Immunologic correction with immunoglobulin of toxemia with exicosis in infants with acute intestinal infections]

The clinical course of acute intestinal infections complicated by toxicosis and exicosis was studied in 150 infants undergoing multimodality therapy, including natural human immunoglobulin for intravenous injections. The use of the new complex in the treatment of intestinal toxicoses was accompanied by increasing host immunological reactivity within short periods and decreasing of the treatment duration by 5.0 +/- 1.3 days; there were no persisting and chronic forms of the diseases and fatal outcomes. It was concluded that the use of the immunoglobulin for intravenous injections in the multimodality therapy of intestinal toxicoses in infants made it possible to prevent death in complicated intestinal infections and at the same time to accelerate their recovery.     

Antibiotic therapy in children with pertussis]

The data accumulated within the last years required revision of the indications to the use of antibiotics in treatment of pertussis. One of the aims of antibiotic therapy in pertussis was to prevent colonization of B. pertussis in the respiratory tracts. With that end in view the choice of antibiotics should be limited by those, to which the pathogen is the most sensitive i.e. erythromycin, ampicillin and augmentin. Comparative efficacy of erythromycin and ampicillin during the first 2 weeks of the disease was studied in 79 infants at the age not older than 1 year with pertussis and it was shown that erythromycin was advantageous by its therapeutic activity and less side effects. Expedience of the antibiotic therapy during the spastic period for providing a preventive effect on development of bronchopulmonary complications was studied in 201 patients with pertussis. No preventive effect of the antibiotics on development of the bronchopulmonary complications defined by the secondary bacterial flora was recorded. In the group of the patients treated with the antibiotics prophylactically (group 1) the complications were 2.6 times more frequent than in the patients treated with pathogenetic agents alone (group 2). Intrahospital pneumonia developed in 8.9 per cent of the patients in group 1 and in 1.5 per cent of the patients in group 2. Therefore, antibiotics should not be used at the late periods of pertussis for prophylaxis of secondary bacterial complications.     

Antibiotic therapy of cystic fibrosis in children]

It is postulated that P. aeruginosa in monoculture or in association with Staphylococcus aureus keeps its leading position in chronic bacterial inflammatory broncho-pulmonary processes in children with cystic fibrosis. Antibiotic resistant strains of Burkholderia cepacia, Stenotrophomonas maltophila, Alcaligenes xylosoxidans were revealed (7.1% of the strains). P. aeruginosa strains were susceptible to aminoglycosides, ciprofloxacin, and polymixin B. Susceptibility of smooth and mucoid forms of P. aeruginosa to ceftazidime stayed at the level of 49.6-57.1%. Such microbial associations as P. aeruginosa sm. + S. aureus, P. aeruginosa sm. + P. aeruginosa muc. + S. aureus were mainly susceptible to ciprofloxacin, aminoglycosides and resistant to ceftasidime. Meropenem, cefepim and ciprofloxacin are highly effective antibiotics for the treatment of broncho-pulmonary processes exacerbations at children with chronic P. aeruginosa cystic fibrosis. Intravenous use of antibiotics out of hospital for the treatment of the children with cystic fibrosis is clinically effective, and is economically and psychologically reasonable. It should be used more widely in medical practice.     

Antibiotic therapy of children in a gnotobiological unit]

The clinical effect of antibiotics in treatment of children at the age of 2 months to 5 years with acute pneumonia during a gnotobiological department in the wards of the 1st class purity and under the conditions of a routine pediatric hospital was estimated. The course of the antibiotic therapy amounted to 4.7 +/- 0.42 days in the gnotobiological department and 12.0 +/- 0.3 days in the routine hospital. After recovery the patients were discharged in 7.61 +/- 0.76 days from the gnotobiological department and in 15.2 +/- 1.11 days from the routine hospital.     

Antibiotic therapy in acute diffuse peritonitis]

The pharmacokinetics and clinical efficacy of antibiotics administered by various routes in acute diffuse peritonitis were studied on 25 non-inbred dogs and potential of lymphotropic administration of the antibiotics through the mesentery of the small intestine in urgent surgical operations because of the diseases of the abdominal cavity was estimated. It was shown that the intra-mesenteric administration of the antibiotics was more efficient. In acute diffuse peritonitis it provided high therapeutic concentrations of gentamicin in the central lymph and lymph nodes of the abdominal cavity.     

Chemotherapy of newborns with intestinal infections caused by opportunistic gram-negative aerobic bacteria]

A clinical bacteriological examination was applied to 100 newborns with intestinal infections caused by opportunistic gram-negative aerobes. There was a correlation between the decrease in the quantity of the bifidobacteria and the predominance of various species of opportunistic gram-negative aerobes and their associations, as well as high sensitivity of clinical isolates of the opportunistic bacteria to phosphocin, gentamicin, polymyxin and specific bacteriophages. The study showed that the combined use of antibiotics with the biopreparations (the specific bacteriophages and bifidumbacterin) was effective in treating the newborns with the above mentioned infections.     

The etiological structure of acute intestinal infections in children in the Republic of Tajikistan]

The Republic of Tajikistan belongs to the territories, traditionally hyperendemic with respect to acute enteric diseases (AED). The problem of AED still remains topical in recent years, especially among child population. The study of the etiological structure of AED in children has made it possible to establish that more than 70% of these diseases are of infectious nature. The leading role in the etiological structure of these diseases belongs to Shigella infections (32.4%), enterovirus diarrhea (12.1%) and Escherichia infections (8.9%). No significant differences in the character of the etiological structure of AED in children of urban and rural areas have been detected with the exception of enterovirus diarrhea, found to occur 2.7 times more frequently on children of urban areas (15.9%) than in those of rural areas (5.8%). The ascertaining of the etiological structure of AED in Tajikistan will make it possible to essentially increase epidemiological surveillance on AED and render it more concrete.     

Antibiotic therapy of acute dysentery in children with immunologic deficiency conditions

One hundred children with acute Sonnei and flexneri dysentery were followed up with respect to the infection process and main immunity indices. In 32 children the immunity indices were physiological (group 1) and in 68 children secondary immune deficiency was observed (group 2). The children were treated with aminoglycoside antibiotics and prodigiozan and it was stated that the time of recovery in the children with immune deficiency was longer by 5.2 days as compared to that in the children without immune deficiency. In the children with immune deficiency the combined use of one of the aminoglycosides, prodigiozan and lysozyme, led to a reduction of the host immunological reactivity and recovery within the same periods as those recorded for children with the physiological immunity status. It is recommended to use the antibiotic combination with prodigiozan and lysozyme in the treatment of all the forms of dysentery in children with secondary immune deficiency.     

Etiology of intestinal Enterobacteriaceae infections in young children

Enterobacteria, potentially capable of causing infections, were isolated from the feces of 88.7% of young children in the intestinal department of an infectious disease hospital. Opportunistic bacteria were considered to be the causative agents of infections only in cases of their high concentration in the material under test. In about a half of the cases the etiological role of the suspected microorganisms was confirmed by the detection of antibodies in low titers. The presence of maternal antibodies did not interfere with diagnostic procedures. The detection of antibodies to autocultures, even in a single case, is of diagnostic importance in the examination of young children. Autoserologically confirmed mixed infection was found to take a more prolonged course than autoserologically confirmed monoinfection.     

Treatment of intestinal dysbacteriosis in children with diabetes mellitus]

The use of the probiotic Acylact in combination with Viferone containing human recombinant interferon-alpha 2 in the treatment of intestinal dysbacteriosis in children with insulin-dependent diabetes mellitus (IDDM) was shown to be highly efficient. Elimination of microecologic disorders in the intestine was accompanied in all the children by immune rearrangements. The quantity of secretory and serum immunoglobulins and complement increased and the white blood cell chemiluminescence proved to be higher. The correction of the immune status of the children with IDDM resulted in a certain decrease of glycemia. The data are indicative of the fact that such a treatment of intestinal dysbacteriosis in children with IDDM is promising.     

Etiological structure of acute intestinal infections caused by opportunistic bacteria in young children

Altogether 587 children with diagnosed acute enteric infections were examined. In 26.4% of them pathogenic enterobacteria were detected, and in 59%, opportunistic enterobacteria. In 38.2% of children these bacteria were found to be the etiological factor of the disease. A reverse relationship between the contamination of feces with pathogenic enterobacteria and the age of children was established.