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Objective: to identify modern epidemiological features of viral acute intestinal infections in children and adolescents in the Sakhalin Region.Materials and methods. Data on acute intestinal infection incidence obtained from statistical reports of the Rospotrebnadzor during 2021-2023 was compared with long-term average incidence rates calculated over the period before the COVID-19 pandemic (2010-2019) to perform epidemiological analysis. Incidence was calculated for different age groups; according to months of the year, monthly long-term average incidence rates were established. Index of seasonality, coefficient of seasonality, and index of seasonal growth were determined.Results and discussion. Manifestations of acute intestinal infections epidemic process in the Sakhalin Region indicate persisting conditions for an increase in the registration of both sporadic cases of diseases and outbreaks of infectious diarrhea. Viruses were prevailing in the structure of cases of known etiology (mainly caused by rotaviruses and noroviruses). Their intra-annual dynamics showed changes in rotavirus and norovirus infection incidence rates: a shift in periods of increased incidence, a decrease in the coefficient of seasonality, and for rotavirus infection, a decrease in the index of seasonal growth. Age-adjusted rotavirus infection incidence showed predominance of the infection among preschool-aged children; norovirus infection was frequently detected among schoolchildren and adolescents. An increase in the focality index may indicate ongoing problems in the public catering sector, non-compliance with sanitary rules and hygiene standards, and untimely detection and isolation of patients with acute intestinal infections.Conclusion. Obtained results confirm the epidemiological significance of viral gastroenteritis and the necessity of anti-epidemic measures optimization.

Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive tract from the group of disorders of interaction in the gut-brain axis. IBS has a negative impact of on patients' quality of life and the significant social and economic burden of the disease due to the low effectiveness of available treatment strategies, which are only symptomatic, without impacting factors and mechanisms of intestinal dysfunction. From this perspective, it is critical to study the factors contributing to the onset and persistence of IBS symptoms to improve the early diagnosis of the disease and implement targeted prevention technology in at-risk groups. The objective of this paper is to systematize data on the main risk factors for IBS, including hereditary predisposition, stress and psycho-emotional state, diet and eating habits, and acute intestinal infections.

Introduction. Diarrheal syndrome is the most characteristic symptom of HIV infection, which occurs in 70% of patients and is often fatal. The severity of diarrheal syndrome, irrespective of immune status, is usually determined by specific microorganisms colonising the gastrointestinal tract. The objective of this study is to assess the prevalence of classical pathogens of acute intestinal infections in diarrheal syndrome in HIV-infected residents of the Chechen Republic (Grozny). Materials and methods. Stool samples (n = 191) of HIV-infected patients with a history of diarrheal syndrome were studied by real-time PCR with two kits of reagents: "AmpliSens OKI screen-FL" for the detection of DNA/RNA of Shigella spp./EIEC, Salmonella spp., Campylobacter spp., Adenovirus, Rotavirus, Norovirus and Astrovirus; "AmpliSens Escherichiosis-FL" for the detection of diarrheagenic E. coli (DEC) DNA of five pathogroups: EPEC, EHEC, ETEC, EIEC, EAgEC. Results. Genetic markers of the acute intestinal infection pathogens were detected in 20.9% of the examined individuals. In patients aged 0–7 years and 18–24 years, DNA/RNA of the tested pathogens were not detected. DNA of bacterial pathogens accounted for 93.9%, RNA of viral pathogens — 6.1%. The etiological structure of bacterial infections was represented by a significant predominance of DEC (84.8%) compared to 10.9% of Campylobacter spp. and 4.4% of Salmonella spp. The structure of viral infections included 66.7% Rotavirus and 33.3% Norovirus. Genetic markers of Adenovirus and Astrovirus have not been identified. In 77.5% of HIV-infected patients, diarrheal syndrome was caused by one pathogen (mono-infection), but in nine examined patients (22.5%) it had a combined etiology. Conclusion. The etiology of acute intestinal infections in HIV-infected patients of the Chechen Republic includes bacterial and viral pathogens, in every fifth the cause of diarrheal disease was DEC. Due to diarrhea in HIV-infected people being a polyetiological disease, it is necessary to introduce a comprehensive, fast, reliable, and affordable method for identifying a wide range of pathogens that cause secondary infections.

Acute intestinal infections caused by Escherichia coli affect the gastrointestinal tract, leading to development of diarrheal syndrome, intoxication, and, in some cases, generalization of the pathological process. Diarrheagenic E. coli (DEC) strains differ from non-pathogenic (commensal) strains by the presence of specific virulence genes, pathogenesis characteristics, clinical and epidemiological manifestations of the diseases they cause. Based on the virulence determinants, 6 pathogenic DEC groups are distinguished: enteropathogenic, enterotoxigenic, enteroinvasive, shiga toxin-producing, enteroaggregative, diffusely adherent E. coli strains. The strains of each pathogenic group have distinct pathogenic mechanisms responsible for inflammatory processes in different compartments of the human intestine, which are clinically manifested as diarrheal syndrome. This paper presents a review of current scientific publications on epidemiology, pathogenesis, genetic properties, and antigenic characteristics of pathogenic E. coli. Although DEC biological properties have been extensively studied, many aspects require deeper insights to develop effective laboratory-based diagnostic techniques, treatment methods, epidemic control measures, and prevention strategies against E. coli infections.

Relevance. Over the past two decades, due to the effectiveness of anti-epidemic measures, the incidence of infectious diseases in the Republic of Dagestan (RD) has been declining. However for some nosologies it is considerably higher than the Russian Federation average.Objective. To analyze the incidence of infectious diseases in RD in 2019–2022 in order to identify areas for preventive and anti-epidemic measures to be strengthened.Material and methods. The data on morbidity taken from federal statistical observation form No. 2 «Information on infectious and parasitic diseases», State reports on sanitary and epidemiological well-being of the population for 2019, 2020, 2021, 2022, prepared by Rospotrebnadzor and the Department of Rospotrebnadzor for Dagestan Republic were analyzed. A descriptive epidemiological method was used, which does not require statistical data processing.Results and discussion. In 2022, in the Republic of Dagestan, the infectious disease incidence was 7492.2 per 100 thousand of the population, which is 22.2% lower than in 2021, but higher than the long-term average (6149.4). In 2022, compared to 2021, there was a decrease in the incidence of 10 nosoforms of infectious diseases in the RD and 6 in the Russian Federation. Along with a decrease in morbidity, there is an increase in morbidity, in particular Sonne dysentery by 5.1 times, аcute intestinal infections (established etiology) by 39.3%. chronic hepatitis B by 97.9%, chronic hepatitis C by 2.14 times, whooping cough by 5.1 times, chicken pox by 18.6%, mumps by 2.2 times, brucellosis by 24.4%, HIV-infection by 36.3%, influenza 43.4 times. In the structure of infectious and parasitic diseases in 2022, as in previous years, acute infections of the upper respiratory tract and аcute intestinal infections prevailed.Conclusions. Despite the ongoing systematic work aimed at reducing the incidence of infectious diseases and the progress made in improving the situation with a number of infections, more measures are needed to combat acute intestinal infections, hepatitis B and C, HIV-infection, brucellosis.

The tactics of activities of the specialized anti-epidemic team (SAET) of the Rospotrebnadzor on the territory of the Republic of Crimea has been determined by the conditions of emergency situation of sanitary-epidemiological and natural character. The aim of the work was to analyze the features and effectiveness of the functional response of the Rospotrebnadzor SAET to the dynamics of epidemiological risks caused by emergency of combined nature in the Republic of Crimea in 2020–2021. Materials and methods. We used report materials of the Rospotrebnadzor SAET; information materials of the Interregional Rospotrebnadzor Administration in the Republic of Crimea and the Federal city of Sevastopol; “Coronavirus Monitor” service data. Results and discussion. Tactical decisions on the work of the SAET on the territory of the Republic of Crimea had the stage-by-stage nature. In the event of a complication of the epidemiological situation on the new coronavirus infection, a mobile group of the SAET was involved. Together with specialists from the Plague Control Station of the Republic of Crimea, it conducted 211 148 studies of clinical material to detect SARS-CoV-2 RNA using PCR during the period of 2020–2021. In response to the emergence of additional risks caused by the consequences of a dangerous meteorological phenomenon, the group of SAET specialists was reinforced and mobile complex (MС) of the SAET was deployed. During the entire course of work, a prolonged target rotation of personnel was implemented in order to provide for adequate laboratory support for monitoring upon epidemiological indications in accordance with the nature of emerging risks. That tactics of operation made it possible to conduct 18 591 screening studies of clinical material for acute respiratory viral infections (ARVI), natural-focal and acute intestinal infections (AII), as well as the study of 280 water samples for cholera. Introduction of the sequence of operational procedures adapted for work in emergency situations resulted in isolation of 10 Vibrio cholerae O1 ctxA– strains from water bodies. The phased involvement of the mobile group of SAET specialists, and later the MC of the SAET, in combination with the consistent operational target rotation of personnel in order to provide adequate laboratory support for monitoring studies, determined the tactical features of the SAET functioning. Prompt investigation, substantiation of potential and response to realized (actual) epidemiological risks associated with the extraordinary situation made it possible to prevent complications of the epidemiological situation in the territory of the tourist cluster of the Russian Federation.

During more than 50 years, a heterogeneous population of Vibrio cholerae non-O1/non-O139 (NAGs) exists in Rostov region of Russia, whose representatives periodically cause acute human intestinal infections; the last case was registered in 2018. In 2022, a sick child was again revealed in Rostov, from whom 2 NAG subcultures were isolated. Aim of the study: bioinformatics analysis of whole genome sequences (WGSs) of the 2022 clinical NAG isolates, genetic determinants of pathogenicity factors and relevant products. Materials and methods. Isolation, identification of cultures, as well as antibiotic sensitivity were carried out according to the MUK 4.2.3745-22. SNP analysis of WGSs obtained on the MiSeq Illumina platform were analyzed by means of designed software; BioEdit 7.2.5, Vector NTI Advance 11 package, CARD database were used to identify and analyze genes and relevant deduced products. Results. The isolated cultures with identical phenotypic features, PCR-genotypes and results of SNP analysis, were identified as a non-toxigenic NAG. The agent showed sensitivity to chloramphenicol, ceftriaxone, streptomycin, gentamicin, nalidixic acid, ciprofloxacin, ampicillin, amikacin and intermediate resistance to tetracycline, doxycycline, furazolidon and co-trimoxazole. WGSs lacked CTX and preCTX prophages, pathogenicity island VPI, thermostable and cholix toxin genes, pandemic islands VSP-I and VSP-II. The determinants of the type 6 secretion system (T6SS) were not presented completely, which evidenced in favor of the loss of its functionality. An intact T3SS cluster was revealed, which was adjacent to the nan-nag region of the VPI-2 pathogenicity island in the absence of the proximal and distal parts of the latter. Other determinants of pathogenicity factors were revealed: RTX cluster responsible for synthesis of MARTX cytotoxin, genes for hemolysin HlyA, cytotonic toxin Cef, several serine and metalloproteases. The nucleotide compositions of most determinants differed from the prototypes, but their putative products preserved characteristic active domains. The adhesive activity might be provided by mannose-insensitive MSHA-like pili, since the msh-cluster included all the genes necessary for their production, as well as flagella, as both clusters responsible for their assembling were 99% identical to the prototype. From antibiotic resistance determinants only -lactamase VarG gene was found. Conclusion. The NAG strain examined here contains a sufficient set of intact virulence-associated genetic determinants, expression of which could contribute to the development of the disease.

Today, as in ancient times, diarrhea (loss of water and electrolytes along with stool) accompanies many pathological conditions in humans. The pathophysiology of various types of diarrhea has been studied, which made it possible to optimize therapeutic approaches and save the lives of many people. The most dangerous conditions occur in young patients with osmotic and exudative types of diarrhea, as they result in exicosis within a short time. In arriving at a diagnosis, rehydration therapy should be started as soon as possible. The article presents the historical aspects associated with the global pandemics of cholera. The history of the creation of solutions for intravenous and oral rehydration is covered. The authors presented tables for calculating fluid losses and the required volume of solutions for oral or parenteral administration. The modern requirements for rehydration solutions and the principles of rehydration in children are presented. Oral rehydration is particularly problematic for young children due to the limited range of drugs and requirements for the composition of solutions used in pediatrics. According to the recommendations of the World Health Organization and ESPGHAN, clinical recommendations of the Russian Federation, low-osmolar solutions should be used. When complex solutions containing probiotic and zinc are used, the therapy compliance increases. A rehydration solution, which contains a weighted amount of salt for the preparation of a low-osmolar solution, as well as the probiotic L. reuteri DSM 17938 at least 1 billion of viable bacteria and zinc sulphate 0.004 g is one of the latest solutions. The results of studies of this solution are provided.

Acute intestinal infections are widespread and hold the second place among infectious diseases, giving way solely to respiratory diseases. In this regard, much attention has been paid to examining acute intestinal infections, including immunopathogenetic mechanisms. And since proinflammatory and antiinflammatory cytokines play an important role in development of inflammatory reactions affecting disease severity and outcome, it becomes reasonable to study polymorphism of genes governing production of related molecules. Thus, the aim of our study was to examine the polymorphism in the IL-1β Т31С and IL-2 T330G genes; such mutations were characterized by nucleotide replacement affecting the gene promoters, which influenced production rate and level of the relevant cytokines. There were enrolled 108 patients with acute intestinal infections comprising main group as well as 94 apparently healthy subjects in the control group. Genomic DNA was isolated from the whole blood leukocytes by using a DNA-express-blood reagent, followed by conducting amplification reaction with two pairs of allele-specific primers. The polymorphism in the IL-1β, IL-2 genes was determined by PCR with primers purchased from Litech LLC (St. Petersburg). Data processing was carried out by using the statistical Statistica 6 suite software. While assessing the carriage rate of IL-1β T31C gene polymorphic markers by using the multiplicative inheritance model in both groups, the prevalence of the normal T allele and, respectively of the —31TT and —31TC genotypes with OR = 1.83 and an interval of 1.04—3.22 (χ2 = 6.35, p = 0.04, df = 2) was found, which allowed us to identify a relationship between the carriage of IL-1β в gene heterozygous variant and potentially elevated risk of AII. Regarding the IL-2 T330G gene, it was found that pathological G alleles was more markedly abundant in patients with acute intestinal infections compared to control group. Analyzing diverse IL-2 T330G carriage rate in patients with acute intestinal infections revealed that carriers of the TG heterozygous variant predominated — 56.48% (χ2 = 17.75, F = 0.000031), whereas pathological genotype GG was found in 13.89% (χ2 = 12.31, F = 0.000663, p < 0.05), with high probability of the relationship between carriage of these genotypes and a risk of disease development (OR — 3.63 [1.97—6.68] and OR — 6.91 [2.12—22.59]). Hence, the carriage of polymorphic variants of the IL-1β T31C and IL-2 T330G genes was associated with elevated risk of developing AII in case of infection with pathogenic microorganisms.

The aim of this work is to study the etiological and epidemiological features of infectious hemocolites (IG) in hospitalized children of different ages.Materials and methods of research. An analysis of the results of a survey of 3103 children admitted to hospital treatment for acute intestinal infections (AII) from January to December 2018, among which patients with IG were identified. The etiology of the disease was determined based on the results of the bacteriological method, PCR studies of faeces with Amplicens ® OKI screen-FL reagents, serological and immunological methods. Microscopic examination of faeces was performed to identify protozoa. Patients were divided into age groups: infant (n=78; 30%); early (n=74; 28,5%); preschool (n=63; 24,2%), school (n=45; 17,3%).Results. The incidence of IG in hospitalized children with AII was 8,4%. Bacterial pathogens of IG were detected in 66,5% of children, IG of unspecified etiology was diagnosed in 24,2%. Viral and bacterial infections were rarely detected (9,2%). Among intestinal viruses, rotavirus (37,5%), norovirus (29,2%) and enterovirus (20,8%) were more frequently detected in hemocolitis of combined viral and bacterial etiology. In the IG age structure, infants (30%), young children (28,5%) and pre-school children (24,2%) made up the majority. The maximum number of IG patients was detected in the summer (10,9% of all cases of AII). Salmonellosis was more often detected in autumn (31,6%), campylobacteriosis – in summer (17.9%) and autumn (24,1%), escherichiosis and shigellosis – in summer (11,5% and 6,4%, respectively). The maximum detection of IG in infants was observed in June (14,1%) and October (12,8%), in young children – in July (17,6%), in preschoolers – in June (12,7%) and November (15,9%), in schoolchildren in May (13,3% of cases) and in October (15,6%).Conclusion. The incidence of infectious hemocolites in hospitalized children with acute intestinal infections was 8,4%. The bacterial etiology of the disease was detected in 66,5% of children. The age structure of the IG was dominated by children of infant, early and preschool age. The maximum detection of patients with IG was observed in the summer.

Outcomes of severe variants of acute infectious diarrhea in children with acute renal injury/failure (ARI/ARF) remain unsatisfactory, and mortality reaches 70% and more. ARI/ ARF therapy requires high material costs, which represent significant burden on health financing systems. It makes us consider AFR as one of the most important medical and social problems.The aim of our study was to investigate predisposing factors contributing to the development of renal dysfunction in acute infectious diarrhea associated with hemocolitis (AIDH), as well as to study the relationship of the developed renal dysfunction with the severity of endogenous intoxication, damage of vascular endothelium and hemostasis system.We examined 60 sick children with AIDH, divided into two groups: with ARF and without kidney pathology.Susceptibility to ARI/ARF in severe forms of AIDH is mediated by early childhood (up to 3 years in 89,5% of patients), artificial and mixed feeding (in 52,6% and 36,8% of children respectively), pathology of pregnancy in the first trimester, mother diseases during pregnancy (84,2%) and the late admission to hospital (89,5%) on the 4,9±0,2 day of the disease, i/m administration of furosemide without volume circulating blood restoration, i/m administration of nephrotoxic antibacterial medicines. Shigella spp. and Escherichia coli as etiologic factors of diarrhea in 42,1% and 47,4% of cases respectively. Thus due these parameters we can predict the loss of kidneys adaptation ability in diseases with severe course including acute infectious diarrheas.Interrelationships between elevation of the number of antigen binding lymphocytes to tissue antigens of vascular endothelium up to 8,1±0,6% in children with ARF and development of hemorrhagic syndrome (decrease of PTI to 72,5%) and intensity of endogenic intoxication (average molecular peptides up to 9,7±0,6 g/l) and worsening of AFR signs were established.Thus, it was found that AKI most often develops when rehydration therapy is started late or inferiorly performed, when nephrotoxic antibiotics and loop diuretics are prescribed without circulating blood volume (CBV) compensation and is accompanied by an increase in the degree of endogenous intoxication and vascular endothelial damage.

Introduction. The article presents basic information on approaches to pathogenetic therapy of acute intestinal infections. Data from our own research on the diagnosis and treatment of gastrointestinal manifestations of COVID-19 in children aged 3 months to 18 years are presented. The aim of the study was to evaluate the effectiveness of complex rehydration, cytomucoprotective and probiotic therapy for infectious diarrhea of various etiologies, including those developing with a new coronavirus infection. Materials and methods. We analyzed data from our own observations of patients aged 3 months to 18 years with diarrhea against the background of acute intestinal infections of various etiologies (120 children), as well as with a new coronavirus infection caused by the SARS-CoV-2 virus (32 children). The children were treated in accordance with current standards and treatment recommendations. Clinical examples are presented.Results and discussion. Diarrhea was observed in 64% of patients with a new coronavirus infection. Clinical cases confirm the effectiveness of rehydration, cytomucoprotective and probiotic therapy for infectious diarrhea, regardless of the etiology, including COVID-19.Conclusions. Diarrhoea and other symptoms of gastrointestinal disorders in COVID-19 are stopped when pathogenetic therapy is recommended for patients with acute intestinal infections.

Relevance. According to the scientific literature in the Russian Federation (RF), over recent years there has been a decrease in the incidence of acute bacterial intestinal infections (AII) and, conversely, an increase in the incidence of AII of viral etiology. The reasons for these trends remain unclear in many respects. Goal. To study the trends in the long-term dynamics of the incidence of AII of bacterial and viral etiology among the population of the RF. Materials and methods. The work uses the materials of state reports of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being for 2000 - 2018. The incidence rates of bacterial AII (dysentery, salmonellosis, intestinal yersiniosis, Escherichiosis and intestinal infections caused by opportunistic bacteria) and viral AII (rota-, noro-, enterovirus infections), as well as the results of microbiological control of food and drinking water were studied compliance with sanitary regulations. Results. A tendency towards an increase in the incidence of acute intestinal infections with an average annual rate of 1,7% in population of the Russian Federation was revealed. At the same time, there was a decrease in the incidence of bacterial AII with an average annual rate of 3,8% and, conversely, an increase in the incidence of viral AII with an average annual rate of 384,1%. These changes were observed on the back of a decrease of samples` percent of food and drinking water that did not meet sanitary standards for bacteriological indicators, and an expansion of the range of virological methods for diagnosing viral AII. Conclusion. During 2000–2018 revealed a decrease in the incidence of bacterial OCI in the Russian Federation against the background of improved quality of food and drinking water according to microbiological indicators and, on the contrary, a sharp increase in the incidence of viral OCI associated with the expansion of the spectrum and scope of diagnostic virological studies.

Radioactive contamination of the environment has become one of the most important environmental factors and the problem of the possible consequences of the global and rapid change in the level of radiation load on the biosphere for all living things is of particular importance. The objective: to study the activity of AChE in the small intestine of rats - males and females of different ages - both under physiological conditions and under conditions of prolonged γ-irradiation in a total dose of 0.75 Gray. Experimental studies were performed on 510 rats of different ages and sexes of the Wistar line. All animals were kept under standard conditions and on the standard diet of the vivarium. Total γ-irradiation was performed with the use of gamma therapeutic unit "AGAT-R" №83 (isotope 60Co). Analysis of the results showed that the most significant changes in AChE activity underwent in the small intestine of males and females 12 days after the end of the ionizing factor, and for all subsequent stages of the study was characterized by its gradual decrease. Previously unknown pathophysiological mechanisms of violation of the morphofunctional status of the small intestine of offspring obtained from predecessors after chronic γ-irradiation in low doses, the implementation of radiation effects of parental irradiation in their offspring have been obtained. The results of experimental research will provide an opportunity for theoretical justification and practical development of ways of metabolic correction of negative manifestations of radiation-induced damage to the genome in the body of the offspring of irradiated parents. Given the dynamics of changes in acetylcholinesterase activity during the aging of animals, we concluded that prolonged exposure to ionizing radiation at a total dose of 0.75 Gray contributes to the strengthening of involutional changes in the functional state of the small intestine.

Relevance. Acute intestinal infections still retain their social and medical significance in the world, with a reduction in the incidence of well-studied bacterial infections, such as salmonellosis and, especially, shigellosis.Discussion. Since 2006, the incidence of bacterial dysentery in Russia has continued to decrease, in the Republic of Dagestan it is at a high level, exceeding more than 10 times the national average. Mostly children are sick (up to 75%). Cases of shigellosis are recorded throughout the year, the seasonal increase in the incidence in the summer and autumn is associated with the activity of the main transmission pathogens – water and food. The main causes of epidemiological well-being for schigеllosis in Dagestan are determined by: poor state of the water supply system and sanitary and communal improvement of populated areas; the use of food products stored, transported and sold in the distribution network in violation of sanitary and hygienic requirements. So, in 2017 and 2018 – 67.1% and 32.69% of drinking water samples of water pipelines did not meet hygienic standards, respectively, in terms of sanitary and chemical indicators, 53.1% and 65.6% of water pipelines did not meet the requirements of sanitary legislation. The flare incidence, which is recorded annually, indicates the activity of the epidemic process of acute intestinal infections and shigellosis in the republic. The experience of various territories of the country, including those affected by adverse environmental and climatic phenomena (floods, floods, flooding), shows high efficiency along with traditional measures aimed at breaking the transmission mechanism of the pathogen, Shigellosis vaccine prophylaxis. In Dagestan, vaccination is limited, mainly in foci, where bacteriophage polyvalent dysentery S. sonnei and S. flexneri 1, 2, 3, 4, and 6 serotypes are used more widely for prevention and treatment. In this situation, the optimization of the system of epidemiological surveillance of shigellosis, which consists in improving the pre-epidemic diagnosis and epidemiological monitoring of measures aimed at each link in the epidemic process, including the creation of immunity to pathogens in individual population groups due to specific prevention, is of particular relevance to the Republic.Conclusion. The constant flare incidence of dysentery dictates the need, along with traditional measures to interrupt the transmission of the pathogen, to carry out vaccine prophylaxis more widely in risk groups. Potential sources of shigella have formed in the republic; there is a potentially high risk of the mechanism of transmission of the pathogen, as well as the population potentially susceptible to the pathogen, indicating the presence of such a danger and the need for its comprehensive study as an object of risk-oriented surveillance. Thus, the key directions in improving the surveillance of shigеllosis in the Dagestan Republic should be pre-epidemic diagnosis in a risk-based epidemiological surveillance system. The introduction of modern sensitive, specific, standardized methods of laboratory diagnostics will make it possible to effectively carry out risk-oriented epidemiological surveillance, which makes it possible to identify the transition of risk factors from potential to real, activating the epidemic process.

The review presents the results of studies on the existing problems in the sanitary condition of Tajikistan’s surface water bodies related to its pollution by waste and sewage from settlements, industrial and agricultural enterprises. Due to the weak development of centralized water supply, a significant part of the population of Tajikistan is forced to use surface water for household and drinking needs, as a result of which, for many years, the republic has been a region of the incidence of acute intestinal infections, mainly in rural areas. In order to carry out measures for the sanitary protection of water bodies, the introduction of modern technologies for the neutralization and disinfection of waste and effluents from human and animal life, as well as the disposal of household waste having not only sanitary and hygienic, but also environmental significance is everywhere required.

Acute intestinal infections (AII) are one of the most common infectious diseases, the eighth most important cause of annual mortality among all age groups, and the fifth most common cause of death among children under 5 years of age worldwide. From 3 to 5 million children are affected each year, with nearly 446.000 fatalities. This is facilitated by: international migration, the interstate exchange of food products and raw materials of animal origin, the intensification of industrial production of livestock and poultry products, urbanization, activation of recreational processes, climate change, environmental degradation. Viruses are the dominant etiological factors, both during the period of a seasonal increase in the incidence of AII (65-76% of cases) and according to the analysis of sporadic cases (62.6%). The most common and significant viral agents of the causative agent of AII rota-, calici, adeno- and astroviruses. In most acute respiratory infections, the immune response formed in childhood is sufficient protection against infection in more advanced adulthood. The main reason for the absence or insufficiency of immune defense is a significant genetic and antigenic diversity of viral pathogens. The only means of identifying viruses are molecular genetic methods. Currently, there are no effective measures to deal with outbreaks of AII. The quality of drinking water remains the most important way of their prevention, which is a very difficult task for many countries. The development of vaccines for most viral pathogens is difficult. One of the promising methods for preventing the incidence of AII is the use of boiled water and the development of food processing technologies with a high risk of virus contamination, which include seafood, fresh vegetables and ready-to-eat foods.

During the preparation of the FIFA World Cup 2018 in 2015-2017 genetic features of regional pathogenic strains in the city of Sochi are determined. The strains and nucleic acid isolates of bacterial and viral infectious diseases causative agents — acute intestinal infections: rota-, noro-, astro and enteroviruses, Salmonella enteritidis, natural focal infections: hantaviruses, Rickettsia of tick spotted fevers group, Borrelia are genotyped. In result, complex genetic profiling of infection diseases causative agents variants that are actual for the Sochi region has been carried out. The obtained database was used to provide molecular analysis of pathogens during the XIX International Festival of Youth and Students (2017) and during the FIFA World Cup (2018). The perspective of using this algorithm of genetic analysis in description of outbreaks (cases) of infectious diseases in specific areas is shown.

The authors assessed microbiological risks of acute intestinal infections (AII) with viral etiology caused by drinking water taken from centralized water supply systems among overall urban population in Arkhangelsk region over 2006-2017. The re-search was performed with Quantitative Microbial Risk Assessment (QMRA) procedure. It was revealed that acute intestinal viral infections prevailed among intestinal infections; the most widely spread ones were rotavirus infection (86.9%), norovirus infection (7.7%), and enterovirus infection (3.7%). The authors also performed comparative analysis of spatial distribution and long-term dynamics of incidence with AII which were possibly caused by infectious agents entering a body with water. The analysis revealed that rotavirus and norovirus infections frequently occurred in Arkhangelsk, Novodvinsk, Koryazhma, and Kotlas. Incidence with rotavirus infection among population in Koryazhma and Arkhangelsk grew 1.5-1.6 times faster than epidemiological processes on the reference territory. Coliphages contents were equal to Р95in drinking water taken from centralized water supply systems in Arkhangelsk and Koryazhma, and it was 1.4 and 2.2 times higher respectively than the hygienic standard. Rotavirus, norovirus, and enterovirus infections were highly likely to occur in Arkhangelsk (R=0.97-0.99), and rotavirus infection, in Koryazhma (R=0.95). Average probability of norovirus infection (R=0.58) and enterovirus infection (R=0.43) was detected in Koryazhma. The research results indicate that Quantitative Microbial Risk Assessment (QMRA) procedure is feasible and significant within the system of sanitary-epidemiologic surveillance over water treatment; it substantiates the necessity to create and implement virology monitoring over centralized drinking water supply.

The analysis of clinical and epidemiological features of the course of Klebsiella intestinal infection in children has been carried out. It was found that a high incidence of Klebsiella infection is observed in children in the first years of life. Clinical features of Klebsiella infection are characterized by acute onset, fever, diarrhea. The disease course is moderate-to-severe. Patients under 1 year of age are characterized by the presence of water deficiency exsiccosis. Klebsiella infection is more common in children with an unfavorable premorbid background. During outbreaks of acute intestinal infections that occur in children’s groups, patients should be examined for the presence of potentially pathogenic intestinal microorganisms. This will optimize not only the methods of treating patients, but also anti-epidemic measures.

Infectious diarrheas are a current problem of children’s age. Despite prevalence in structure of acute intestinal infections at children of a viral gastroenteritis dysentery keeps the relevance owing to development of severe forms of a disease and serious complications. The choice of drug for etiotropic treatment of bacterial diarrheas at children’s age taking into account the existing international and Russian recommendations is difficult and ambiguous. The efficiency of many modern antibacterial drugs which are traditionally used for treatment of a shigellosis and others infectious diarrheas decreases because of high prevalence of polyresistant strains. It is known that so far, at infectious diarrheas unreasonably long antibacterial therapy with change of 3–4 medicines is carried out, repeated courses of germicides at a reconvalescents bacterioexcretion of activators of infectious diarrheas are widely appointed, unfairly short antimicrobial therapy takes place less often. Despite existence modern diagnostic the test of systems antibiotic-associated diarrheas are often late diagnosed that lead to development of severe forms of a disease or complications. The negative C. difficile toxins test does not allow to exclude the antibiotic-associated nature of diarrhea completely. The clinical case of dysentery of Fleksneri at the child caused by a strain with a multiple antimicrobial resistance and which led to development of antibioticassociated colitis and dynamic intestinal impassability is given as an example in article. Therefore, when choosing antimicrobial drug means for treatment of infectious diarrheas it is necessary to consider regional features of the circulating activator strains.

Aim. To evaluate a possible role of herpes viruses in the pathogenesis of various infectious diseases of children in the first six months of life, including acute gastroenteritis and identify the markers of herpesvirus infections which occur most frequently. Materials and methods. Samples of biological materials (blood serum and blood cells, breast milk, urine, feces) were studied in 35 children aged 14 days to 5 months who are being treated in MRRCI Vladimirsky with diagnoses of «acute infectious gastroenteritis of unspecified etiology» (n=24), «urinary tract infection» (n=6), «intrauterine infection» (n=5) and of their mothers. To determine the antibodies of IgM, IgG in serum, an enzyme immunoassay was used, to detect common antigens of viruses in blood cells, urine, breast milk - an indirect reaction of immunofluorescence, to detect early antigens of viruses and their reproduction - a rapid cultural method. Results. Infection with herpesviruses was found in 85% of children and 91% of mothers, with the most often identified markers of active forms of infection caused by the herpes simplex virus. In children with a diagnosis of acute infectious gastroenteritis of unspecified etiology, no pathogens of viral and bacterial intestinal infections were detected in a large number of active forms of herpesviral infections in both children and their mothers (33% and 91%, respectively). As well as mothers and their children, there have been cases of mixed infections caused by associations of herpesviruses, most often with HSV. Conclusion. Detection of active forms of herpesviral infections in the absence of positive results in studies on viral and bacterial intestinal infections make it possible to assume that herpesviruses can participate in the etiology of these diseases and cause infectious complications in this pathology, as well as often act as a co-infection. An important epidemiological importance has a large number of identified latent forms of herpesvirus infections, because when exposed to adverse factors they can go into active forms.

Introduction. Acute intestinal infections and diarrhea-associated hemolytic-uremic syndrome (HUS) are the main cause of acute renal failure in children. Objective: to establish the frequency of development of acute renal failure in children hospitalized in the intensive care unit of an infectious hospital with severe forms of acute intestinal infections. Material and methods. A retrospective comparative statistical analysis of 123 case histories of children with acute intestinal infections who were undergoing treatment in the intensive care unit of the Grodno Regional Infectious Disease Clinical Hospital was conducted. Patients were divided into 3 groups: 1 group (n = 84) - children with acute intestinal infections and lack of clinical and laboratory signs of impaired renal function; 2 group (n = 27) - children with acute intestinal infections and prerenal acute renal failure (reduced diuresis, increased urea and / or serum creatinine, normalized against the background of ongoing rehydration therapy during the day); 3 group (n = 12) - children with acute intestinal infections and renal acute renal failure. Results. The age of the children was 1.0 (0.2, 2.2) year. Children prevailed up to a year – 49,6%, from one to five years – 42,3%, over 8 years – 8,1%. Oligouria was recorded in 28.5% of children, anuria in 3.3%. A statistically significant difference in levels of urea and creatinine in groups (p˂0,05) was established. The highest rates were observed in patients of the 3 group. In 9 of them (75%), a typical HUS associated with infectious diarrhea was diagnosed. Conclusion. In 21,9% of children with acute intestinal infections, prerenal acute renal failure was diagnosed, in 9,8% - renal. The main cause of renal acute renal failure in children with severe forms of acute intestinal infections is a typical HUS associated with the infectious etiology of diarrhea.

Aim. The objective of the study was to substantiate the rationality of using monochromatic polarized incoherent optical radiation (photochromotherapy) on the abdomen as a supplement to the standard program for the treatment of acute intestinal infections in children.Material and methods. Twenty-six children with acute intestinal infections from 6 months to 12 years old were observed during inpatient treatment. In the comparison group (n = 11), children received standard therapy, including diet therapy, rehydration, sorbents, probiotics or prebiotics, as well as indications for etiotropic drugs. In the main group, patients (n = 15) in addition to standard therapy received photochromotherapy as an effect on the abdomen with monochromatic polarized incoherent optical radiation from the Bioptron apparatus with a blue filter at a distance of 5 cm labile along the bowel. The duration of photochromotherapy was 5 minutes, the course of treatment included 4-5 sessions 1 time per day. The effectiveness of the therapy regimens used in the groups was assessed by the duration of the disease, the length of inpatient treatment, the dynamics of changes in the clinical blood test at the time of discharge. Results. The advantage of the technique with the addition of standard treatment of acute intestinal infections by photochromotherapy was established. In the main group of patients, the duration of the disease was significantly shorter (9,1±0,8 days) compared to the comparison group (10,2±1,5 days, p=0,02) against the background of a significant decrease in the severity of inflammatory manifestations in the hemogram in form of a decrease in thrombocytosis. Conclusion. The obtained data make it possible to recommend the method of photochromotherapy in the complex therapy of intestinal infections of various etiologies in children older than 6 months.

The article presents modern data on syndrome of acute, prolonged and chronic diarrhea in children, its etiology and mechanisms of development of different types of this di­sease and its clinical symptoms. Prolonged diarrhea is usually defined as acute-onset diarrhea lasting for 7 days or more, but less than 14 days. There is a trend towards its decline in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. Prolonged diarrhea is more difficult to treat than acute diarrhea, it often leads to nutritional and metabolic complications. The pathogenesis of prolonged diarrhea is multifactorial and is essentially based on persistent mucosal damage due to specific infections, host-related factors including micronutrient and/or vitamin deficiency, undernutrition, high mucosal permeability caused by previous infectious processes and nutrient deficiency with consequential malabsorption and microbiota disruption. The рathogenetic therapy of prolonged diarrhea is comprehensive and should include an assessment of the intestinal microbiome, evaluation of the enzymatic function of the child’s body, the presence of functional gastrointestinal disorders.

Acute intestinal infections remain an urgent problem of medicine due to the high level of morbidity and mortality. There are nearly 1.7 billion cases of childhood diarrhoeal diseases every year. Each year, diarrhoea kills around 525,000 children under five years of age. The article provides recommendations for the treatment of acute intestinal infections based on the international guidelines.

Nowadays dysbiotic complications are spread all over the world. They are usually accompanied by acute intestinal infections. The main infectious agents of acute intestinal infections of bacterial origin are microorganisms of the family Enterobacteriaceae . Functional fermented milk products are used to prevent such disorders. They help restore good intestinal microflora. The authors developed a production technology of fermented milk bioproducts that contain probiotics (bifidobacteria B.bifidum, B.longum, B.breve ), lactulose as prebiotic and immunoglobulin «Lactoglobulin against Potentially Pathogenic Bacteria and Salmonella». These products can not only restore «friendly» bacteria (lakto-and bifidobacteria) in intestine, but also suppress the development of potentially pathogenic microflora. The given article reveals how enriched kefir drinks influence bacteria of Enterobacteriaceae family. The authors used the method of comparing the developing mixed populations with the growth of the test strain in a monoculture based on liquid nutrient mediums with further inoculation on the solid nutrient mediums. The authors established the ability of the enriched kefir bioproducts to inhibit the development and multiplication of bacteria of the family Enterobacteriaceae , namely Salmonella typhimurium , Proteus mirabilis No. 878 (035), Escherichia coli 3912/41, Shigella sonnei (S-form) at simultaneous incubation on the solid mediums within 24 hours at 370. The analysis of the research results demonstrates that kefir products enriched with lactulose (which stimulates growth and development of bifido- and lactobacteria, that are present in the kefir drink and have antagonistic effect on enterobacteria) and immunoglobulin «Lactoglobulin» (which has antibodies to the potentially pathogenic bacteria and salmonella) are most capable of suppressing the development of pathogenic and potentially pathogenic enterobacteria, inhibiting their growth and multiplication, in comparison with the reference sample. The obtained results allow to assume that the developed products can be used to prevent and correct the negative changes in intestinal microflora and dysbiotic complications including acute intestinal infections caused by the representatives of the family Enterobacteriaceae.

According to the official statistical reports of the Ministry of Health in Ukraine using descriptive and analytical methods of epidemiological researches, epidemic process intensity in acute intestinal infections under the current conditions in Ukraine has been studied. It was found that epidemiological situation of acute intestinal infection incidence is unfavourable. The highest rates were registered in the administrative territories adjacent to the Black and Azov Sea as well as in Kharkiv region. Acute intestinal infections of unknown etiology and those caused by viruses and opportunistic pathogens prevail in the nosological structure. Epidemiological situation of acute intestinal infections becomes more complicated due to cases of outbreaks that are more often caused by salmonella and occur in public food facilities.

Acute infectious diarrhea in children is a global healthcare challenge [1]. In 2015, the incidence of acute intestinal infections (AII) in the Russian Federation amounted to 545.89 per 100 thousand people; that is almost exactly the same as in 2014. AII of unknown etiology account for 63.44% of cases. There are still significant differences in the effectiveness of the etiological diagnosis of AII in different areas of the Russian Federation. Along with a reduction in the incidence of separate nosologies, the incidence of campylobacteriosis increased by 30.3%, rotavirus by 14% and norovirus by 26.4% [2].

The article is a review of literature on the specific immunopathogenesis of rotavirus infection in children, as well as current treatment approaches. A clinical case is described demonstrating the effectiveness of the combined antiviral, release active drug Ergoferon. The results obtained in the course of the experimental and clinical studies of Ergoferon and its active components are confirmed by own experience and indicate the possibility of widespread use of the drug in the treatment of rotavirus infection in children as young as 6 months. The clinical efficacy of Ergoferon is explained by its three-component composition - affinity purified antibodies to interferon-gamma, histamine and CD4 in release active form, and a unique mechanism of action that affects the key immunopathogenetic links: the functional condition of CD4+T cells and the interferon synthesis. The antiviral activity of Ergoferon is supplemented by anti-inflammatory and antihistamine effects, thus ensuring a rapid relief of fever, dyspepsia and intoxication associated with rotavirus infection as early as on the 2nd-3rd day of therapy. Ergoferon is effective even if the therapy is started on the second day, while its high safety minimizes the risk of hyperstimulation of the immune system with its subsequent hyporesponsiveness.

Acute infectious diarrheal diseases by the terminology of the World Health Organization or acute intestinal infections (AII) as they are called in Russia is a large group of acute infectious diseases characterized by development in patient of the diarrheal syndrome. The article provides statistical data on the incidence rate of AII among children that take one of the leading places in the structure of the infectious pathology and characterizing by the high mortality rate. Special attention is given to pathogenesis and therapy of acute viral intestinal diseases.

One of the main tasks in expertise of living persons is to determine the harm caused to human health. According to the regulations, only harm to human health caused by an injury and causally related with it is taken into account in the forensic examination of a living person. The establishment of a causal link allows to assess correctly the harm severity caused to human health. In this respect, the study of the effect of biological damaging factor on human body (cause) and the result of this interaction (effect) is a new step in modern science. The article presents the analysis of data from the reports of the Russian Reference Center on monitoring of enteric infection agents for 2016-2021; the results of examinations of subjects who suffered from acute enteric infections for 2018-2019 to study causal links in forensic medicine in cases of acute intestinal infections.

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У статті наведено аспекти актуальності проблеми антибіотикорезистентності в сучасних умовах з акцентом на гострі кишкові інфекції, зокрема сальмонельоз. З метою оптимізації ефективності терапії сальмонельозу запропоновано використання дієтичної добавки Біоспорин та показаний її ефект у дітей раннього віку.

Management of acute intestinal infections remains relevant because of their high incidence, clinical aggravation of certain forms of infection, development of resistance of pathogens to traditional etiotropic medications, and an increase in side effects of antibiotic therapy. Excessive use of antibiotic therapy, even in less severe infections, as well as inadequate use of chemotherapy, may contribute to the development of dysbacteriosis manifested in antibiotic-associated diarrhea. In this case, bacteriophages could be an alternative to antibiotics in the treatment of bacterial diarrhea. Both infectionists and general practitioners should be prepared to develop a set of actions for the prevention and treatment of acute intestinal infections through bacteriophages and step-by-step diet therapy.

It is known today that the key role in maintaining human health belongs to intestinal microflora. Intestinal microflora can be subdivided into following groups: obligate flora, facultative (opportunistic) flora, transient flora, and pathogenic flora. A condition in which potentially harmful bacteria dominate the intestinal microflora is called dysbiosis. Almost all diseases of the gastrointestinal tract are accompanied by dysbiotic disorders. For some diseases, specific disorders of the composition of the microbiome have already been identified which could exacerbate and worsen the underlying disease. Pathogenic microorganisms often cause an acute intestinal infection (AII) in the human organism. AII are the most common cause of diarrhea in children. In the recent years, under the conditions of the growing antibiotic resistance, there has been an increase in the interest in bacteriophages.

The incidence of acute intestinal infections (AII) in the Republic of Dagestan in 2015 was higher than in the Russian Federation as whole, 4.6 times. In the structure of the AII of the revealed etiology, Shigellosis plays a predominant role. The article analyzes the outbreak of shigellosis, registered in 2016 in Makhachkala

The article shows a retrospective epidemiological analysis of the incidence of acute intestinal diseases in 2004 – 2013 in Sumy region. The etiological structure was studied. The properties of Klebsiella pneumoniaе, Enterobacter cloacae, Staphylococcus aureus and Salmonella Enteritidis in a cross-species interaction in populations were studied.It was found, the incidence rates were in the range 159.8 – 193.9 per 100 000 population. The structure of the nosology of acute infectious diarrhea, acute intestinal infection caused by opportunistic pathogens accounted 44.4%. Among the etiologic agents prevailed Klebsiella (28.2 – 34.7%), S. aureus (17.1 – 25.2%) and Enterobacter (12.6 – 18.8%) (p < 0.05). From fecal samples of children were isolated Rotaviruses in 39.5% of cases, adenoviruses – 28.2%, noro-, enteric- and astroviruses respectively – 26.2, 10.4 and 3.2%.It was found the changes in microecological characteristics of intestinal biocenosis in individuals without signs of acute intestinal infection. Association of micro-organisms was characterized by the absence or reduction in the number of representatives of obligate (Bifidobacterium), increasing the number of Enterobacteriaceae, the presence of coliform hemolysing, fungi of the genus Candida, coagulase-negative staphylococci. Among causative agents of diarrhoeal infections K. pneumoniae, E. cloacae and S. Еnteritidis in vitro were revealed indifferent relationships, S. aureus and S. Еnteritidis – synergistic.

The objective: to assess clinical features of food-borne diseases in patients with H. pylori infection.Materials and methods: 98 patients with an acute intestinal infection were examined for the presence of helicobacter pylori infection. Clinical and laboratory parameters were estimated in 82 subjects. Patients were distributed to two groups: 41 H. pylori-infected patients (H. pylori IgG antibodies and DNA in feces) and41 H. pylori-noninfected patients.Results: in patients with Helicobacter pyloriinfection a higher range of leukocytosis were indicated: 10,7±2,5×109/l vs 8,6±2,6×109/l respectively, р

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New approaches to pathogenetic therapy of acute intestinal infections remains a priority for clinical practice. Seventy one patients 71 with acute intestinal infections were include in the study. Thirty three patients of the treatment group received Mukofalk. Patients from treatment group recorded stool normalization earlier than those in the control group (2,9±0,9 days and 4,1±1,2 days of treatment, respectively, p

In order to evaluate contribution of the viral agents into the etiological structure of acute intestinal infection in children during the period of increase in morbidity rate due to intestinal infections from January 2009 to January 2010 there were studied 753 children with diarrheal diseases. It was shown that the diarrheal diseases have viral nature in 52,0% of cases. The Rotaviruses and adenoviruses play the leading role. The infectious agents of diarrheal diseases are presented by rotaviruses in 24,0% of cases, adenoviruses – in 19,1% of cases, astroviruses – in 8,9% of cases. The rising of sporadic morbidity with viral diarrhea was characterized by seasonality and depended on the age of children. On the basis of results of investigation for early diagnosis of viral diarrhea the introduction of the current methods of laboratory diagnosis, PCR into the work of the institutions of practical medicine may be recommended.

Acute intestinal infections remain a significant problem for the majority of economically developed countries. Acute intestinal infection disease incidence in the structure of infectious pathology steadily ranks the 2nd place after acute virus respiratory infections. The urgency of the acute intestinal infections problem is connected with the frequent occurrence of clusters of cases ( outbreaks ) .The last mass and the largest in the last 20 years outbreak of acute intestinal infection , was detected in St. Petersburg in 2013. The Russian Federation takes one of the first places in the world in the number of migrants. The usage of food , stored or ooked with violation of sanitary rules contributes to infection and a high prevalence of intestinal infections among migrants. In the process of medical care when analysing the outbreak among migrants a number of requirements and problems was revealed; solving these problems will make it possible to stop similar epidemic situations during the shortest period and at the lowest cost.

The paper presents the current views on the pathogenesis of acute intestinal infections in children and principles of therapy of diarrhea syndrome. Particular attention is paid to antisecretory therapy and the role of racecadotril in relieving diarrhea.

Analysis of the incidence rate over the past decade as regards acute intestinal infections in the Khabarovsk Territory has revealed unfavorable epidemiological situation on bacterial dysentery, enteric infections of rotavirus and undetermined etiology. The most unfavorable situation in the pre-freshet period was registered in the Nanai District. The large-scale preventive actions for immune-prophylaxis of viral hepatitis A, Sonne dysentery and typhoid fever, as well as a complex of anti-epidemic and sanitary-hygienic measures were performed during the summer flood of 2013. These measures provided for prevention of acute intestinal infections outbreaks as an aftermath and control over epidemiological situation in the Khabarovsk Territory during the flood.

The article presents data about epidemiological characteristics of outbreaks of acute intestinal infections in Bashkortostan for the five-year period, which were obtained in the course of analysis of annual reporting forms # 23 "Information of outbreaks of infectious diseases". Last few years the increasing number of outbreaks of acute intestinal infections and growing quantity of afflicted population are discovered, which is distinctly manifested in outbreaks, registered in organized groups of children and accompanied by steady spreading of pathogens spectrum (with prevalence of Salmonella), mainly transmitted (in 60-100 %) by food. The article also brings up the issue of the necessity of taking into account the identified characteristics of formation and manifestation of outbreaks of acute intestinal infections during the implementation of the system of epidemiological surveillance at regional and municipal levels, with optimization of all its components.

The article introduces the concept of sequential dietetics of acute intestinal infections in children which consists in phasing nutritional support of patients depending on their age, severity and stage of the disease.

The article deals with the study of the efficiency of using contemporary combined prebiotic and probiotic as the component of the holiatry in patients with acute intestinal infection. Clinical and microbiological efficiency of combined pre- and probiotic is well-proven as a bacterial preparation, that could corrects the abnormal intestine microbiocenosis from the first days of acute intestinal disease, caused by salmonella, shigella, citrobacter, proteus, pathogenic staphylococcus. Combined pre- and probiotic can be recommended in the holiatry for patients of different age and sex in case of acute diarrhea syndrome of probably infectious origin.