DOI: https://doi.org/10.22141/2224-0551.13.0.2018.131181

Diarrhea in young children: clinical picture, diagnosis, principles of therapy

O.Yu. Beloysova, K.V. Savytska, N.V. Pavlenko, I.G. Solodovnichenko, A.M. Kaafarani, A.Yu. Volianskyi

Abstract


Many diseases in infants and young children are accompanied by the development of diarrheal syndrome. As a result, there are organic lesions and functional disorders in the intestine. It is well known fact that 1.4 billion children under 5 years in the world suffer from acute diarrhea, and 123 million of them are forced to seek medical help urgently, 9 million require inpatient care, and 1.8 million children die from dehydration. In this connection, the choice of therapeutic regimen remains urgent. Medications that slow intestinal motility (loperamide) are contraindicated in acute diarrhea in children, since the risk of side effects including ileus, drowsiness, nausea (mortality to 1 %) is high. Probiotics are living microbial drugs commonly used to prevent acute diarrhea. A large number of researches have been conducted, and results of meta-analyzes have been published that have revealed the effect of Escherichia coli strain Nissle 1917 (Mutaflor) in reducing the duration of diarrhea in children with acute gastroenteritis. Escherichia coli strain Nissle 1917 is one of the three bacteria in the world, which is better characterized at the molecular-biological level, the most investigated non-pathogenic and genetically stable strain in the world with 100-year history, having a genetic map, the genome of which is completely sequenced, genetic loci are deterministic. The product is included into the German Collection of Microorganisms and Cell Cultures (DSMZ). The purpose of our study was to improve the therapeutic approaches to the correction of diarrheal syndrome using Escherichia coli strain Nissle 1917 (Mutaflor) in the main treatment regimens. Seventy four children were examined and divided into two groups: the first group — children with diarrheal syndrome, who additionally received Mutaflor from the first day, the second group — children with diarrheal syndrome, who received traditional therapy. As a result of the study, the data were obtained proving the effectiveness of Escherichia coli strain Nissle 1917 (Mutaflor) in the treatment of diarrhea in young children, its beneficial effect not only on intestinal microflora and normalization of intestinal kinetics, but also on faster improvement of clinical symptoms, which allows recommending it to children from the first months of life.

Keywords


diarrhea; Escherichia coli strain Nissle 1917; young children; Mutaflor; treatment

References


Belousov JuV. Functional and organic diseases of the stomach and intestines in children: mechanisms of formation, criteria of diagnosis and principles of correction. In: Scientific-practical conference with international participation of Pediatric gastroenterology and nutritiology. 2010 May 20-21; Kharkiv, Ukraine.

Krivopustov SP. Infectious diarrhea: problem-oriented approach in pediatrics. Dytiachyi likar. 2010;(5):50-10 .

Kulichenko TV. Acute infectious diarrhea in children. Meditsinskiy Sovet. 2010;(5-6):28-37.

Kulinichenko TV, Bakradze MD, Patrusheva JuS. Acute infectious diarrhea in children. Pediatricheskaya Farmakologiya. 2009;6(3):97-103.

Belmer SV, Gasilina TV. Differential diagnostics and general principles of therapy of chronic diarrhea in children. Pharmateca. 2011;(1):54-58.

Belousova OJu. Probiotics in Case of Antibiotic-Associated Diarrhea in Children: an Informed Choice 2016;(5.1):15-22. doi: 10.22141/2224-0551.5.1.73.1.2016.78935.

Matuskova Z, Anzenbacherova E, Vecera R, Tlaskalova-Hogenova H, Kolar M, Anzenbacher P. Administration of a probiotic can change drug Pharmacokinetics: Effect of E.coli Nissle 1917 on amidarone absorption in rats. PLoS One. 2014 Feb 5;9(2):e87150. doi: 10.1371/journal.pone.0087150.

Applegate JA, Fischer Walker CL, Ambikapathi R, Black RE. Systematic review of probiotics for the treatment of community-acquired acute diarrhea in children. BMC Public Health. 2013;13 Suppl 3:S16. doi: 10.1186/1471-2458-13-S3-S16.

Taibi A, Comelli EM. Practical approaches to probiotics use. Appl Physiol Nutr Metab. 2014 Aug;39(8):980-6. doi: 10.1139/apnm-2013-0490.

Guarino A, Ashkenazi S, Gendrel D, al. European society for paediatric gastroenterology, hepatology, and nutrition/European Society for Paediatric Infectious Diseases Evidence-based Guidelines for the Management of Acute Gastroenteritis in Children in Europe: Update 2014. J Pediatr Gastroenterol Nutr. 2014 Jul;59(1):132-52. doi: 10.1097/MPG.0000000000000375.

Vitetta L, Briskey D, Alford H, Hall S, Coulson S. Probiotics, prebiotics and the gastrointestinal tract in health and disease. Inflammopharmacology. 2014 Jun;22(3):135-54. doi: 10.1007/s10787-014-0201-4.

Liu XL, Li ML, Ma WX, Xia SL, Xu BL. Clinical trial on the prevention of diarrhea by oral BIFICO for infants aged 1-6 years. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2013 Aug;27(4):277-9. (in Chinese).

Henker J, Müller S, Laass MW, Schreiner A, Schulze J Probiotic Escherichia coli Nissle 1917 (EcN) for successful remission maintenance of ulcerative colitis in children and adolescents: an open-label pilot study. Z Gastroenterol. 2008 Sep;46(9):874-5. doi: 10.1055/s-2008-1027463.

Henker J, Laass MW, Blokhin BM, et al. Probiotic Escherichia coli Nissle 1917 versus placebo for treating diarrhea of greater than 4 days duration in infants and toddlers. Pediatr Infect Dis J. 2008 Jun;27(6):494-9. doi: 10.1097/INF.0b013e318169034c.

Rund SA, Rohde H, Sonnenborn U, Oelschlaeger TA. Antagonistic effects of probiotic Escherichia coli Nissle 1917 on EHEC strains of serotype O104:H4 and O157:H7. Int J Med Microbiol. 2013 Jan;303(1):1-8. doi: 10.1016/j.ijmm.2012.11.006.

Reissbrodt R, Hammes WP, dal Bello F, et al. Inhibition of growth of Shiga toxin-producing Escherichia coli by nonpathogenic Escherichia coli. FEMS Microbiol Lett. 2009 Jan;290(1):62-9. doi: 10.1111/j.1574-6968.2008.01405.x.

Rohrenbach J, Matthess A, Maier R, et al. Escherichia coli strain Nissle 1917 (EcN) in children: results of a prospective survey in 668 patients. Kinder Jugendarzt. 2007;(3):164-167. (in Germany).

Rund SA, Rohde H, Sonnenborn U, Oelschlaeger TA. Antagonistic effects of probiotic Escherichia coli Nissle 1917 on EHEC strains of serotype O104:H4 and O157:H7. Int J Med Microbiol. 2013 Jan;303(1):1-8. doi: 10.1016/j.ijmm.2012.11.006.

Ministry of Health of Ukraine. Order No 59, dated 29 Jan, 2013: On approval of unified clinical protocols of medical care for children with diseases of the digestive system. Available from: http://old.moz.gov.ua/ua/portal/dn_20130129_0059.html.




Copyright (c) 2018 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта