СЕРОТИПОВОЕ РАЗНООБРАЗИЕ И РЕЗИСТЕНТНОСТЬ ПНЕВМОКОККОВ

The pneumococcus (Streptococcus pneumoniae) is a common bacterial pathogen responsible for various infections, especially in children below5 years of age. The severity of pneumococcal infections varies from self-limiting mucosal infections, including acute otitis media, sinusitis, and noninvasive pneumonia, to life-threatening invasive disease like bacteremia and meningitis. A high incidence of pneumococcal infections is combined with a constantly growing antibiotic resistance of this pathogen. The growing resistance is thought to be associated with misuse of antibiotics and emerging of resistant clones that may spread throughout the entire population. Pneumococcal polysaccharide conjugate vaccines (PCV) contain an assortment of pneumococcal capsular polysaccharides (from 7 to 13) that produce serotype-specific protective antibodies. Since early 2000’s, the introduction of PCV into national immunization programs has been shown to substantially decrease the incidence of invasive pneumococcal disease and pneumococcal carriage associated with vaccine-type pneumococci in many countries. In 2014, PCV vaccination was included in the Russian national calendar of prophylactic vaccination. The present article reviews the current literature on serotype prevalence, antibiotic susceptibility, and PCV effect on the evolution of pneumococcus.Пневмококк (Streptococcus pneumoniae) входит в число главных возбудителей острых бактериальных инфекций у детей, особенно в возрасте до 5 лет. Пневмококковые инфекции могут быть мукозальными (например, острый средний отит, синусит, неинвазивная пневмония) и инвазивными, которые включают тяжелые, нередко жизнеугрожающие заболевания (менингит, сепсис). Высокая заболеваемость пневмококковыми инфекциями сочетается с неуклонным ростом резистентности пневмококка к антибактериальным препаратам, наиболее широко используемым в клинической практике. В популяции резистентных пневмококков доминирует небольшое число клонов, которые имеют глобальное распространение, поэтому понимание молекулярных механизмов устойчивости к различным классам антибиотиков помогает прогнозировать вероятность экспансии резистентных генов на конкретной территории. Широкое использование пневмококковых конъюгированных вакцин (ПКВ) для профилактики пневмококковых инфекций оказало существенное влияние на сероэпидемиологию пневмококка в тех странах, где они включены в национальные календари иммунизации. Эти вакцины содержат полисахариды нескольких капсульных вариантов — серотипов — пневмококка (от 7 до 13), в ответ на которые вырабатываются серотипспецифические антитела. ПКВ показали свою высокую эффективность, резко снизив циркуляцию вакцинных пневмококков как среди пациентов с инвазивными инфекциями, так и у носителей. В 2014 г. вакцинация ПКВ была включена в российский календарь профилактических прививок, поэтому современные мировые и российские данные о распространенности серотипов, антибиотикорезистентности и влиянии вакцинации на эволюцию пневмококков, представленные в настоящем обзоре, приобретают особую актуальность

ROLE OF AZITHROMYCIN IN COMPLEX TREATMENT OF RESPIRATORY DISEASES IN CHILDREN

The article contains the analysis of the role of azithromycin (sumamed) in treatment of respiratory diseases in children. It is noted that azithromycin is an efficient antibacterial drug for treatment of extramural and uncomplicated pneumonia and is the drug of choice for atypical mycoplasmal and chlamidia trachomatis pneumonia, as well as for relapses of chronic bronchopulmonary diseases in children. High sensitivity to azithromycin of main pneumotropic and atypical agents, convenience of application, presence of children's pharmaceutical forms, reduction of administration to 1 time per day in case of short treatment schedules, high efficiency and absence of serious adverse events make it possible to recommend this antibiotic as an available means for treatment of respiratory diseases in infants and senior children not only as in patients but as out patients as well.Key words: children, azithromycin, treatment, respiratory diseases

ETIOLOGY AND INNOVATIVE APPROACH TO THE TREATMENT OF ACUTE AND CHRONIC INFECTIOUS INFLAMMATORY DISEASES OF BRONCHOPULMONARY SYSTEM IN CHILDREN

The article presents modern data on etiology of acute and chronic inflammatory diseases of airways in children. Special attention is given to the treatment with oral antibiotics and to the meaning of these drugs. Authors give a literature review of biological, pharmacokinetic and anti-microbal activities of macrolides and particularly azithromycin. Detailed characteristics of effects of macrolide antibiotic azithromycin and tactics of its administration for the treatment of airways diseases in children are presented. The article describes nonantibacterial effects of azithromycin: anti-inflammatory, immunomodulatory and mucoregulatory ones. New activities of azithromycin are structural and functional defence of respiratory epithelium and ability to prevent adhesia of microorganisms. These properties of a drug widen the indications of its administration. The reasonability of its use for treatment of out-of-hospital pneumonias including atypical ones (mycoplasmal and chlamidia pneumonias) and in patients with exacerbations of chronic inflammatory bronchopulmonary diseases was show.Key words: children, acute and chronic respiratory diseases, pneumococcus, hemophilus influenza, azithromycin.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 124–130)</span

ETIOLOGY AND INNOVATIVE APPROACH TO THE TREATMENT OF ACUTE AND CHRONIC INFECTIOUS INFLAMMATORY DISEASES OF BRONCHOPULMONARY SYSTEM IN CHILDREN

The article presents modern data on etiology of acute and chronic inflammatory diseases of airways in children. Special attention is given to the treatment with oral antibiotics and to the meaning of these drugs. Authors give a literature review of biological, pharmacokinetic and anti-microbal activities of macrolides and particularly azithromycin. Detailed characteristics of effects of macrolide antibiotic azithromycin and tactics of its administration for the treatment of airways diseases in children are presented. The article describes nonantibacterial effects of azithromycin: anti-inflammatory, immunomodulatory and mucoregulatory ones. New activities of azithromycin are structural and functional defence of respiratory epithelium and ability to prevent adhesia of microorganisms. These properties of a drug widen the indications of its administration. The reasonability of its use for treatment of out-of-hospital pneumonias including atypical ones (mycoplasmal and chlamidia pneumonias) and in patients with exacerbations of chronic inflammatory bronchopulmonary diseases was show.Key words: children, acute and chronic respiratory diseases, pneumococcus, hemophilus influenza, azithromycin.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 124–130

ACUTE URINARY INFECTIONS AMONG CHILDREN AND THEIR ANTIBACTERIAL THERAPY

The article highlights the findings as to the peculiarities of clinical manifestations and diagnostics of urinary infection in childhood. The researchers provide the information on the urinary infection agent structure and e. coli resistance frequency (most widely spread agent) towards the antibacterial medications. They have also offered recommendations for rational antibiotic therapy.Key words: urinary infection, children, e. coli, cephalosporin of iii generation, ceftibuten

PECULIARITIES OF AMOXICILLIN AND CLAVULANIC ACID APPLICATION AMONG CHILDREN, SUFFERING FROM CHRONIC OBSTRUCTION LUNG DISEASES

The authors review the application peculiarities of augmentin combined antibiotic (amoxicillin + clavulanic acid), analyze its efficacy during the exacerbation of the chronic obstruction bronchopulmonary process among children. They provide indications, contraindications and intake peculiarities of the given medication among children.Key words: amoxicillin, clavulanic acid, chronic obstruction lung diseases, exacerbation, children

INHALATION ANTIBIOTICS ARE ESSENTIAL FOR THE CONTROL OF INFECTION IN CHILDREN WITH CYSTIC FIBROSIS

The article discusses the problem of basis therapy in patients with chronic Pseudomonas aeruginosa infection and cystic fibrosis. Authors showed the safety, good tolerance and high efficacy of constant treatment with special tobramycin solution delivered by nebulizer (Tobi) in children including ones under 6 years old. Even first inhalations of tobramycin result in decrease of Pseudomonas aeruginosa rate in bacterial inoculation or to it complete removal. The drug helps stabilization of clinical and functional state of patients, improvement of airflow and common state, and to clinical remission.Key words: children, cystic fibrosis, chronic Pseudomonas aeruginosa infection, tobramycin, nebulizer therapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 119–123)</span

INHALATION ANTIBIOTICS ARE ESSENTIAL FOR THE CONTROL OF INFECTION IN CHILDREN WITH CYSTIC FIBROSIS

The article discusses the problem of basis therapy in patients with chronic Pseudomonas aeruginosa infection and cystic fibrosis. Authors showed the safety, good tolerance and high efficacy of constant treatment with special tobramycin solution delivered by nebulizer (Tobi) in children including ones under 6 years old. Even first inhalations of tobramycin result in decrease of Pseudomonas aeruginosa rate in bacterial inoculation or to it complete removal. The drug helps stabilization of clinical and functional state of patients, improvement of airflow and common state, and to clinical remission.Key words: children, cystic fibrosis, chronic Pseudomonas aeruginosa infection, tobramycin, nebulizer therapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 119–123

ASSESSMENT OF THE EFFICACY OF COMBINED EFFECT IMMUNOMODULATOR INOSINE PRANOBEX IN PREVENTING RESPIRATORY INFECTIONS IN CHILDREN WITH ALLERGIES

Among children with allergies, particularly with bronchial asthma, patients susceptible to frequent acute respiratory infections make up a large group. In recent years, a strong focus has been on persistency of viruses and other pathogenic microorganisms in various areas of the respiratory tract, which leads to change in responsiveness of the organism and warrants the practicability of applying agents with a combined immunomodulating and antiviral effect. The purpose of this study was to assess the clinical and immunological efficacy of inosine pranobex in children with bronchial asthma and frequent respiratory infections. 37 children with atopic persistent moderate asthma at ages 4 to 15 were examined, 26 of which were administered inosine pranobex orally in prevention dosages at 50 mg/kg twice a day over 14 days. The control group was made up of 11 children who were on no immunopharmacological prevention course. Virus antigens in nasopharyngeal smear samples were identified, cytokine status and antibody immune response were studied. In the main group, 23 children (88,5%) were found to have the frequency and length of intercurrent acute respiratory viral infections decreased 1,5 times (p &lt; 0,05) and the number of asthma attacks decreased 1,7 times (p &lt; 0,05). The obtained results demonstrate the efficacy of preventing respiratory infections with inosine pranobex in children with bronchial asthma and other allergic diseases. Key words: acute respiratory infections, allergy, bronchial asthma, children, prevention, immunomodulators, inosine pranobex. (Pediatric Pharmacology. – 2010; 7(5):30-37

ОПЫТ ПРИМЕНЕНИЯ ЦЕФТИБУТЕНА ПРИ ОСТРЫХ МОЧЕВЫХ ИНФЕКЦИЯХ У ДЕТЕЙ

The article highlights the findings as to the peculiarities of clinical manifestations and diagnostics of urinary infection in childhood. The researchers provide the information on the urinary infection agent structure and e. coli resistance frequency (most widely spread agent) towards the antibacterial medications. They have also offered recommendations for rational antibiotic therapy.Key words: urinary infection, children, e. coli, cephalosporin of iii generation, ceftibuten.В статье представлены данные об особенностях клинических проявлений и диагностики инфекций мочевых путей (ИМП) в детском возрасте. Приведена информация о структуре возбудителей ИМП и частоте резистентности E. coli (наиболее распространённого возбудителя) к антибактериальным препаратам. Предложены рекомендации по рациональной антибиотикотерапии. Ключевые слова: инфекция мочевых путей, дети, E. coli, цефалоспорины III поколения, цефтибутен.(Педиатрическая фармакология. – 2006;3(6):58-60