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Long-Term Effects of Campylobacteriosis in Infants
Background. Campylobacteriosis is the leading cause of bloody diarrhea worldwide. Infants have high risk severe campylobacteriosis as well as development of complications affecting the child growth and development. Objective. The aim of the study is to evaluate the long-term effects of campylobacteriosis in infants. Methods. A multicenter, prospective, dynamic, open, observational study included 80 children aged from 3 months to 2 years. The follow-up period after campylobacteriosis was 12 months. Patients were divided into three groups according to the feeding type: 1 — acidified milk formulas, 2 — non-acidified milk formula without a probiotic, 3 — breastfeeding. Physical examination data and anthropometric indicators were evaluated: height, body weight and z-indices. Moreover, qualitative and quantitative indicators of microbiocenosis were evaluated on the 21st day from the disease onset. Results. Functional gastrointestinal disorders (FGID) were diagnosed in 17 children (42.50%) at the follow-up period after campylobacteriosis: functional constipation (n = 11; 27.5%), functional diarrhea (n = 3; 7.50%), infantile colic (n = 2; 5.00%), cyclic vomiting syndrome (n = 1; 2.50%). Disorders of intestinal microbiocenosis were characterized by Bifidobacterium spp. and B. thetaiotaomicron decrease in all groups. Patients with FGID after campylobacteriosis had profound decrease in the level of Bifidobacterium spp., F. prausnitzii and B. thetaiotaomicron, and slower rate of body weight gain. The more profound decrease in body weight gain rates was observed in patients with initially low indicators. 10 (25.00%) patients after campylobacteriosis had no slowdown in body weight gain. 5 of them were administered with acidified milk formula during the convalescence period. 7 children (17.5%) had a decrease in weight-to-age ratio relevant to body weight deficiency, while 6 children (15.0%) moreover had malnutrition in BMI-to-age index significantly more frequently (p = 0.0050) with non-acidified milk formula without a probiotic after completion of the follow-up. Conclusion. The inclusion of children on formula feeding in the complex of therapeutic measures (with acidified milk formulas with probiotics) contributes to the improvement of qualitative and quantitative indicators of microbiocenosis and the rapid restoration of the body weight gain and growth rates.
Long-Term Effects of Campylobacteriosis in Infants
Background. Campylobacteriosis is the leading cause of bloody diarrhea worldwide. Infants have high risk severe campylobacteriosis as well as development of complications affecting the child growth and development. Objective. The aim of the study is to evaluate the long-term effects of campylobacteriosis in infants. Methods. A multicenter, prospective, dynamic, open, observational study included 80 children aged from 3 months to 2 years. The follow-up period after campylobacteriosis was 12 months. Patients were divided into three groups according to the feeding type: 1 — acidified milk formulas, 2 — non-acidified milk formula without a probiotic, 3 — breastfeeding. Physical examination data and anthropometric indicators were evaluated: height, body weight and z-indices. Moreover, qualitative and quantitative indicators of microbiocenosis were evaluated on the 21st day from the disease onset. Results. Functional gastrointestinal disorders (FGID) were diagnosed in 17 children (42.50%) at the follow-up period after campylobacteriosis: functional constipation (n = 11; 27.5%), functional diarrhea (n = 3; 7.50%), infantile colic (n = 2; 5.00%), cyclic vomiting syndrome (n = 1; 2.50%). Disorders of intestinal microbiocenosis were characterized by Bifidobacterium spp. and B. thetaiotaomicron decrease in all groups. Patients with FGID after campylobacteriosis had profound decrease in the level of Bifidobacterium spp., F. prausnitzii and B. thetaiotaomicron, and slower rate of body weight gain. The more profound decrease in body weight gain rates was observed in patients with initially low indicators. 10 (25.00%) patients after campylobacteriosis had no slowdown in body weight gain. 5 of them were administered with acidified milk formula during the convalescence period. 7 children (17.5%) had a decrease in weight-to-age ratio relevant to body weight deficiency, while 6 children (15.0%) moreover had malnutrition in BMI-to-age index significantly more frequently (p = 0.0050) with non-acidified milk formula without a probiotic after completion of the follow-up. Conclusion. The inclusion of children on formula feeding in the complex of therapeutic measures (with acidified milk formulas with probiotics) contributes to the improvement of qualitative and quantitative indicators of microbiocenosis and the rapid restoration of the body weight gain and growth rates.
The paper analyzes approaches to etiotropic therapy and structural assessment of the range of drugs for the treatment of campylobacteriosis in children. The methods of content analysis, grouping, data aggregation, comparative and marketing analysis were used. The information base of the study was the State Register of Medicines, federal clinical guidelines for the provision of medical care to children with campylobacteriosis, European and American clinical guidelines, as well as instructions for the medical use of drugs.Comparative analysis showed that Russian clinical guidelines contain 15 international non-proprietary names used for the etiotropic therapy of campylobacteriosis. The analysis carried out by drug producing countries shows that the leading positions in the supply structure are occupied by Russian producers (68.26%). Structuring by dosage forms makes it possible to single out tablet positions (47.46%). At the same time, 36.47% of the range of drugs are approved for use from the age of 12, which limits the implementation of modern approaches to the rational etiotropic therapy of campylobacteriosis in pediatrics. Structural analysis of the range of pharmaceutical substances identifies a significant contribution to the structure of imports of Chinese producers (46.30%), which, in turn, justifies the prospects for import substitution. Solving the problem of improving the quality of medical care for children with campylobacteriosis determines the prospects for further research based on the principles of evidence-based medicine using the tools of mathematical-statistical and pharmacoeconomic analyses.
Campylobacteriosis is one of the most common bacterial intestinal infections with high risks of severe and prolonged infection in childhood. The growing incidence of campylobacteriosis, the variety of clinical forms of the disease, the difficulties of timely diagnosis of the infection against the background of a high level of resistance of the microorganism to a number of antibacterial drugs determine the need to optimize the rational tactics of treating this infectious disease. One of the possible ways to overcome these difficulties is to further expand the use of probiotics and autoprobiotics. Aim: to reveal the features of the influence of autoprobiotic and probiotic E. faecium strains on clinical and laboratory parameters in children with non-smooth forms of campylobacteriosis .. Materials and methods: In the period from 2018 to 2020. In DNCIB FMBA, a comprehensive single-center prospective dynamic open observational study of 34 children with an uneven course of campylobacteriosis was carried out. For therapeutic purposes, patients were prescribed an autoprobiotic (group A; n = 15) or a probiotic strain E. faecium (group P; n = 19). Clinical and laboratory parameters and indicators of the intestinal microbiocenosis composition were assessed by real-time PCR. Results: Studies of the effect of two different approaches to prescribing probiotic strains of enterococcus to children with a protracted course of campylobacteriosis - a conditionally “reference” industrial strain E. faecium L3 and autoprobiotic strains with a comparable frequency (88.9% and 93.3% of cases, respectively) revealed their significant positive impact on the course of protracted forms of campylobacteriosis, which was expressed by the disappearance of abdominal pain syndrome, normalization of the frequency and consistency of stools, relief of hemocolitis in the absence of undesirable side effects. Analysis of the dynamics of coprograms before and after taking autoprobiotics and probiotic E. faecium L3 also did not reveal significant differences: there was an equivalent positive dynamics in the form of improvement in most of the macroscopic and microscopic characteristics of the stool. The study of the composition of the intestinal microbiota showed that after the course of administration of autoprobiotic strains of E. faecium, there was a significant increase in the content of butyrate-producing indigenous representative - F. prausnitzii, which promotes the repair of the intestinal mucosa. The studies also showed that the course use of autoprobiotic strains of enterococcus contributed to a decrease in the frequency of convalescent release of campylobacter, which suggests a sanitizing effect of autoprobiotics and does not exclude a similar effect in relation to other bacterial pathogens of intestinal infections in children.
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