The results are presented of a comprehensive  study in 108 children aged 6 months up to 12 years, suffering various variants of mycoplasmal and herpesvirus infections (HVI): in mono and mixed combinations. The aim of the study was a comparative assessment of the state of the microbiota of the two main biotopes, the oropharynx and the intestine, depending on the variant of mycoplasmosis and HVI flow.

A correlation  was established between the depth of dysbiosis of these biotopes, the variant of the course of mycoplasmosis and HVI, and cardiovascular disorders. Immunological criteria for the formation of post-inflammatory fibrosis of blood vessels and heart valves against the background of vasculitis in mycoplasmal-herpesvirus infection have been determined.

Objective. To reveal the clinical and epidemiological features of еnterovirus meningitis (EVM) in 140 children of Krasnoyarsk in the period of seasonal rise of morbidity in 2017.

Materials and methods. For the etiological interpretation of the enterovirus infection (EVI), a molecular biological and virological study of the cerebrospinal fluid, two samples of feces, a swab from the oropharynx, the contents of the vesicles was carried out. Statistical processing of data was carried out using the PASW Statistics 17.0 program.

Results. In the Krasnoyarsk Territory, an annual increase in the incidence of EVI is registered, exceeding the average for the country. Serous meningitis is traditionally the main clinical form of EVI. Among the observed patients with EVM, the main group consisted of preschool children (32.9%) and school age (30%), mainly organized in children's groups (84.3%), and the summer-autumn seasonality of the disease remains. Meningitis was observed in 82.8% of patients, meningitis combined with exanthema — in 10%, with herpangina — in 2.1%, with myalgia  — in isolated cases . Mediastinal forms of the disease predominated (96.4% — 135 people), severe forms of the EVM were diagnosed only in 3.6% (5 patients). The clinical picture is traditionally represented by three leading syndromes: intoxication, cerebral and meningeal. The implementation of the epidemic process in 2017 was mainly represented by enteroviruses Coxackie B, B1, B2, B4. Despite the relatively favorable course of the EVM, residual events were in 10% of patients (14 people) at the time of discharge.

The article presents the analysis of clinical and immunological features of the combined course of pertussis and respiratory chlamydia in children. The study of the prodromal period and spasmodic cough symptoms showed that concomitant chlamydial infection did not significantly affect the severity of pertussis: 63.2% of patients had mild degree and 36.8% — moderate severity of the disease. However, in this case, the disease was delayed. Bronchitis and in some cases obstructive bronchitis was observed mainly in children under 1 year.

The study of the lymphocytes subpopulation found that the content of NK cells decreased only in 10.5% of children, T helpers — in 21.1%, the ratio of CD4+ /CD8+ — in 26.3%. The function of cytokine network was characterized by more active production of such proinflammatory cytokines as IFN and TNF than their production during pertussis monoinfection. The levels of production of IL-8 and IL-6 were similar in all the studied groups. The production of IL-4 by lymphocytes in children with whooping cough in combination  with chlamydial infection was weaker then in patients with pertussis monoinfection  or in healthy children. These features are considered as immunological predictors of long reconvalescence in patients with association of pertussis and respiratory chlamydia.

Purpose: to study the features of the parietal intestinal microbiota of pregnant women at risk of intrauterine infection and their effect on the mother-placenta-fetus system and the formation of infant health.

Materials and methods. 20 mother-child pairs of a risk group for intrauterine infection with an assessment in mothers: the course of previous pregnancies, the presence of infectious and inflammatory diseases of the pelvic organs, as well as monitoring of the current course of pregnancy, childbirth, the postpartum period and the course of the neonatal period were performed. in their infants: the presence of perinatal infections-cytomegalovirus infection and neonatal herpes, transferred to ARVI, the nature of feeding. All women  for 34—37 weeks of gestation and their infants in 15—30 days of life to evaluate the species and quantity composition of the parietal intestinal microbiota used the method of gas chromatography-mass spectrometry with the determination of the concentration of microbial markers (fatty acids of the cell wall of microorganisms) by drop of blood, concentration which is identical to that of the parietal microbiota of the intestine.

Results: In all women,  an excessive number of microbial markers, predominantly of the Firmicutes type: Anaerobes, Aerobic Actinomycetes, Cocci, Bacilli and some species of microscopic Fungi, were detected in the deficit of priority genera (Bifidobacterium spp., Lactobacillus spp., Eubacterium spp., Propionibacterium), which led to a decrease in the plasmalogen level to 12—39 μmol / L (norm 50) and the excess of endotoxin to 1.5 nanomol / ml (normal 0.5), as well as the excess of the reference values of the markers of the herpes viruses by 3 or more times and their associations.

Conclusion: violations of parietal intestinal microbiota of pregnant women and their negative impact on the «mother-placenta-fetus» system and the formation of infant health have been established.

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.

Objective: study of immune status indices in newborns  in cases of late detection of cytomegalovirus (CMV) DNA in blood and urine.

Methods: 147 newborns  with non-specific clinical symptoms were studied. Тyping of lymphocytes relating to different clusters CD3+, CD69+, CD71+, CD95+ using monoclonal antibodies produced by IMMUNOTECH (France) have been performed. Expression of membrane markers of immunocompetent  cells was measured on a laser flow cytofluorometer Beckman COULTER Epics XL II.

Results: In 123 newborns CMVI has been confirmed by the positive result of PCR, while in 24 newborns the negative result was obtained. In 24 three-month old babies, who had a negative  result following DNA diagnostics in the first month  of their life, cytomegalovirus in blood and urine and increase of anti-CMV IgG have been found, which allowed to diagnose CMVI.

The following formula reflecting the dependence of CMVI on CD69+ and CD95+ content in newborns having non-specific clinical symptoms in cases of late detection of CMV DNA has been offered.

The article reflects the changes in both cellular and humoral immunity in rotavirus infection, as well as the correlation between the degree of severity of immunological disorders and the peculiarities of the clinical course of the disease in childhood.  The most significant changes in cytokine status are associated with an increase in interleukin-1b, which is a marker of intoxication. In addition, during rotavirus infection in children reduced the level of induced interferon a and у, that justified the application of a2b-interferon that is part of the drug VIFERON®, containing also vitamins E and C. The appointment of drug VIFERON®, along with basic therapy, including the probiotic strains LGG and ВВ12 in the complex of therapeutic measures  in children with rotavirus infection allows to improve the dynamics of clinical and immunological indicators, as well as to reduce 1.5 times the number of cases of ARI within 6 months of the follow-up observations after the acute period of the disease.

The aim of the study was to evaluate the clinical efficacy and safety of the probiotic containing Lactobacillus acidophilus and Kefir grains (Acipol®) in the complex therapy of chronic gastroduodenal diseases with a syndrome of excessive bacterial growth in children aged 6 to 17 years.

We observed 43 children with chronic gastroduodenal diseases associated with Helicobacter pylori infection, accompanied by a syndrome of excessive bacterial growth. Patients were divided into 2 groups: 1 group comprised 28 children who received Acipol 2 weeks on a background of standard therapy, and 2 group (15 people) received standard therapy without Acipol. All children  of both groups were assessed pain index, dyspeptic index, hydrogen respiratory test with lactulose, quantitative PCR in feces before treatment, after 2 weeks, after 6 weeks.

After 2 weeks, there was a significant decrease in pain index and dyspeptic index in group 1, by 6 weeks this decline continued. The hydrogen breathing  test with lactulose, conducted after 2 weeks, became negative in group 1 in 13 children (46%), and was preserved in 15 (54%). The same result was noted after 6 weeks. That is, elimination of the syndrome of excessive bacterial growth was achieved in 43% of children against the background of Acipol.

The results of a laboratory examination of 520 children aged 1—3 years are presented. The examination was conducted to determine the DNA of cytomegalovirus in children with acute cytomegalovirus infection in various biological media by polymerase chain reaction. The differences in the virus shedding  into the blood, saliva, and urine are established: the median of the viral load for saliva is 4.9 lg copies of DNA/ml, the blood 3.4 lg copies of DNA/ml, urine — 3.85 lg copies of DNA/ml. The cut of extreme values of the viral load are determined with the help of mathematical modeling which determine the clinical probability of developing acute CMV infection which allows for more accurate and timely assignment of etiotropic therapy.

The article considers the main childhood infections that occur with the exanthema. Rules for the description of exanthemа, their classification, basic differential-diagnostic symptoms are presented. The article is illustrated with photographs of their author's archive.

The sensitivity to some antibiotics of Acinetobacter spp., that cause pneumonia and septic infections in surgical clinic were studied. Acinetobacter spp. were isolated as dominant causative agent 14.6% from sputum of the patients with pneumonia and 13% from blood of the patients with septic infections.

Acinetobacter spp. were highly resistant to some antibiotics. Most strains isolated from sputum were susceptibile to colistin and half of strains, isolated from blood to colistin and tigesikline.

The defeat of the central nervous system in influenza reflects the properties of both the pathogen itself and the complex pathogenetic mechanisms of the influenza infectious process.  Existing modern  theories do not fully explain the pathological conditions of influenza in the central nervous system, which is still accompanied by ambiguous clinical arguments about the direct cytopathic effect of the influenza virus on neural tissue with the development of encephalitis. Another rare complication of the flu is acute disseminated encephalomyelitis. The autoimmune mechanism of the development of this disease is universally recognized, despite the continuing difficulties of diagnosis in the absence of oligoclonal antibodies in blood plasma and spinal cerebral fluid in the majority of patients.

Clinico-epidemiological characteristics of parvovirus В19 infection are presented. Especially dangerous is the virus for pregnant women in the first and second trimesters of pregnancy, as it can lead to spontaneous abortion, the development of non-immune dropsy or intrauterine fetal death. Infectious erythema is characterized by a bright erythema of the cheek skin — a symptom of «spanked» cheeks, a patchy-papular «lacy» rash on the skin of the trunk and extensor surfaces of the extremities, more common in children aged 4 to 10 years. Diagnosis of parvovirus infection B19 is based on the results of serological methods, PCR, detection of IgM, immunoblot IgM/IgG. A clinical case of infectious erythema in a girl of 5 years is described.