Intestinal Infections in Children

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

[1], [2], [3], [4], [5], [6]

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 deliberately pathogenic enterobacteria (typhoid fever and paratyphoid A, B, C. Shigellosis, salmonella, iersiniosis, cholera, etc.) or opportunistic microorganisms ( klebsiella, proteus, clostridia, Pseudomonas aeruginosa, cytrobacter, enterobacter, Providence, Ervinias, etc.);
• intestinal infections of a viral nature (rotavirus infection, intestinal infections caused by adeno-, entero-, astro- and caliciviruses, Norfolk group viruses, etc.);
• intestinal infections of protozoal etiology (amebic dysentery, cryptosporidiosis, schistosomiasis, etc.).

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Symptoms of intestinal infection in children

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

Primary neurotoxicosis as a kind of nonspecific generalized reaction to an infectious agent (or products of its vital activity) develops with a massive intake of a toxic agent into the blood (primarily toxins of bacteria) and endotoxinemia.

In toxicosis with exsicosis as a nonspecific reaction of the organism, metabolic disturbances associated with dehydration and loss of electrolytes are leading. Depending on the preferential loss of water or electrolytes, iso-, hypo- and hypertonic types of dehydration are distinguished. Clinical manifestations of exsicosis depend not only on the type, but also on the degree of dehydration. There are three degrees of toxicosis with exsicosis:

• I degree - loss of body weight as a result of 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 children of early age, acute intestinal infections are caused mainly by rotavirus, enteropathogenic escherichia, staphylococcus, salmonella and especially opportunistic enterobacteria (klebsiella, proteus, citrobacter, etc.): shigellosis is rarely observed. Clostridiosis, cholera.
• The children of the senior (school) age are dominated by shigellosis and salmonellosis with food through infection, as well as iersiniosis, typhoid fever, paratyphoid, etc.

Treatment of intestinal infection in children

With rotavirus infection, it is advisable to use antiviral drugs in order to increase the clinical effectiveness of basic therapy. The original domestic antiviral drug Arbidol acts in 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 solid evidence base, including the effectiveness and safety of Arbidol in children. Studies have shown that the high efficacy of Arbidol is the result of the diversity of its biological activity and is due, in addition to the specific effect on viral reproduction, also the ability to induce interferon, an immunostimulatory 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 the symptoms of toxicosis with exsicosis, intoxication and diarrhea syndrome, and also accelerates the elimination of rotavirus from the intestine.

It was revealed that Arbidol interferes with the replication of both the rota- and adenovirus in the epithelial cells of the small intestine and. Thus, reduces the severity and further progression of morpho-functional disorders in the digestive tract. Contributes to a significant reduction in the timing of elimination of viruses from the intestine.

Arbidol is applied orally. Form of release - convenient for use in children tablets (50 mg) and capsules (100 mg). Arbidol has a systemic effect, is rapidly adsorbed and distributed to organs and tissues. Bioavailability of the drug does not depend on food intake.

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