The objective. To evaluate the frequency and laboratory characteristics of pneumonia in children when influenza is combined with other respiratory viruses.
Materials and methods. We examined 72 children aged 1 month to 17 years who were hospitalized in a specialized hospital in 2017–2019 with influenza type A (72 %) or B (28 %). The main group included 36 patients who had a laboratory-confirmed combination of influenza with other respiratory viruses, and the comparison group included 36 cases in which influenza was the only pathogen detected.
Results. The analysis of the frequency of complications showed that in the main group, pneumonia developed significantly more often – in 22 % (8 children), and in the comparison group – in 6 % (2 children, p < 0.05).
Conclusions. 1) The combination of influenza with other respiratory viruses is a risk factor for the development of pneumonia in children. 2) There are no significant changes in the indicators of clinical blood analysis in pneumonia developing against the background of influenza, including in combination with other respiratory viruses.

The article presents the data of the research on the problem of two clinical forms of enteroproducing Clostridium perfringens (C. perfringens) – associated infection in the children who are not connected with food – antibiotic-associated and sporadic forms. Within the period of 2019–2021 a retrospective analysis of the results of complex clinical and laboratory study of children aged from 2 months to 18 years with diarrhea (acute intestinal infection, n = 406 children) was carried out within the framework of the algorithm developed by Pediatric Research and Clinical Center for Infectious Diseases (Russia, Saint Petersburg). The material for the study included stool tests, coprofiltrates and strains of the microorganisms determinating microbiocoenosis of the intestines including enterotoxigenic strains of C. perfringens. The main group included children with diarrhea (n = 38 of 406 children with diarrhea) who at admission presented C. perfringens enterotoxin in coprofiltrates found by immune-enzyme analysis and there were identified the cultures of enterotoxigenic strains of C. perfringens by tests of intestinal contents. The first group included children (n = 30 of 406 children; 7 %) with antibiotic-associated diarrhea (AAD). The second group included children (n = 8 of 406 children; 2 %) with sporadic diarrhea. An overwhelming majority of patients with ААD (n = 20; 92.3 %) of the first 8 (100 %) years of life presented intensity of diarrhea syndrome in direct dependence on colonization activity of enterotoxigenic C perfringens (colony-forming units/g feces) (r = 0.78). The disease proceeded mainly with the syndromes of gastroenteritis, enterocolitis and hemorrhagic colitis. There was noted a reliable high frequency of severe forms of both ААD, and sporadic diarrhea (р < 0.05) caused by enterotoxigenic strains of C perfringens in children of the first year of life. Deep decompensated disorders of large intestine microbiota associated with Klebsiella spp., Staphylococcus aureus and Candida albicans, were characterized by severity and prolonged character of the course (р < 0.05). The received results determine the tactics of differential diagnosis and treatment of AAD and sporadic diarrhea caused by enteroproducing strains of C. perfringens.

The article considers the role of herpes simplex viruses of 1st, 2nd types in the development of reproductive disorders in married couples. The clinical example shows the difficulties of diagnosis, possible errors in treatment approaches, and the lack of results from the use of artificial insemination methods in the presence of persistent herpetic infection. Prolonged antiviral therapy led to the onset of pregnancy and the birth of a child.

The article presents the results of an open prospective study of the clinical assessment of the efficacy and safety of the use of nifuratel during exacerbations of recurrent cystitis. The aim of the program was to assess the change in the duration of the relapse-free course of recurrent cystitis and the effectiveness of the course treatment with Nifuratel-SZ in the treatment of recurrent cystitis. During a non-interventional program, Nifuratel-SZ has been shown to be an effective and well-tolerated drug for the treatment of recurrent uncomplicated lower urinary tract infection.

The article presents a clinical case of recurrent eczema. Despite treatment lasting more than 5 years, the patient observed only a short-term effect of the therapy. The cause of the continuous course of severe eczema was malnutrition and hypovitaminosis of vitamins A and E, due to a lack of fish and seafood in the diet. Despite the relatively rare occurrence of eczema in the outpatient practice of a general practitioner, on average from 2 to 5 % of the adult population in the world suffers from this disease. Among the main methods of treating eczema is long – term antihistamine and anti-inflammatory therapy. However, these methods of treatment are not always enough. The reason for the continuous course of eczema was irrational nutrition with a lack of fat-soluble vitamins A and E. Correction of the diet using a sorbent based on the herb Zostera marina allowed to achieve significant improvement and remission of the disease.
Conclusions. 1) A thorough analysis of anamnestic data is required to determine the treatment regimen in cases of prolonged persistence of eczema symptoms, with resistance to standard therapy algorithms. 2) Patient’s refusal of certain types of food can lead to hypovitaminosis, which is accompanied by skin symptoms. 3) The appointment of retinol, tocopherol acetate and vitamin D 1 will contribute to a rapid and effective improvement of the condition of the skin in cases with insufficient consumption of products containing fat-soluble vitamins. Preparations made from the sea grass Zostera marina help to improve digestion, sorb and remove unwanted biologically active substances, reducing the severity and relieving skin manifestations.

The review presents an assessment of the dynamics of the change in procalcitonin as the main marker of bacterial inflammation in patients with the syndrome of systemic inflammatory reaction, sepsis and septic shock, clarification of the practical and predictive significance of PCT in patients with an identified and not identified focus of infection.

In recent years, the problem of resistance of gram-negative microorganisms to carbapenems, as well as the emergence of multiresistant strains is gaining urgency. This problem is of particular importance in neonatal practice due to the age limitations of the use of many antibiotics and the lack of specific recommendations. Local bacteriological monitoring data should be taken into account when selecting a starting antibiotic, and for this purpose, methods of rapid identification of the pathogen and its resistance mechanisms should be introduced. Pediatricians need controlled trials of new antibiotics to successfully treat MDR-Gram-infections.

Purpose of the study. Comparative assessment of the incidence of nosocomial purulent-septic infections (PSI) in children after open and closed heart surgery for congenital defects.
Materials and methods. 503 medical records of children after cardiac surgery were studied. GSI was identified according to epidemiological standard case definitions.
Results. It turned out that the incidence rate of PSI in children after open heart surgery is an order of magnitude higher than after minimally invasive endovascular interventions. Hospital-acquired pneumonia most often occurs in children after operations.
Conclusion. The increased incidence of PSI after open heart surgery, as compared to endovascular surgery, is due to a longer surgical intervention and the subsequent longer stay of patients in the intensive care unit, where such an epidemiologically significant procedure as artificial lung ventilation is performed.

The results of a new method for detecting the contamination of intravascular catheters and drains are presented to assess its clinical and cost-effectiveness. Catheters are one of the most widely used devices in critically ill patients. The insertion of a catheter into the central venous system is an invasive procedure that can potentially lead to life-threatening complications for the patient. Catheters are a gateway for infection as they connect the external environment to the internal parts of the human body, causing catheter-associated infections. More than 15 % of patients with an established IVC develop complications, of which the most frequent and requiring removal of the vascular catheter are infectious (5–26 %) and mechanical (up to 25 %). Risk factors for catheter-associated conditions are crucial for hospital mortality.

In the conditions of modern realities of domestic healthcare, more and more attention is paid to the quality of medical care provided by both doctors and paramedical personnel. In order to minimize risks when performing routine medical procedures, it is necessary to create standard operating procedures that should help medical staff to provide high-quality and timely medical care in real practice. The article offers an answer to frequently asked questions regarding the development of standard operating procedures and an example of a standard operating procedure for the rehabilitation of the tracheobronchial tree and tracheostomy care.