polsce.

AIM OF THE STUDY: Our study aimed to investigate the ambulatory antibiotics use for acute gastroenteritis in children admitted to the hospital in 1998-2000. MATERIAL AND METHODS: The retrospective analysis of medical records was performed in 369 children up to two-years of age; including 87 admitted in 1998, 136 - in 1999 and 146 in 2000 year. Results. Antimicrobials use decreased year after year. In 1998 the antibiotics therapy was included in 44.9% of children, in 1999--in 35.3% and in 2000 year in 32.2% (p = 0.02). In 1998 year, the antibiotics were ordered mainly for children diagnosed as bacterial diarrhea (76.9%) compared to viral etiology (18%). In 2000 year the antibiotics were prescribed for viral gastroenteritis twice more often (61.7%) than for bacterial etiology (29.8). Children with acute gastroenteritis and coexistent signs and symptoms were given antibiotics for treatment diarrhea in the similar percentage as those without any: in 1998--54.2 and 45.8%, in 1999--50.8 and 49.2%, in 2000--40.3 and 59.7%, respectively. Microbiologic examination was not performed in any case before treatment. CONCLUSIONS: This study demonstrates the discrepancies between recommendations and ambulatory practice in the antibiotic treatment of acute diarrhea in children both before and after implementation the healthcare system reform. Education programs are needed for optimal management of acute gastroenteritis in children including training in necessity of coproculture before prescribing antimicrobials.