Optimization of diagnostics of viral and bacterial enteric infections in children and adolescents
The objective. To determine the significance of viruses and bacteria in the etiology of enteric infections, clinical aspects of diagnosis, prognostic criteria of adverse course of disease. Patients and methods. The observation included 1378 children and 1438 adult patients with acute enteric infections. Standard methods of examination and PCR testing of faecal samples were used. Levels of NO in blood serum were assessed by the amounts of nitrite (NO 2) and nitrate (NO 3) metabolites. The sum of end products of NO metabolism was determined in blood serum according to L.C. Green and co-authors using Griess reagent in modification of E.N.Korobeynikova. (2002). Results. The most common pathogens of enteric infections in children were rotaviruses (36.3%) and noroviruses (27.5%), and in adults - salmonella (12.9%) and noroviruses (10.3%). Colites were not characteristic for viral enteric infections. Viral gastroenterites were aggravated in children by development of dehydration in this study. In adults, complications in salmonellosis (10.1%), dysentery (6.5%), campylobacteriosis (2.1%), astrovirus (5.8%), rotavirus infection (8%) are conditioned by the development of shock. Viral enteric infections with an adverse course were observed in case of low levels of proinflammatory cytokines and high levels of nitrogen oxide. Conclusion. A significant role of viruses in the etiology of enteric infections in children and adults with the most informative indices for clinical diagnosis has been established and prognostic criteria of an adverse course have been determined.