[PROBIOTICS, NUTRITIONAL STATUS AND RESISTANCE TO RESPIRATORY INFECTIONS IN INFANTS].

Aim of this study was to investigate the efficacy of prophylactic use of a liquid probiotic form based on Enterococcus faecium L3 in children first year of life to increase resistance to acute respiratory infections (ARI) in the winter-spring period and improve nutritional status. In a specialized (psychoneurologic) orphanage of St. Petersburg within three months of winter-spring period in 2014 observed 29 children in the first year of life. Observed children were randomly divided into two groups. The main group (n = 14) within three months received daily per os liquid probiotic form based on E.faecium L3 in a daily dose of 1.5 x 10(9) CFU. A control group of children (n = 15) was comparable with the main group by gender and age. The children observed groups studied the incidence of ARI; number of vaccinated children; the number of children who received two or more vaccinations at the same time; the number of children with acute infectious diseases within 1 month after vaccination; dynamics of Chulitskaya index, body mass index, body weight and length. The data obtained are subjected to statistical analysis, the results were considered significant at p < 0.05. The results showed that the use of probiotic forms E.faecium L3 in infants helped to reduce the average number of ARI cases per child (0.29 ± 0.13 vs. 0.73 ± 0.12 in the control group; p < 0.05) only in the first month of the observation that combined with a significantly higher BMI values increase this month (0.54 ± 0.25 vs. 0.07 ± 0.22 kg/m2 in the control group; p < 0.05). Use the liquid probiotic form E.faecium L3 in infants had a positive impact on overall health, which is reflected in the implementation of routine vaccination activities--in the main group, the number of children who received two or more vaccinations at the same time was 18.1% more.

[Resistance of clinical strains of pathogenic E. coli to antibiotics and bacteriophage in hospitalized children with escherichiosis in St. Petersburg].

The data on the resistance frequency of the diarrheagenic E. coli isolates to antibacterial agents and a specific bacteriophage are presented. The strains were isolated from hospitalized children in St. Petersburg in 2011-2013 and belonged to three groups, i.e. enteropathogenic (EPE), enterotoxigenic (ETE) and enteroinvasine (EIE). It was shown that in the children aged from 1 month to 18 years the average antibiotic resistance was maximum in the EIE isolates and decreased in the following order: EIE (15.2%), EPE (6.0%), ETE (3.3%). The clinical EIE isolates showed no resistance to the new generation cephalosporins (cefuroxime, cephepime) and nitrofurans. The E. coli isolates of the three groups were characterized by high resistance to a specific bacteriophage which decreased in the following order: ETE (44.8%), EIE (37.0%), EPE (28.8%). The multiple resistance of the diarrheagenic E. coli isolates of the three groups to the antibacterials averaged 2.8%. The maximum frequency of resistance of the clinical isolates of the three groups to nalidixic acid was observed: EIE - 28.6%, EPE - 26.3%, ETE - 9.1%. The results of the study may be useful in the tactics of therapy of diarrheagenic E. coli infection in children.

[Value of probiotic in reducing frequency of infectious complications in premature infants].

Fifty five premature infants with very low body weight were observed as inpatients to assess effectiveness of the nursing. The standard program of the care included: adequate primary resuscitation, respiratory support (use of surfactant), thermal mode, early provision of nutrients with full or partial parenteral nutrition, antimicrobial therapy and if possible early enteral nutrition. The patients of the main group (n = 29) along with the standard therapy (the volume of the enteral nutrition of 5 ml or more) were treated orally with liquid probiotic based on E. faecium L3 in a dose of 0.5 ml (5 x 10(8) CFU) 3 times a day for 14 days. The control group (n = 26) was under the standard therapy. The effectiveness of the infants management was estimated by the frequency of disruption of the nutrition, the frequency of infectious complications, the changes in the hematologic indices, the dynamics of the composition of the intestinal microflora. The infectious complications were evident from perinatal viral infection, intraamniotic infection, necrotizing enterocolitis. In the main group patients there was recorded a significant decrease of the frequency of infectious complications: 20.7% against 53.9% in the control group patients. The use of probiotic strain E. faecium L3 in the preterm infants promoted conservation of the immunomodulatory function of the intestinal indigenic microflora and restricted the growth of the nosocomial flora.

[Problem of the choice of the probiotic dose in the physician practice].

Currently, there is ample evidence of the usefulness of probiotics for human health, but, despite this, progress in the scientific and medical recognition of the legal force (legalization) of probiotic agents remains extremely slow. Probiotic preparations are prescribed with the preventive and medical purpose, must be not only safe, but always effective, because these properties affect the economic component of medical activity. Clinical efficacy of probiotics is determined not only by the specifics of strains, but also the adequacy of daily and course dose that should not be underestimated. Recent studies prove the identity of the impacts on human health probiotic agents and functional food products containing probiotic strains in optimal concentrations. Definition of preventive and curative doses of probiotics in children in different age periods remains a challenge for pediatricians.

[Dynamics of contamination and persistence of Clostridium difficile in intestinal microbiota in newborn infants during antibiotic therapy and use of probiotic strain enterococcus faecium L3].

Ninety four infants were observed as inpatients. Thirty nine of them were mature neonates and 55 were premature infants with a very low body weight. The majority of the patients were treated with antibiotics. The mature infants were treated with penicillins, aminoglycosides, cephalosporins and the premature neonates were treated in addition with carbapenems, fluoroquinolones, glycopeptides. The mature infants were randomized into 2 groups: the control group (n=18) received the standard therapy and the main group (n=21) in addition received 1 ml of liquid probiotic Enterococcus faecium L3 (with a titer of 5x10(8) CFU/ml) 2 times a day for 10 days. The premature newborn infants were also randomized into 2 groups. The control group (n=26) received the standard therapy. The main group (n=29) additionally received 1 ml of liquid probiotic E.faecium L3 2 times a day for 10 days. The effectiveness of the therapy in the mature neonates was evaluated by the frequency of dyspeptic disorders and in the premature infants by the frequency of infectious complications and the episodes of food intolerance. The intestinal microbiota of the infants was investigated by the real-time PCR and bacteriological analyses of the feces: in the mature infants on admission to the hospital and 10 days after the treatment (periods 1-2), in the premature infants on admission to the hospital and then twice with an interval of 14 days (periods 1-2-3). It was shown that the use of the probiotic strain E.faecium L3 during the antibiotic therapy in the premature infants promoted significant reduction in the frequency of infectious complications. In the mature neonates the probiotic therapy reduced the risk of dyspeptic disorder. The studies showed reduction in persistence of Clostridium difficile in the intestinal microbiota of the newborn infants receiving the antibiotic therapy in combination with probiotic E.faecium L3, that was accompanied by preserving and growth of bifidobacteria and lactobacilli and reduction of the number of opportunistic microorganisms.

[Probiotic strains of enterococci as a means of therapy and prophylaxis of intestinal diseases in children (review of literature)].

Probiotic enterococci a widely used by pediatricians and infection diseases doctors in Russia as means for the treatment of dysbiosis, irritated bowel syndrome and in the treatment and prevention of different functional and chronic intestinal diseases. Strains E. faecium M74 and E. faecium SF-68 are included in several probiotic drugs and have been proved as effective and safe. Several studies suggest that the usage of Russian probiotic strain E. faecium L3 in pediatrics is promising. The review is devoted to the analysis of clinical studies in pediatric practice employing probiotic enterococci.

[Correction of secondary hyperlipidemia in children with diabetes].

At 25 children with insulin dependent diabetes mellitus (IDDM, Type I) in a decompensation stage was estimated efficiency of correction secondary hyperlipidemia. The basic group (n = 11) along with insulinotherapy and a lipotrophic preparation (methionine) accepted probiotic Bifiform Baby in a dose 0.5 g once a day within 10 days; the comparison group (n = 14) received insulin therapy and a lipotrophic preparation. Efficiency of treatment was estimated on dynamics of lipids in serum of blood: triglycerides (TG), the total cholesterol (TH), betalipoproteides (BLP). At patients of the basic group authentic decrease TG, TH, BLP was established; at patients of group of comparison--decrease TH and BLP. Advantage of therapy secondary hyperlipidemia at children with diabetic ketoacidosis with use of Bifiform Baby consists in the elimination of the main infringement of a metabolismus of lipids in the given disease--hypertriglyceridemia.

[Probiotics as an items of increasing the effectiveness of treatment of community-acquired pneumonia in adolescents].

The aim of the work was to evaluate the efficiency of microbial probiotics Vitaflor and metabolic probiotic Aktoflor-C in complex treatment of community-acquired pneumonia in adolescents in a hospital. The observation involved 38 children aged 11 to 18 years with radiologically verified community-acquired pneumonia, including 23 boys and 15 girls. Patients were divided in 3 groups. Patients in group 1 (n = 13) simultaneously with the antibiotic therapy received per os Vitaflor probiotic containing symbiotic strains of Lactobacillus acidophilus; patients in group 2 (n = 10) along with antibiotic therapy received per os metabolic probiotic Aktoflor-C, containing low molecular weight exometabolites bacteria; patient of the comparison group (n = 15) received antibiotic therapy only. The effectiveness of the used treatment schemes was assessed on the dynamics of the gut state microbiot acoarding to an extended bacteriological examination of faecal flora, level of saliva IgA secretory (before and after treatment), the dynamics of SF-36 quality of life 1 month after discharge from hospital. Was conducted a study of economic efficiency of different modes of therapy. Results showed that adolescents with community-acquired pneumonia during standard antibiotic therapy indicated development of dysbiotic bowel disturbances in the form of reliable oppression of the bifidobacteria and laktoflora. Dysbiosis of the microbial associations are not conducive to proper implementation of immune and nutritional functions of the intestine that shows the imperfection of rehabilitation of patients with pneumonia according to the evaluation of SF-36 quality of life. Pharmacoeconomic analysis revealed the benefits of probiotic metabolic type "Aktoflor" used in addition to standard therapy of community-acquired pneumonia in adolescents.

[Choice of probiotic for rational therapy of infection caused by Klebsiella in children].

AIM: To choose lactobacilli-contained probiotic for complex treatment of acute enteric infection caused by Klebsiella in infants. MATERIALS AND METHODS: On the basis of bacteriological analysis the group consisting of 40 infants with acute enteric infection caused by Klebsiella was formed. Efficacy of three probiotic preparations--lactobacterin, vitaflor, and biobacton--was assessed depending on biological features of causative agents and contents of lactobacilli and bifidobacteria in obligate gut microflora. Intraspecies antagonistic characteristics of manufacturing strains of lactobacilli against 9 clinical isolates of K. pneumoniae and 8 strains of indigenous lactoflora, as well as interspecies antagonism between Klebsiella and probiotic and indigenous strains of lactoflora were studied. RESULTS: It was shown that complex therapy of Klebsiella infection in infants using vitaflor or biobacton promoted elimination of K. pneumoniae and restoration of indigenous microflora which became apparent in significant increase of titer of lactobacilli. In vitro maximal antagonism to K. pneumoniae was noted for vitaflor, lactobacterin and heteroenzyme autostrains of ill children's lactoflora. Contrantagonism to lactoflora was typical for slowly growing strains of Klebsiella. CONCLUSION: It is therapeutically rational to use vitaflor, which promotes rapid elimination of infectious agent, in initial phase of acute infection caused by Klebsiella, and biobacton, which increases the titers of indigenous lactoflora, in phase of convalescence.

[Reaction of the autonomic nervous system of children to a magnetic field]. / Reaktsiia vegetativnoi nervnoi sistemy detskogo organizma na vozdeistvie magnitnogo polia.

A study was made of some reactions of the child's body to the magnetic field action with the aid of thermography, investigation of the parameters of vegetative functions and determination of the changes in the amount of the formed elements of white blood in 20 normal children and 20 patients aged 6-15 years suffering from chronic gastroduodenal diseases. It has been established that the changes in infrared radiation on the surface of the anterior abdominal wall in the patients mirror the adequacy of the compensatory reactions of the vegetative nervous system to the magnetic field action. The parameters of the function of the vegetative nervous system, mainly those of its sympathetic part, are indicative of the effect of the magnetic field on the patient's body.