[Role of opportunistic infection causative agent in etiology of obstructive bronchitis and prolonged subfebrility in children].

AIM: Determine the role of opportunistic infections causative agents in ethology of obstructive bronchitises and prolonged subfebrilities in children. MATERIALS AND METHODS: 56 children with the diagnosis of obstructive bronchitis and 46 children with the diagnosis of prolonged subfebrility were examined for the presence of herpes, mycoplasma and pneumocystic infections. EIA, IIF, rapid culture method, PCR were used. RESULTS: The highest number of cases of mixed infection was detected in children with HHV-6 infection. Mixed infection was diagnosed 6 times more frequently in children with obstructive bronchitis and 9 times in children with prolonged subfebrility. The number of children with pneumocystosis in combination with other infections was 2.4 and 2 times higher than with monoinfection; with CMV infection--4 and 2 times; with HSV infection--5 and 4 times; EBV infection--6 and 3.7 times. The only exception was mycoplasmosis detected in children with obstructive bronchitis where the difference between the number of mono and mixed infection cases was insignificant. CONCLUSION: The data obtained give evidence of wide spread of opportunistic infections.

[Study composition of lactoflora of the large intestine in patients with food allergy and irritable bowel syndrome].

Patients of different ages with various forms of food allergy and also with the irritable bowel syndrome with locks are studied. The quantitative levels of bifido- and lactoflora of large intestine, the qualitative characteristics of lactoflora population, including specific gravity of individual representatives in the sum of the isolates, are investigated, species composition is identified. Shown that food allergy, irrespective of the disease manifestation form induces the balance disturbance of bifido- and lactoflora in large intestine, significantly affects the reduction in the number of species of Lactococcus and Leuconostoc spp. and on the narrowing of the enzymatically active species of Lactobacillus spp.

[Detection of Pneumocystis carinii DNA in clinical samples from children with respiratory diseases].

Method of Pneumocystis carinii DNA detection in clinical samples (sputum) is presented. Primers to one fragment of 16S rRNA gene were used for detection of DNA. Isolation and amplification of DNA were performed in presence of internal DNA control. Analytical sensitivity of method was 200 copies of DNA per 1 ml. Analytical and diagnostic specificities were 100% and 95% accordingly. Sputum from 176 children with frequent respiratory infections were sampled before start of antibacterial therapy and studied simultaneously by the polymerase-chain reaction (PCR) and immunofluorescent assay (IFA). Results of PCR and IFA coincided in 167 (94.89%) children. From them, P.carinii was detected in sputum in 5 (2.85%) children. All children with positive results were treated with antibiotics. Repeated tests of sputum 8 days after start of treatment were all negative. PCR could be recommended as part of complex of clinical diagnostics and control of treatment.

[Detection of Pneumocystis carinii DNA in air and washes from medical equipment in hospitals].

Results of study of rooms' air and washes from medical equipment by PCR assay to detect Pneumocystis carinii DNA are presented. PCR assay sensivity was 200 copies/ml. Method of taking of air samples by MC-2 sample-taking device was modified for P. carinii detection. Sensivity of the method was 10 copies/m3. 27 air samples and 105 washes from medical equipment were studied and P. carinii DNA was not detected. It has been shown during the study that DNA of pneumocysts remains intact at room temperature during 12 days including 2-hour ultraviolet (UV) radiation treatment. After processing of studied surfaces with 0.1% solution of chloramine with subsequent UV radiation treatment during 30 minutes results of PCR assay were negative.

[Optimization of treatment of children with acute intestinal infections by application of Russian biological microbial preparations].

The article presents the results of long-term (several years) use of Russian bifido- and lactocontaing probiotics and data on the clinicolaboratory effectiveness of bifidumbacterin forte, probifor, bifidin, bifilis, calcidum, florin forte, acipol and acilact in children with various intestinal infections of known and unknown etiology. The presented results were obtained by studies conducted according to the requirements of The Governmental Program of L. A. Tarasevich State Institute of Standartization and Medical Biological Preparation Control, which included randomization of groups of patients receiving codified preparations or placebo according to their age, nosology, the degree of the process severity, premorbid status, and the time when the treatment was started. Each of the programs included several hundreds of children, receiving probiotics; in which of the programs the studies were multicentered. The courses of treatment with probiotics were short (1 to 2 weeks). No significant adverse effects were observed.

[Formation of probioticotherapy in Russia].

Probioticotherapy and probioticoprophylaxis have been applied widely in Russia and the world of late. The article presents the main medical, strain-related, and biotechnological stages of their development in this country, in comparison with the results of the world practice. The authors substantiate appropriateness of creation of probiotics and which would contain either only growth medium components, able to activate normoflora (to increase colonization ability and stimulate production of biologically active substances) upon entering the organism, or only probiotic strain components and/or biologically active substances produced by biologically active strains in mono- or associative cultivation, or combination of the listed components.

[Interferon therapy of infectious diseases: the state of the problem and prospects].

The data contained in literature and obtained in our own investigations, aimed at the evaluation of the significance of interferon preparations for the correction of immunological disturbances are presented. A special place is given to the role of mild medicinal forms of interferon, the necessity of their use is grounded and good prospects for their inclusion into the complex therapy of infectious diseases are shown.

[Interferon-based immunobiological preparations. An outlook of their use in the treatment of patients with infections]. / Interferonovye immunobiologicheskie preparaty. Perspektivy ikh primeneniia v lechenii infektsionnykh bol'nykh.

The paper contains the generalizing results of many-year research related with using various ready-made medication forms (RMF) of human genetic-engineering interferon-alpha 2 and of methods of its administration into the body. Extensive clinical materials were made use of to show convincingly that the most effective therapy for infectious diseases is ensured within a short time period and with a consequent long-term rehabilitation effect by using separate RMFs and methods of application of interferon-alpha 2, when their impact on the lesion focus is monitored by the parameters of the cellular-and-humoral chains of the general and local immunity. It is noteworthy, that a selection of RMF adequate for an actual nosologic form or of an administration method can reduce the medication dose of interferon-alpha 2 (thus, the incidence of complications to the drug goes down), it can also eliminate the influenza-like syndrome and production of autoantibodies related with the intramuscular administration of interferon-alpha 2, besides, it essentially prolongs the presence of interferon-alpha 2 in the body. It is important that the application of interferon-based preparations for infectious diseases can eliminate, in a number of cases, the use of antibiotics and other antibacterial drugs, it enhances the efficacy of antibacterial and antiviral therapy within a comprehensive treatment scheme, it contributes to a higher resistance of normal flora to the action of antibiotic and antibacterial drugs, and, finally, it arrests quicker the manifestations of dysbacterioses of various localizations.

[Arbidole--a new drug for prevention of influenza and acute viral respiratory infections in children]. / Arbidol--novoe sredstvo dlia profilaktiki grippa i ostrykh respiratornykh virusnykh infektsii u detei.

The antiviral drug arbidole reduces influenza and acute respiratory diseases (ARD) in children by 1.5-2 times when given in a dose of 0.1-0.2 g 2-3 or 5 times a week, by making influenza and ARD milder and decreasing their duration by 1.4-2.8 days. Unified regimens for prophylactic use of arbidole in influenza and ARD in children and adults are proposed.

[Detection of an agent similar to rotavirus in infantile gastroenteritis]. / Obnaruzhenie agenta, skhodnogo s rotavirusom, pri detskom gastroénterite.

The etiology of nonbacterial enterovirus infections in children was studied in autumn and winter under conditions of focal outbreaks in Moscow hospitals. Electron microscopy revealed a reovirus-like agent in concentrated suspensions of feces collected in the acute period of the disease from children suffering from diarrhea. Examinations of paired sera from the patients by the CF test with the antigen of Nebraska calf disease virus established significant rises in antibody titers in 68.3% of cases. The results permit a conclusion that in this country a virus of acute gastroenteritis of children (viral gastroenteritis A) is circulating, causing outbreaks of the disease. The virus belongs to the genus Rotavirus of the Reoviridae family.

[Level of antibodies to influenza viruses A and B in the blood sera of children under 13]. / Izuchenie urovnia antitel k virusam grippa A i B v syvorotkakh krovi detei molozhe 13 let.

The level of antibodies to influenza A (H1N1), A (H2N2), A (H3N2), and B viruses in the blood sera collected in October and November, 1980, from 224 children under 13 resident in Moscow and its suburbs was studied The results of the study showed convincingly the influenza A (H2N2) viruses did not circulate at that time among the population of Moscow and its suburbs. The 4 positive (not exceeding 1 : 40 findings in sera from younger children were due to the presence in them of the antibodies cross-reacting with A (H2N2) and A H3N2) viruses which could be completely eliminated from the sera by adsorption of the latter with A/USSR/174/79 (H3N2) virus. The A (H3N2) viruses were the main cause of ARD developing in children in July-September, 1980. These diseases appeared to be the closing part of the influenza A (H3N2) epidemic of 1979-1980. A high percentage of children with antibody titres of 1 : 40 or higher to A (H3N2) viruses indicated that these viruses could hardly cause an epidemic of influenza in children in 1980-1981. A low percentage of children with serum antibodies to influenza B virus (1-10%) in titres of 1 : 40 or higher indicated a possibility of occurrence of an epidemic of this etiology in Moscow in the season of 1980-1981. The occurrence of influenza A (H1N1) epidemic in this period was less likely because of higher levels of antibody to influenza viruses of this subspecies in the sera of children and particularly adults.

[Humoral immunity to influenza A and B viruses in the blood sera of children younger than 14 in 1981]. / Gumoral'nyi immunitet k virusam grippa A i B v syvorotakh krovi detei molozhe 14 let v 1981 g.

Blood sera from 317 children with the history of noninfectious diseases or normal children pretreated with RDE were collected and examined for antihemagglutinins to 7 influenza virus strains in order to check the results of studies of 1980 and to study the immunity status to influenza A (H1N1), A (H2N2), A (H3N2) and B in the preepidemic period of 1981. Negative results of antihemagglutinin detection to influenza A/Iksha/1/57 (H2N2) in sera of all the children have confirmed the conclusion made in the previous paper (1) that influenza A (H1N2) viruses have not circulated in recent years among the population of Moscow City and suburban areas. Fourteen sera positive in HI tests with A/Shklyawer/49 virus similar to A/PR/8/34 (H1N1) in titres from 1:20 to 1:40 did not produce hemolysis zones with A/PR/8/34 virus in RHT, but most of these sera gave similar results of both tests with A/Brazil/11/79 and A/Khabarovsk/1/77 viruses. This attests to cross, nonspecific nature of hemagglutination-inhibition with A/Shklyawer/49 virus which evidently does not circulate now in the population of Moscow City and suburbs. An increase in the level of immunity to influenza B and A (H1N1)/1977 viruses reflected the epidemic situation of the previous year.

[Selection of antigenic variants of the influenza virus on the cells of different hosts]. / Selektsiia antigennykh variantov virusa grippa na kletkakh raznykh khoziaev.

Antigenic differences were found in influenza B virus variants isolated and propagated in different systems: chick embryos (E variants) and MDCK cell culture (M variants). The antigenic differences in M and E variants were detected in HI tests with polyclonal mouse sera and monoclonal antibodies as well as in biological neutralization tests in chick embryos and MDCK cell culture, and confirmed when M and E variants were used as antigens for antibody detection in human sera. By protein mobility in PAGE, M and E variants did not differ from each other and were also identical with the reference B/Victoria/87 strain.

[Biological preparations in the overall therapy of children convalescing after dysentery]. / Biologicheskie preparaty v kompleksnoi terapii detei--rekonvalestsentov posle dizenterii.

In studying the state of microbial population in the intestine of children after dysentery dysbacteriosis was revealed in 72.7% of cases. Use of biological preparations normalizing microbial population in the intestine (colibacterin) in 859 children reduced the incidence of protracted forms of the disease and of repeated excretion of the causative agent in comparison with the control group (785 children).

[Immunoglobulin efficacy for intravenous administration in the therapy of newborn infants with a suppurative infection]. / Effektivnost' immunoglobulina dlia vnutrivennogo vvedeniia v terapii novorozhdennykh s gnoinoi infektsiei.

The data on the results of clinico-immunological examination of 46 infants having purulent inflammatory infections in the first month of their life and treated with (a) immunoglobulin for intravenous injection, (b) with hyperimmune antistaphylococcal plasma and immunoglobulin for intravenous injection and (c) without the use of specific hyperimmune preparations are presented. The clinico-laboratory data thus obtained (the levels of serum immunoglobulins and the content of T-rosette-forming lymphocytes) are indicative of the expediency of including the intravenous injection of donor immunoglobulin into the complex therapy of newborn infants with severe and moderate forms of purulent inflammatory infections at an early period of the disease irrespective of its etiology.

[Microbiocenosis of the mucous membranes of the upper respiratory tract and its correction with acipol in the treatment of patients with acute respiratory virus infections]. / Mikrobiotsenoz slizistykh obolochek verkhnikh dykhatel'nykh putei i ego korrektsiia pri ispol'zovanii atsipola v lechenii bol'nykh ORVI.

Clinical and laboratory evaluation of the preparation Acipol in 45 children greatly susceptible to acute respiratory virus infections (ARVI) was carried out. Simultaneously with the clinical analysis, the study of the microflora of the mucous membranes of the upper respiratory tracts and intestine, as well as the levels of secretory IgA in saliva and coprofiltrates before and after treatment, was made. The inclusion of Acipol into the therapy of ARVI patients facilitated their clinical convalescence, uncomplicated course of the disease, correction of disturbances in the biocenosis of the upper respiratory tracts and increased infectious resistance.

[Comparative evaluation of the sensitivity of immunofluorescence methods, immunoenzyme analysis and the lectin test for the rapid diagnosis of influenza]. / Sravnitel'naia otsenka chuvstvitel'nosti metodov immunofliuorestsentsii, immunofermentnogo analiza i lektin-testa dlia ékspress-diagnostiki grippa.

Comparative study of the sensitivities of immunofluorescent microscopy (IFM), enzyme immunoassay, (EIA), and lectin test (LT) in the detection of influenza virus antigen in nasopharyngeal washings from patients with influenza, acute respiratory diseases, pneumonia, and laryngitis has been carried out. EIA modification (used in this study) based on the detection of a complex of viral core proteins (M + RNP) has been shown to be no less sensitive than IFM and suitable for use in the rapid diagnosis of influenza. It can be used in combination with other methods. The optimum time for collecting the washings off is day 2 from the disease onset for analysis by EIA technique and day 4 for LT.

[Conditionally pathogenic microflora of the Enterobacteriaceae family of healthy young children and children with acute intestinal infections of unknown etiology]. / Uslovno-patogennaia mikroflora semeistva énterobacteriaceae zdorovykh i bol'nykh detei rannego vozrasta s ostrymi kishechnymi infektsiiami nevyiasnennoi étiologii.

The study of quantitative and species composition of intestinal microflora in infants with acute intestinal infection of unknown etiology and in normal infants maintained on mixed feeding has revealed that most often bacteria belonging to the genus Proteus are found. The main difference between these groups consists in the presence of bacteria belonging to the genus Klebsiella, as well as other opportunistic intestinal bacteria, in greater amounts in sick infants than in healthy ones; at the time sick infants show a decrease in bifido- and lactobacteria.

[The seroepidemiological aspects of respiratory diseases and the prospects for their prevention in organized children's sanatorium-type collectives]. / Seroépidemiologicheskie aspekty respiratornykh zabolevanii i perspektivy ikh profilaktiki v detskikh organizovannykh kollektivakh sanatornogo tipa.

68 children aged 3-7 years, undergoing general sanative treatment in a bronchopulmonary sanatorium in the vicinity of Moscow between November 10 and December 29, 1990, were examined. During the stay of these children in the sanatorium cases of respiratory diseases, mainly of parainfluenza etiology, were registered, which was confirmed by serological laboratory studies. At this season no cases of Legionella and Mycoplasma infections were detected. The necessity of taking prophylactic measures with the use of reaferon and lysozyme in sanative groups of children in due time, starting from the first day of the formation of such group, was substantiated.

[The development and clinical evaluation of the probiotic Bifidumbacterin forte]. / Razrabotka i klinicheskaia otsenka probiotika "Bifidumbakterin forte".

A new probiotic "Bifidumbacterin forte" containing bifidobacteria immobilized on carbon sorbent has been developed. The results of extensive clinical observation on the use of the preparation in patients (children and adults) with the infectious and surgical pathology of the gastrointestinal tract are presented. The clinico-bacteriological effect thus obtained makes it possible to recommend this new probiotic "Bifidumbacterin forte" for medical practice for the complex treatment of children and adults with acute and chronic diseases of the gastrointestinal tract.