Etiology of acute bronchitis in young children

In the microbiological examination of 132 children aged 0-3 years with acute bronchitis, Streptococcus pneumoniae and Haemophilus influenzae at a concentration of greater than or equal to 10(4) cells/ml, as well as different species of opportunistic bacteria, were isolated from tracheobronchial washings obtained from 100 of these children. S. pneumoniae and H. influenzae were found to play the leading role in the etiology of the acute bacterial inflammatory process in acute bronchitis in children.     

The role of Chlamydia pneumoniae in etiology of acute bronchitis in children

During examination of 60 children aged 3-15 years with manifestations of acute bronchitis Chlamydia pneumoniae antigen was detected in their nasal and pharynx smears in 11.7% of cases with the use of enzyme immunoassay and indirect immunofluorescence test. In 10% of cases chlamydial pneumonia was diagnosed serologically. In the course of complex laboratory diagnostics C. pneumoniae was detected in 13.3% of cases. The most complete information could be obtained by a combination of different methods of the antigen detection as well as specific IgG and IgM antibodies.     

Rapid diagnosis of exacerbations of chronic bronchitis of pneumococcal etiology in children

The diagnostic possibilities of the microscopic examination of bronchial secretion smears, stained by Gram's method, from 56 children with chronic bronchitis at different stages of exacerbation have been studied. The following criteria have been proposed for confirming the etiological role of pneumococci in cases of endobronchitis in children: the number of paired diplococci in the visual field must exceed 10 with polynuclears covering the whole field. In 84% of cases the use of this method makes it possible to determine the pneumococcal etiology of the disease within two hours from the arrival of the pathological material to a bacteriological laboratory; this method can also be used for evaluating the effectiveness of antibacterial therapy at its different stages.     

Laboratory criteria in the diagnostics of intestinal infections of staphylococcal etiology in children

Faecal samples were investigated from 948 children hospitalized with the diagnose of acute intestinal infection. The authors studied the isolation and properties of a broad spectrum of microorganisms from children's faeces: Salmonella, Shigella, E. coli, S. aureus, rotaviruses, Klebsiella, Morganella, Proteus. As a result, laboratory criteria were formulated of diagnosing in children intestinal infection of staphylococcal etiology.     

Nosospecific features of the dynamics of immunological parameters in young children with acute respiratory virus infections of varying etiology

The study of acute viral respiratory infections has shown that in the course of these infections fluctuations in the content of antigen-nonspecific immunocytes and immunoglobulins occur, depending on the etiology of the disease. This dependence should be taken into consideration in the evaluation of the immune status of young children with acute viral respiratory infections.     

The use of hypoxic stimulation in chronic and relapsing bronchitis in young children ]

214 children of different age with various forms of bronchitis were subject to immunological and biochemical examination. Against a background of hypoxic state of patients the values of quantitative indices of cellular immunity (E-RFC, blast-transformation reaction with phytohemagglutination) were revealed to decrease and dysimmunoglobulinemia-to form. It is shown that in the period of exacerbation of clinical symptoms of bronchitis the concentration of malonic dialdehyde and resistance of erythrocyte membranes to peroxide hemolysis significantly increase. Analysis of peroxidation level against a background of improvement of clinical indices after the performed treatment indicates that there is no tendency to normalization of metabolic disorders. The above results show that it is necessary to carry out normobaric hypoxic stimulation aimed at treating and preventing bronchitis in children of early age.     

The epidemiology of acute intestinal infections of undetermined etiology in children

Materials obtained in the study of conditions for contacting acute enteric infections of uncertain etiology, based on the analysis of the age structure of patients, the structure of clinical diagnoses and the monthly dynamics of cases registered in one of the districts of Moscow for 3 years (1984-1986), are presented. An important role of the alimentary factor in the spread acute enteric infections of uncertain etiology among the population of different age groups and everyday contacts in the spread of such infections among young children has been shown. The authors put forward a suggestion concerning the formation of natural immunity to infective agents, serving as etiological factors in the development of enteric infections of uncertain etiology, in children of preschool age.     

冬季急性下呼吸道感染住院儿童病原学分析及临床流行病学特点

目的了解冬季儿童急性下呼吸道感染病原谱及临床流行病学特征,为临床抗感染及病原检测提供依据。方法对我院2006年12月～2007年2月急性下呼吸道感染住院患儿采用一次性无菌吸痰管经鼻腔插入7～8cm,达到咽部以下负压吸取1～2ml深部鼻咽分泌液送细菌培养,并对呼吸道合胞病毒(RSV),腺病毒(ADV),A、B型流感病毒(IFV),1、2及3型副流感病毒(PIV)等7种常见呼吸道病毒抗原进行检测及运用荧光定量聚合酶链反应(PCR)技术检测标本中支原体和衣原体DNA。结果①381份下呼吸道感染儿童痰标本中细菌培养阳性81份,病毒检测阳性133份,支原体和衣原体阳性分别12份与6份,混合感染标本44份,总标本病原学检出率为50.66%(193/381)。②RSV阳性标本112份,为最重要的感染病原,连续3个月RSV检出率均在30%左右,6月龄以下儿童占61.61%,2岁以下儿童占86.61%,阳性标本中78.57%的患儿有喘息表现。③大肠埃希菌(16株)、肺炎链球菌(14株)、肺炎克雷伯菌及金黄色葡萄球菌(各10株)、卡他莫拉菌布兰汉亚种(8株)、流感嗜血杆菌和副流感嗜血杆菌(各6株)表现为主要的致病菌。结论RSV感然仍为儿童冬季急性下呼吸道感染最主要的病原,尤其在2岁以下儿童,且易表现为喘息发作。仍有40%以上感染病原未明,儿童急性下呼吸道感染病原谱需进一步完善。     

Severe acute hepatitis in children with unknown aetiology,etiology analysis and the next action

Highlights
1. MIS-C and severe acute hepatitis might share the common pathogenic mechanism;
2. SARS-CoV-2 persistence throughout multiorgan and tissues;
3. Relationship between COVID-19 vaccines and severe acute hepatitis worth investigating.