Pediatric Research and Clinical Center of Infectious Diseases under the Federal Medical Biological Agency, Saint Petersburg, Russia Investigation of the role of cerebrospinal fluid components in the processes of patho- and sanogenesis of central nervous system diseases is a fundamental problem of medicine and biology. The work aim was to study immunomodulatory features of cerebrospinal fluid in case of bacterial purulent meningitis (BPM) in children by an in vitro experiment.

There were studied immunomodulatory features of high-molecular and low-molecular fractions of cerebrospinal fluid of 33 children with bacterial purulent meningitis of different etiology and 12 children without meningitis by phytohemagglutinin (PHA)-stimulated reaction of leukocyte blast transformation. There was studied the influence of homogeneous cerebrospinal fluid samples of 8 children with bacterial purulent meningitis upon the production of immunoregulatory cytokines by blood cells. Concentration of cytokines (Interleukin (IL)-12, Tumor necrosis factor (TNF)-a, IL-8, IL-6, IL-10, IL-1b) in supernatants of 3-day old cultures of blood cells was detected by flow cytometry method.

The effects of cerebrospinal fluid fractions directed on both stimulation and suppression of blast production were identified by phytohemagglutinin-stimulated reaction of leukocyte blast transformation (PHA-RLBT) test. The maximal frequency of stimulating effect of fractions was revealed in children with meningococcal meningitis. There was detected a link between the dynamics of blast forms production under the influence of cerebrospinal fluid fractions and severity of the disease course. The studied cerebrospinal fluid samples of children with bacterial purulent meningitis stimulated IL-6 proinflammatory cytokine production by blood cells as much as possible whereas the influence upon the synthesis of other immunoregulatory cytokines was ambiguous.

The purpose of our study was to investigate the characteristics of severe form of influenza A (H1N1) pdm 2009 with a fatal outcome, given the comorbidities. Materials and methods. Medical histories of 105 people who died in hospitals of St. Petersburg for the period of the epidemic of 2015/16 served as material for analysis.

The lethality caused by the pandemic virus type A/ H1N1 / 2009 pdm was higher in males. Most of the patients had concomitant chronic diseases in the anamnesis. Obesity was observed in 44.8% (47/105) of patients, diabetes mellitus — 28.5% (30/105), isolated heart disease — 19.0% (20/ 105), combined pathology — 48.6% (51/105). In the first biochemical analysis of blood, creatine phosphokinase, lactate dehydrogenase were increased, total protein and prothrombin consumption index were reduced. The patient's death occurred after 5 days of illness in 88.6% cases, in 11.4% — up to 5 days of illness (inclusive). The analysis of fatal cases up to 5 days of a disease and death from complications (2—4 week) didn't find significant differences in the character and frequency of comorbidity. Specific antiviral therapy has been assigned to all patients, but 48 hours later.

Bilateral subtotal viral and bacterial pneumonia was identified on the section, in the majority of cases, in 70.5% with hemorrhagic component. 30% patients had cerebral oedema, 41% patients had severe toxic parenchymatouse degeneration of miocardium, liver and kidneys. The pathology of the cardiovascular system, diabetes and obesity worsen the prognosis of the disease. Increased creatine phosphokinase, lactate dehydrogenase, and reduced total protein and prothrombin consumption index can be considered as markers of severe influenza. The ineffectiveness of antiviral therapy due to its late appointment, thus timely initiation of etiotropic treatment is very impotent. 

The aim of this study was to investigate the clinical and diagnostic significance of the detection of core-antigen of hepatitis C virus (HCV) in children with chronic hepatitis C (CHC). Sera of 101 patients and 24 non-infected participants were analyzed. Core-antigen was determined by chemiluminescent method using «ARCHITECT HCV Ag» (Abbott, USA). HCV RNA was detected by highly sensitive OT-PCA. The presence of liver fibrosis was established by non-invasive methods. Antibody to core-antigen was detected by ELISA using commercial test-systems. A correlation was found between concentration of core-antigen and HCV RNA, viral subtypes, ALT level, and presence of liver fibrosis. High sensitivity and specificity of the chemiluminescent method for the detection of core antigen in children with CHC was shown. For the first time three ranges of core-antigen concentrations were proposed. 

In recent years, the number of adenoviral epidemic keratoconjunctivitis (EKC) cases in a neonatal intensive care unit (NICU) has increased, which is primarily due to the establishment of an ophthalmologic service in these institutions, and the increase of the number of ophthalmologic examinations and manipulations.

To characterize the features of the course and to identify the most effective methods of preventing adenoviral EKC of children during the first months of life who are on care and treatment in NICU. Adenoviral EKC is diagnosed in 284 children aged from 2 days to 3 months, who are on nursing in perinatal centers of Moscow. In 165 children with EKC retinopathy of prematurity (ROP) was noted. The course of adenoviral EKC in children in the age of the first months was accompanied by eyelids edema and conjunctiva edema, the formation of membranes (49.3%), hemorrhages (69.7%), corneal edema (30.3%), and absence of folliculosis of the eyelid conjunctiva. Cornea infiltrates occurred in 1.9% of cases and always disappeared in 1—2 weeks. after appearance. The development of adenoviral EKC in premature infants against the background of ROP complicates its course. Carrying out laser coagulation in children with ROP against the background of adenoviral EKC is safe and causes the same effect as in children without conjunctivitis. Conducting cryocoagulation at the peak of the conjunctivitis course is ineffective. Adherence to measures of the prevention of adenoviral EKC reduced the duration of the outburst to 1 month.

The course of adenoviral EKC of children during the first months of life is severe, but in the end, no one child had any complications (long-term corneal infiltrates, conjunctivitis adhesions).

A comparative study of the state of health of 110 women with allergopathology at the stage of pregnancy and their newborn children, with an assessment of the influence of factors burdening fetal fetal development and contributing to the implementation of allergopathology in the first months of life.

Trigger factors of disturbances in the formation of the intestinal microbiota, immune system and congenital decrease in the resistance of the child's organism — gestosis (c2 = 5.2, p = 0.022), Feto-placental insufficiency (c2 = 6.2, p = 0.012), chronic intrauterine fetal hypoxia (c2 = 5.7, p = 0.017), due to the presence in a woman with an allergic disease of combined somatic pathology and pathology of the genitals, malnutrition and microecological status.

Such women should be classified as a high-risk group for intrauterine fetal sensitization and taken from the first days of pregnancy for primary prevention of allergopathology already at the stage of intrauterine development of the fetus. 

The purpose is to characterize the features of the clinical picture, interferon and immune system status in shigellosis associated with herpesvirus infections in children, and to justify the inclusion of recombinant interferon-a2b (VIFERON®) in the complex treatment program of the disease. Clinical and immunological examination of 136 patients with shigellosis at the age from 1 to 3 years was carried out. In 65 children the active form of herpesvirus infection was diagnosed, in 20 patients it was absent. Active form of herpesvirus infection developed in children with a burdened premorbid background. These patients showed a violation of the immune response regulation by cellular type (reduction of interferon-g spontaneous and stimulated production, expression of CD119 receptors), the effector stage of the adaptive immune response. Clinically associated shigellosis was characterized by a severe course, a frequent development of complications. Inclusion of recombinant interferon-a2b (VIFERON®) in the complex program of treatment promoted the modulation of the regulatory and effector stages of the immune response. There was a reduction in the duration of the main symptoms of the disease and the stay of patients in the hospital.

High efficiency of recombinant interferon-a2b (VIFERON®) application make it possible to recommend the inclusion of this drug in the treatment of shigellosis associated with herpesvirus infection in children. 

During 1993—2016 there were treated 1255 children 9 months — 14 ages old with tick-bite infections in Kirov Infectious Clinical Hospital and 1214 children from them with the verified diagnosis of Lyme disease. Damage of nervous system was detected in 98 (8.1%) patients in the forms of serous meningitis, meningoencephalitis, polyneuropathies, neuropathies, disseminated encephalomyelitis, diencephalic syndrome with impaired thermal regulation. 45.9 % of cases were mixed-infection (tick-bite encephalitis and Lyme disease). 

The results of genotyping of feces from 53 childrens with rotavirus infection are presents. The techniques of enzyme-linked immunosorbent assay and polymerase chain reaction were applied. In the Orenburg region, during epidemic seasons (2016—2017) 6 genotypes of rotaviruses group A were circulating. The frequency of detection of genotypes [P]G of rotaviruses group A was as follows: G9[P]8 — 54.7%; G4[P]8 — 26.4%; G2[P]4 — 9.5%; G1[P]8 — 5.6%; G3[P]8 — 1.9%, GХ[P]8 — 1.9%. The dominant genotype alternatives of rotaviruses are detected and their regional diversity of combinations. The genotypes G9[P]8 and G4[P]8 were presented as the most frequently occurring in this period. The clinical characteristics of rotavirus infection in children depending on genotype in different age groups is established. 

The analysis of the antenatal period of ontogeny in 1267 children of city Achinsk found risk factors that contributed to the development of pathology in the early postnatal period in 43.7% of newborns, the emergence of an acute infectious (32.5%) and somatic (19.2%) pathology requiring hospitalization in 6.9% of cases. The pilot project on immunization against rotavirus infection of newborns in city Achinsk has reduced the number of hospitalizations for intestinal infections in this group by 39.1%. 

The analysis of serological efficiency and duration of maintaining specific immunity at the children imparted by various vaccines against hepatitis B within the national calendar of inoculations in the territory of St. Petersburg is submitted. It is revealed that high credits of antibodies (more 100 mME/ml) were more often observed at children in the first 3 years after vaccination (68.2%). Eventually levels of antibodies decreased, and in 5 years protective credits have remained at 84.5% examined, the number of patients with a caption of antibodies less than 10 Mmeml has grown from 8.5 to 15.5%.

This review article presents the current data on vitamin D metabolism, «classical» and «nonclassical» functions which are most widely studied in recent years. Vitamin D inhibits cell proliferation and stimulates cell differentiation, inhibits adaptive immunity and promotes innate immunity. In recent years, proven the impact of vitamin D on the development and functioning of the nervous system, including the process of myelination. These effects can largely determine the role of vitamin D in the prevention and for a number of widespread diseases of modern man, including infectious pathology, autoimmune diseases, neuropsychiatric disorders, which explains the necessity of studying the therapeutic potential of vitamin D in a variety of human pathology. 

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. 

The results of application of the drug of natural origin (Aflubin) with immunomodulating, anti-inflammatory, detoxifying effect in complex treatment of influenza and acute respiratory infections in children are presented. The inclusion of Aflubin in the complex treatment of diseases contributed to reducing the severity and duration of intoxication, reducing the duration of catarrhal phenomena, preventing the development of secondary bacterial complications. Relative simplicity of the drug (drops) at affordable cost, therapeutic and preventive efficacy in all age groups ensure its high compliance. 

Acute respiratory infections and diarrheas are the main cause of hospitalization. We do not have a routine practice of etiological verification of respiratory viruses, the diagnosis is based on clinical presentation and instrumental investigations. We do not perform identification of respiratory syntycial virus (RSV), however there are effective methods of specific prophylactic and treatment with monoclonal antibodies available worldwide. Another point is wide application of antibiotics without clear indications on bacterial infection, especially if a patient is hospitalized. We analyzed clinical data of children aged 0—3 months with acute respiratory viral infections and found a big number of patients with bronchoobstruction associated with bronchiolitits which in fact points on possible involvement of RSV.