Intestinal infections in children

Acute intestinal infections (AII) occupy one of the leading places in infectious pathology of childhood. According to WHO, more than 1 billion people in the world suffer from acute gastrointestinal infectious diseases (diarrhea) every year, of which 65-70% are children under 5 years of age.

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Causes of intestinal infection in children

According to the etiological principle, all acute intestinal infections in children can be divided into three groups:

• intestinal infections of bacterial origin caused by obviously pathogenic enterobacteria (typhoid fever and paratyphoid A, B, C, shigellosis, salmonellosis, yersiniosis, cholera, etc.) or opportunistic microorganisms ( Klebsiella, Proteus, Clostridia, Pseudomonas aeruginosa, Citrobacter, Enterobacter, Providencia, Erwinia, etc.);
• intestinal infections of viral origin (rotavirus infection, intestinal infections caused by adeno-, entero-, astro- and caliciviruses, Norfolk group viruses, etc.);
• intestinal infections of protozoan etiology (amoebic dysentery, cryptosporidiosis, schistosomiasis, etc.).

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Symptoms of intestinal infection in children

All acute intestinal infections, regardless of their etiology, are clinically manifested to varying degrees by a pronounced general toxic syndrome ("intestinal toxicosis") and local disorders associated with damage to various parts of the gastrointestinal tract (gastritis, enteritis, colitis, gastroenteritis, etc.). The body's response to an infectious agent can be both non-specific (toxicosis, intoxication) and specific, which is determined by the properties of the pathogen of a particular intestinal infection. In children, toxicosis as a non-specific reaction to an infectious agent in acute intestinal infections is most often accompanied by exicosis, less often by neurotoxicosis or a toxic-septic condition.

Primary neurotoxicosis as a kind of non-specific generalized reaction to an infectious agent (or its waste products) develops with a massive influx of a toxic agent into the blood (primarily bacterial toxins) and endotoxinemia.

In toxicosis with exicosis as a non-specific reaction of the body, the leading ones are metabolic disorders associated with dehydration and loss of electrolytes. Depending on the predominant loss of water or electrolytes, there are iso-, hypo- and hypertonic types of dehydration. Clinical manifestations of exicosis depend not only on the type, but also on the degree of dehydration. There are three degrees of toxicosis with exicosis:

• Stage I - loss of body weight due to dehydration does not exceed 5%:
• II degree - 6-9%;
• III degree - 10% or more.

The etiological structure of acute intestinal infections in children of different age groups is not the same.

• In young children, acute intestinal infections are caused mainly by rotavirus, enteropathogenic Escherichia coli, staphylococcus, salmonella and especially opportunistic enterobacteria (Klebsiella, Proteus, Citrobacter, etc.): shigellosis, clostridiosis, and cholera are observed less frequently.
• In older (school-age) children, shigellosis and salmonellosis with foodborne infection predominate, as well as yersiniosis, typhoid fever, paratyphoid fever, etc.

Treatment of intestinal infection in children

In case of rotavirus infection, it is advisable to use antiviral agents in order to increase the clinical effectiveness of basic therapy. The original domestic antiviral drug Arbidol acts at the early stages of viral reproduction and inhibits the fusion of the viral lipid membrane with intracellular membranes, preventing the penetration of the virus into the cell.

Arbidol has a serious evidence base, including the effectiveness and safety of Arbidol in children. Studies have shown that the high effectiveness of Arbidol is the result of the diversity of its biological activity and is due, in addition to the specific effect on viral reproduction, to the ability to induce interferon, an immunostimulating effect. antioxidant activity. The use of Arbidol for the treatment of rotavirus infection in children significantly reduces the duration of the acute period of the disease, including symptoms of toxicosis with exicosis, intoxication and diarrhea syndrome, and also accelerates the elimination of rotavirus from the intestine.

It was found that Arbidol prevents the replication of both rota- and adenovirus in the epithelial cells of the small intestine and, thus, reduces the severity and further progression of morphofunctional disorders in the gastrointestinal tract. It contributes to a significant reduction in the time of elimination of viruses from the intestine.

Arbidol is used orally. The release form is convenient for use in children tablets (50 mg) and capsules (100 mg). Arbidol has a systemic effect, is quickly absorbed and distributed throughout the organs and tissues. The bioavailability of the drug does not depend on food intake.

In addition, as an important component of complex therapy of acute intestinal infection, enterosorbents of the latest generation can be used, which not only adsorb and remove viruses from the body, but also protect the mucous membrane of the gastrointestinal tract. Such drugs include Neosmectin, which has a combined sorption and mucocytoprotective effect. Neosmectin is a promising modern enterosorbent with proven effectiveness in a number of gastrointestinal diseases accompanied by a violation of the integrity of the mucous barrier, gastric and intestinal dyspepsia, exo- and endotoxicosis, intestinal dysbiosis, as well as digestive dysfunction. Neosmectin contributes to a reliable reduction in the duration of the acute period of acute intestinal infection, including rotavirus, is characterized by a high level of safety and can be used even in children of the first year of life. The drug is available in a convenient form - 3 g sachets in a package of 3, 10 or 30 sachets.