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Norovirus infection (NVI) ranks second in the structure of intestinal infections of viral etiology in children, is the main cause of outbreaks in all age categories and accounts for up to 50—90% of group cases. The incidence of NVI in the Russian Federation and the Yaroslavl region remains at a fairly high level. Purpose of the study: analyze the clinical and laboratory features of norovirus infection in children. Materials and methods: the article presents literature data on the significance of the problem of NVI in children at the present stage and the results of our own observations of 1332 children hospitalized in the Infectious Diseases Clinical Hospital of Yaroslavl in the period from 2017 to 2022. Results: in the age structure of cases, children of the first three years of life predominated (59.0%); children under 1 year old were 10.3%. An increase in the number of severe forms of NVI has been noted. The severity is due to toxicosis with exicosis. In recent years, NVI occurs in combination with other pathogens of intestinal infections, as well as respiratory viruses, which aggravates the course of the underlying disease, creating an important practical significance of the problem.

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.

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.

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.

A clinical observation of a Salmonella infection (seeding Salmonella enteritidis) in an 8-year-old child with invasive diarrhea in the form of gastroenterocolitis with se- vere toxicosis and exsicosis of II degree is described. In dynamics, this infection was complicated by acute kidney injury. Inflammatory changes (increased C-reactive protein, procalcitonin, neutrophilia), coagulopathy (increased D-dimer, fibrinogen), metabolic acidosis, azotemia (increased urea, creatinine), filtration disorders, urinary syndrome (proteinuria up to 0.495 g/l in a single serving, cylindruria, bacteriuria, erythrocyturia up to 5850/ml). Ultrasound revealed pronounced phenomena of mesadenitis, inflammatory changes in the intestine, cholestasis, an increase in the size and echogenicity of the parenchyma of both kidneys. Acute kidney injury of the 2nd degree according to KDIGO (increase in serum creatinine by more than 3 times) of prerenal origin was diagnosed. As a result of the complex treatment, a positive trend was obtained and the child was discharged under outpatient supervision.

The aim is to study the antibiotic and phage resistance of K. pneumoniae strains isolated from children with acute intestinal infections. Materials and methods. 490 K. pneumoniae strains isolated by the bacteriological method from feces from patients with intestinal infections of various etiologies aged from 1 month to 18 years in the period 2019—2021 were studied. The diagnosis of intestinal infection caused by K. pneumoniae was established taking into account the detection of the pathogen at a concentration of at least 5 lg CFU/g (n = 283; 57.8%). Children with Klebsiella seeding, made up three age groups: from 1 to 12 months of life (n = 245; 50%); from 1 to 3 years (n = 131; 26.7%); from 3 to 18 years (n = 114; 23.3%). Results. A higher frequency of K. pneumoniae seeding in high concentrations from fecal samples of children with intestinal infections aged from 1 to 12 months was established (?2 = 14.24; p < 0.001). Analysis of the frequency of K. pneumoniae resistance to antimicrobials revealed its increase to ampicillin/sulbactam from 4.2 ± 1.6% to 9.7 ± 1.9% and to gentamicin from 3.0 ± 1.3% to 7.6 ± 1.7% (p < 0.05) with an increase in the concentration of the pathogen from 3—4 to 5—6 lg CFU/ml. In K. pneumoniae strains isolated in low concentrations, resistance to polyvalent anti-klebsiella bacteriophage was significantly higher than to monovalent bacteriophage. Conclusion. Children of the first year of life belong to the risk group for the development of klebsiella intestinal infection. An increase in the frequency of K. pneumoniae resistance to ampicillin/sulbactam and gentamicin correlates with an increase in the concentration of the pathogen in fecal samples.

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.

Aim: to study the structure, features of the findings and treatment of mixed infections in children at the present stage.Materials and methods. 85 case histories of children aged 5 months to 17 years and 10 months were examined, the final diagnosis of which included 2 or more infections on the basis of the children's infectious diseases department City Clinical Hospital № 7 of Izhevsk. Children with acute infectious pathology (acute intestinal infections, acute respiratory infections, herpes infections) are hospitalized in this hospital. Diagnostic methods: polymerase chain reaction, ELISA, bacteriological.Results. Mixed infections are equally common in both boys and girls, while there is a predominance of mixed infections in young children (up to 1 year and from 1 year to 3 years) 62.4%. The structure of infectious morbidity is consistently dominated by acute enteric infection – 83.5% cases and acute respiratory infections – 53.0% cases. The progression of SARS-CoV-2-associated and herpes-associated mixed infections is characterized by a pronounced polymorphism of clinical manifestations. The etiological factor for each nosology was deciphered only in 17.7%; in 43.5% of cases, only one etiological factor was verified in the laboratory; in 38.8% of cases, no etiological factor was confirmed in the laboratory.

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.

The glucose positive coliform bacteria (GCB) were detected in drinking water, that meets the requirements of SanPiN, in the towns of Azov and Tsimlyansk. This figure includes the conditionally pathogenic and pathogenic microorganisms that have a high resistance to the disinfectants used in wastewater treatment plants. Therefore, when calculating the microbial risk of the occurrence of the acute intestinal infections transmitted by water way in the population, it is necessary to focus on the integrated GCB indicator.

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.

Clinical and epidemiological features of acute intestinal infections (AKI) caused by opportunistic enterobacteria (UPE) in young children, depending on the etiological factor were established. The information sources were the data of Rospotrebnadzor Administration in the Astrakhan oblast (AO), medical documentation (720 case histories) of patients under the age of 1 year treated in GBUZ «Regional clinical infectious hospital named. A. M. Nichogi» Astrakhan from January 2000 through December 2020. AKI caused by UPE in children in AO is 74%, including 60% in children under 1 year of age, of the total number of patients with AKI of specified bacterial etiology. Regardless of the etiological factor, AKI caused by UPE occurred in the form of monoinfection (83%), moderate severity (62%). Symptoms of intoxication had a direct correlation (r = 0,52 to 0,76; p < 0.001) with the severity of diarrheal syndrome and dehydration. With a decrease in the age of the child, the duration of relief of these symptoms increased (r = -0,72; p < 0,001).

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.

Objective: to establish the clinical and epidemiological features of acute intestinal infections (AII) in children in the Astrakhan region, depending on the etiological factor, age, season of the year.Materials and methods: a retrospective analysis of the incidence of acute intestinal infections in children in the Astrakhan region for 2019 and 3335 case histories of patients diagnosed with acute intestinal infections, under the age of 17 years, who were treated at the Regional Infectious Clinical Hospital, Astrakhan, during 2019.Research results: Acute intestinal infections of established etiology in children in the Astrakhan region is 35%. Among acute intestinal infections caused by established pathogens, the viral etiology of the disease occurred in 22%, bacterial in 78% of patients. The etiological structure of аcute intestinal infections in children has changed due to an increase in the number of intestinal infections caused by opportunistic bacteria. In the age structure of patients with acute intestinal infections caused by opportunistic bacteria, children of the first year of life dominated (69%). Refined viral diarrhea in 86% of patients proceeded with a topical diagnosis of enteritis, gastroenteritis, bacterial diarrhea proceeded on the type of enterocolitis and colitis in 91% of patients.

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.

In recent years, there has been an increase in the incidence of salmonellosis in children, including in the Yaroslavl region by 52.7%.In order to study salmonellosis in children at the present stage, we observed 185 patients aged from 1 month to 18 years who were hospitalized in the Infectious Clinical Hospital of the city of Yaroslavl from 2015 to 2017. The analysis of the main clinical, epidemiological and laboratory parameters was carried out and the peculiarities of the course of salmonellosis in children were established.Results: Salmonella enteritidis remains the dominant pathogen. The children of the first 3 years of life prevailed — 65.4%, of which under the age of 1 year — 18.9%, unorganized in preschool institutions — 49.2%. Alimentary infection was found in 49.7% of cases. In 71.4% of patients, the disease developed against a background of concomitant pathology. In most cases (74.1%), damage to the gastrointestinal tract was manifested by gastroenterocolitis or enterocolitis. In 38.9% of cases, salmonellosis occurred in combination with bacterial and viral pathogens, especially with rota and noroviruses (81.9%), which aggravated the course of the infection. Severe forms accounted for 24.9% and were due to the development of dehydration, mainly in patients with mixed infections.

Objective: to study the clinical and laboratory manifestations of acute intestinal infections of bacterial etiology in hospitalized children, depending on the etiology, age, topic of the lesion, and complications.A cohort clinical study of 570 children hospitalized from January to October 2019 in the infectious wards of Children's Clinical Hospital No.9 in Moscow was conducted. Studies included routine laboratory methods, bacteriological analysis of feces, Latex test, ELISA, PCR to detect pathogens, serological reactions to detect specific antibodies in blood serum. Two groups of patients were specially formed to compare the features of the course of bacterial diarrhea without hemorrhagic colitis (n = 111) and with hemorrhagic colitis (n = 125).Among 33.2% of cases of deciphered etiology of bacterial diarrhea, Salmonella was isolated in 14.6%, Campylobacter — in 4.7%, Shigella — in 3%, in other cases — conditionally pathogenic flora. Salmonellosis and Сampylobacteriosis with the same frequency are recorded in children in the age groups of 1—3 and 3—7 years, in half of the patients proceed as enterocolitis (58 and 52%, respectively). Shigellosis is diagnosed in children older than 1 year of life with the same frequency in age groups 1—3, 3—7 and older than 7 years, a third of patients (35%) develop severe forms.In most cases (83.2%), a complicated course of bacterial diarrhea was detected, more often dehydration 1 and 2 degrees (36.5%), acute respiratory viral infections (19.6%), mesadenitis (11.2%), community-acquired pneumonia (4.6%).Enterocolitis is the topic of lesion in half of the children, and every 5th patient develops hemorrhagic colitis (21.9%). In 44% of cases of established etiology of hemorrhagic colitis, Salmonella was confirmed. Hemocolitis also develops more often with shigellosis, campylobacteriosis and clostridiosis. In the group of bacterial diarrhea with hemorrhagic colitis, significant differences were revealed compared with the group without hemocolitis: by the frequency of development in children under 3 years of age; by the duration of treatment in a hospital; by the frequency of mesadenitis; by the content of stab neutrophils in the hemogram, reflecting a more pronounced inflammation in hemorrhagic colitis.Thus, bacterial diarrhea in children remains relevant due to the severity of inflammation, the incidence of complicated course and hemorrhagic colitis, which requires hospitalization.

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.

A clinical study was conducted to evaluate the effectiveness of Adiarin ^Ыте tannatе) in infants and young children with acute intestinal infections (AII) of various etiologies. As a result of the study, reliable positive dynamics of the main clinical symptoms of acute intestinal infections (reduction of the duration of diarrhea, normalization of stool frequency and nature) were established when the drug Adiarin ^Ыте tannatе) was used in the acute period of the disease, which indicates its effectiveness.

The article presents modern data on etiology of acute intestinal infections, their clinical manifestations, modern approaches to diagnosis and treatment. The questions of probiotic and metabolic therapy in acute intestinal infections are discussed. The antimicrobial, antitoxic, enzymatic action of a preparation based on the concentrate of metabolic products of saccharolytic (L. acidophilus, L. helveticus and E. faecalis) and proteolytic (E. coli) microflora, is explained. Evidence of its effectiveness in the treatment of infectious diarrhea of different etiologies in children is presented.

The article presents the basic information about the various effects of probiotic strains on the formation of resistance of the human body to various pathogens and immune response. The data of studies confirming the influence of lacto- and bifidobacteria on the incidence of various acute respiratory and intestinal infections are presented. It is shown that preventive administration of compositions containing studied probiotics, or, if necessary, polycomponentsynbiotic complexes, promotes adequate functioning of the immune system, reduces seasonal morbidity in children and adults.

Acute intestinal infections is a significant issue in pediatrics. One of the links of pathogenesis is destabilization of microbiocenosis system, which is associated with the action of intestinal infection agents. In this connection, probiotics become the key link of pathogenic therapy of acute intestinal infections. Prescription of these preparations allows to reduce the period of diarrheal syndrome and probability of severe forms development. Choosing the strategy of probiotic therapy, it is necessary to follow the features of the strains which proved their efficiency under acute intestinal infections.

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.

A retrospective analysis of the etiological structure and clinical manifestations of acute intestinal infections was conducted in 8459 children hospitalized in a specialized infectious disease department at the Children's City Clinical Hospital No.9 in Moscow, in 2015—2017 based on the study of statistical reports of the Children's City Clinical Hospital No.9 for 2015—2017 and 2417 case histories of children aged 1 month to 18 years old.It was found that children with age 1—7 years of age (58.5%) are more likely to have acute intestinal infections and are hospitalized. The etiological interpretation of acute intestinal infections remains at a low level and is 28.6%. The leading causative agents of acute intestinal infections are viruses (83%), mainly rotaviruses (62%), less often noroviruses (18%). Topical diagnosis in the vast majority of patients with acute intestinal infections was gastroenteritis (74.7%), which leads to the development of toxicosis with exsiccosis, especially in young children, which is the reason for hospitalization in the hospital. The share of bacterial diarrhea is small (17%), among them salmonella is significant, and in young children — staphylococcal infection. In recent years, the relevance of identifying campylobacter and clostridium, these pathogens may be the cause of the development of diarrhea with hemoccolitis.

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.

Specific features of the course of acute intestinal infections of viral and bacterial etiology in children are described, features of the syndrome of endogenous intoxication in children carrying infectious diarrhea are characterized. As a result of the study, the efficacy and safety of gelatin tannate (LLC «YADRAN», Croatia) with intestinal infections of bacterial and viral etiology in children has been confirmed.

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].