Current clinical features and treatment of acute enteric infections in children

Aim. To study the current clinical manifestations and treatment of acute enteric infections in children at an early age.

Methods. 225 in the age of 4 months to 3 years were followed-up. Clinical presentations and clinical current of the disease, as well as features and type of gastrointestinal system damage and treatment effects were registered in specially developed report forms. Bacterioloicy, microbiologic, immunologic and genetic tests were used to determine the causative factor of the acute enteric infections. Principal component analysis was used for mathematical modelling and factorial analysis. The optimal number of isolated factors was determined using Kaiser criterion, Scree-test and the completeness of the factorization.

Results. The clinical picture of acute enteric infections was quite severe in all children. The disease had a typical clinical current, with relapses registered in 63 (28.0%) patients. Gastroenterocolitis was the most frequent clinical form of the disease, with prevalence of moderately severe cases (167 children, 74.2%). Severe enteric infections were seen in 58 children (25.8%) who developed acute toxemia and stage III dehydration. All children (100%) had comorbidities. Causative factor was determined in 77.6% of patients. It should be considered that acute enteric infection and its treatment using antibiotics in 100% of cases leaded to enteric dysbiosis and may be a reason of antibiotic-associated diarrhea caused by Clostridium difficile.

Conclusion. Fever duration, pain intensity, level of Escherichia coli with normal enzyme activity, causative factor and opportunistic pathogenic microbiota were the strongest factors influencing the baseline condition of children with acute enteric infections. The most effective treatment choice was gentamicin, in cases of moderate and severe cases - ceftriaxone.