Relevance. During the ongoing pandemic of a new coronavirus infection (COVID-19), assessment of humoral immunity to vaccinepreventable diseases in healthcare workers is crucial to estimate the risk of healthcare-associated infections. Aim. To assess the humoral immunity to vaccine-preventable diseases: whooping cough, influenza A, viral hepatitis A and B, new coronavirus infection (COVID-19), in healthcare professionals working with infectious patients.Materials and methods. We conducted a cross-sectional study enrolling 252 healthcare workers, which included a survey and assessment of immunoglobulins G to Bordetella pertussis, influenza A virus, hepatitis A virus, HBsAg and HBcAg of hepatitis B virus,
The purpose was to study the clinical and epidemiological features of respiratory syncytial virus infection in hospitalized children the first year of life with lower respiratory tract diseases in different regions of the Russian Federation (Russia) during the 2015–2016 epidemic season.Materials and methods: in the original study data of a multicentre observational study conducted on the basis of children’s hospitals in St. Petersburg, Arkhangelsk, Kazan, and Saratov are presented. Etiology of acute respiratory viral infections were confirmed by examination of smears from the posterior pharyngeal wall by polymerase chain reaction. The study sample included 991 child’s first year of life with lesions of the lower respiratory tract.Results. In the etiological structure of the surveyed children in the season of 2015-2016, RSVI ranged from 14% to 46,2%, an average of 33%. RSVI dominated in the Centers of St. Petersburg (38,3%), Arkhangelsk (36.2%) and Kazan (42.5 per cent).RSVI significantly more often (p<0.01) leads to the development of bronchiolitis (29.4% against 16.3% and 10.0%, with rhinovirus infection and parainfluenza, respectively. Patients with RSUI often develop pneumonia (23,5%) vs 20.6% and 20,0% with rhinovirus infection, and parainfluenza. Patients with RSVI often suffer severe forms of the disease require oxygen support (13,8%) and treatment in the departmentof intensive care (15,9%).Seasonal peaks of hospitalization due to RSVI in all Centres were recorded in December-April 2015 and 2016. Regional differences in monthly intensity of hospitalization of children with RSVI were established.Thus, the high prevalence of RSVI among children in the first year of life, especially with heavy and complicated forms of lower respiratory tract disorders requiring intensive care benefits, represents a socially important issue, which requires monitoring for effective prevention in children at risk.
нг/мл, не было различий при бронхиолитах и пневмониях. Выводы: респираторно-синцитиальная вирусная инфекция-ведущая причина поражения нижних дыхательных путей у госпитализированных пациентов первого года жизни. В большинстве случаев не отмечено повышения С-реактивного белка и прокальцитонина. Фактором риска тяжелого течения РС-инфекции является ранний возраст (менее 6 месяцев).
Острые кишечные инфекции остаются одной самых актуальных проблем педиатрии в связи с высоким уровнем заболеваемости, развитием тяжелых форм и летальности, особенно у детей первых пяти лет жизни. В большинстве случаев тяжесть заболевания обусловлена развитием эксикоза, в основе которого лежат потери электролитов и жидкости в следствии эметического и диарейного синдромов. Однако существуют различия в механизмах формирования дегидратации в зависимости от вида инфекционного агента. Так при дегидратации, вызванной вирусами, в основе лежит механизм нарушения абсорбции, причиной которого являются дистрофические изменения в энтероцитах и уменьшение количества клеток, способных адсорбировать жидкость из кишечника. Повышение осмотического давления в процессе нарушенной ферментации нерасщепленных дисахаридов приводит к перемещению воды в просвет кишечника и объясняет появление осмотической диареи и, как следствие, тяжелой дегидратации при отсутствии своевременной коррекции данного патологического состояния. При внедрении бактериальных кишечных патогенов, происходит воздействие различных энтеротоксинов на мембранные комплексы. В частности, стимулируется выработка медиаторов воспаления, повышается уровень внутриклеточного циклического аденозинмонофосфата или циклического гуанозинмонофосфата или происходит нарушение проницаемости слизистой оболочки кишечника под влиянием специфических белков инвазивных патогенов и в целом изменение активности нормального процесса обмена ионов. В статье так же рассмотрены альтернативные механизмы развития диареи при участии энтероэндокринно-нейронных рефлексов, а также описаны типы дегидратации с детализацией водно-электролитных нарушений и современные подходы к регидратационной терапии. Знание и понимание особенностей патогенеза, диагностики типа дегидратации необходимо практикующему врачу для выбора тактики патогенетической терапии острых кишечных инфекций у детей. Acute intestinal infections are one of the most urgent challenges in pediatrics due to a high morbidity, development of severe forms and mortality, especially in children under five years. In most cases, severity of the disease is due to development of exicosis induced by loss of electrolytes and fluids as a result of emetic and diarrheal syndromes. However, the mechanisms of dehydration differ depending on the type of infectious agent. Thus, dehydration caused by viruses is due to the mechanism of absorption disorders induced by dystrophic changes in enterocytes and reduced number of cells that could absorb fluid from the intestine. The increase in osmotic pressure under disturbed fermentation of unsplit disaccharides results in translocation of water into the intestinal lumen, which explains the development of osmotic diarrhea and ensuing severe dehydration in the absence of timely correction of this pathological condition. After invasion of bacterial intestinal pathogens, various enterotoxins impact membrane complexes. Specifically, production of inflammatory mediators is stimulated, levels of intracellular cyclic adenosine monophosphate or cyclic guanosine monophosphate increase, or specific proteins of invading pathogens affect the permeability of intestinal mucosa and, eventually, change the activity of normal ion exchange process. The article also addresses alternative mechanisms of diarrhea involving enteroendocrine-neural reflexes and focuses on types of dehydration with a detailed description of water-electrolyte disorders and modern approaches to rehydration therapy. Knowledge and understanding of the pathogenetic and diagnostic features specific for a dehydration type are necessary for practitioners to choose the tactics for pathogenetic therapy of children’s acute intestinal infections. The aim of this review was to summarize modern aspects of the pathogenesis of exicosis syndrome in acute intestinal infections in young children.
Introduction. Infants younger than 3 months old are at high risk of severe pertussis, complications and pertussis-associated mortality. Newborns receive protection against pertussis from maternal antibodies transferred predominantly during late pregnancy. Neither disease, nor vaccination provides lifelong immunity against pertussis. So most of women have low antibody concentrations, leaving their newborn infant at a higher risk for disease in the first months of life.The aim of this study was to assess the concentration of antibodies against Вordetella pertussis among mother-baby dyads.Methods. We performed a cross-sectional study including 119 mother-baby dyads. Maternal antibodies were measured in venous blood specimens during the last trimester of pregnancy for women and in cord blood for newborn infants.Results. The median age was 30 (25; 34) years. The half of participants had unknown vaccination status (49,6%). Only 12,6% had a protective level (>18 U/mL) of anti-pertussis antibodies, 74,8% of participants had a nonprotective (<14 U/mL) level and 12,6% had an equivocal (14–18 U/mL) antibody concentrations. All newborns of seropositive women and 11,5% infants of women with an equivocal titers receive protection against pertussis. Transplacental transport ratio of antibodies against pertussis was higher in newborns of seropositive women.Conclusion. We revealed a huge proportion of pregnant women (87,4%) and newborns (77,3%) susceptible to pertussis. Maternal antibody level against pertussis was the major predictor of the antibody level in the infant.
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