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The article presents a clinical observation of severe acute hepatitis of unknown aetiology with liver transplantation in a 16-year-old child, which occurred in October 2021. Initial symptoms were abdominal pain, diarrhea. The general wellbeing of the girl did not suffer, there was no fever, no intoxication syndrome. Over the next days, she began to notice the appearance of edema on the legs, an increase in the size of the abdomen. From the 10-11th day of illness – darkening of urine, acholia of feces, jaundice were observed. She was examined by a pediatrician, a biochemical blood test was performed, according to the results the girl was hospitalized with a diagnosis of acute hepatitis. According to the severity of the condition, she was hospitalized in the ICU. On admission she complained of abdominal pain, jaundice, edema, and weakness. On examination: jaundice, scleral icterus, hemorrhagic rash at the site of the tourniquet, bleeding from injection sites, hepatomegaly, anasarca. In blood tests: progressive anemia, thrombocytopenia, increased AST (with a decrease in dynamics against the background of progression of liver failure), a decrease in total protein and albumin, fibrinogen, prothrombin according to Quick. Laboratory excluded viral hepatitis A-E. The only infectious agent diagnosed was group F adenovirus in feces. By the third day of hospitalization developed of multiple organ failure, DIC. On the 4th day of hospitalization, the child was transferred to a specialized hospital, where an emergency liver transplantation was performed. The operation was successful, the child was discharged in a stable condition.

The formation of biobanks in the structure of scientific and treatment and diagnostic institutions with prospects for interregional integration is a fundamental link in monitoring and predicting diseases of various origins, creating and testing highly effective diagnostics, and developing novel therapeutic agents.Aim. To describe standard operating procedures and principles for the formation of bioresource collections (BRC) in medical institutions with biobanking.Material and methods. The data of scientific and practical biomedical projects using BRC obtained from patients with genetic, multifactorial and infectious diseases in St. Petersburg and Surgut are presented. As of September 2022, the BRC collected on the basis of the Pediatric Research and Clinical Center for Infectious Diseases of the Federal Medical and Biological Agency includes biosamples from 1619 patients, and the BRC collected in the Medical Institute of Surgut State University includes biosamples from 450 patients and healthy individuals of different sex and age. The selection of biosamples from apparently healthy individuals and patients with various diseases can serve as a strategically important resource for future research in terms of etiology, epidemiology, the development of regulatory environment and scales, innovations in the development of diagnostic approaches and treatment of the Russian population.

Since March 2020, the first reports have appeared about the increasing, almost everywhere, number of children who have undergone a new coronovirus infection caused by SARS-Cov-2 with a symptom complex resembling the manifestations of Kawasaki disease. A special feature of the clinical manifestations of this syndrome, which is called “Pediatric multisystem inflammatory syndrome associated with COVID-19”, is the high incidence of life-threatening conditions caused by the sharp development of arterial hypotension against the background of cardiogenic or vasogenic shock.In St. Petersburg, since the end of November 2020, there has been a sharp surge in admissions of children to the ICU of various hospitals with the clinic of Pediatric multisystem inflammatory syndrome, who have laboratory confirmation of the transferred COVID-19.The purpose of this article is to attract the attention of doctors of various profiles, to combine efforts to study this pathology, to determine the criteria for verifying the diagnosis, optimal treatment regimens and dispensary monitoring of patients who have been ill.

The article provides a detailed analysis of modern publications focused on a studies an astrovirus gastroenteritis. Based on our own examination of 3470 children with acute intestinal infections aged from 1 month to 1 8 years old, who were treated at the Children's Research and Clinical Center for Infectious Diseases, FMBA of Russia, St. Petersburg, from May 201 7 to July 2018 a detailed description of the characteristic epidemiological, clinical and laboratory features of the disease is given. It was shown, that astroviruses remain a significant causative agent of acute intestinal infections in children, accounting for 1.36% of all cases of disease. Among the combined forms of astrovirus infection, associations with rotaviruses, noroviruses and campylobacter spp. are most common. It was established, that the disease is more often observed in boys aged 1 to 3 years. Clinical course of astrovirus infection in children is characterized by an acute or gradual onset with repeated vomiting, moderate intoxication and symptoms of gastroenteritis. Due to the lack of pathognomonic clinical and laboratory features of the course of viral gastroenteritis, diagnosis is necessary using laboratory methods including molecular genetic research methods.

The authors' findings and literature data on the pharmacotherapeut efficacy of cycloferon, an interferon inductor (immunomodulators) are described. The drug effect in the treatment of various socially significant children' diseases, including acute respiratory tract viral infection, bronchial asthma, allergic conditions with infection protection disturbances, mycoplasmic infection, bronchopulmonary complications of acute respiratory tract viral infection with low intensity of free radical oxidation is indicated. The use of cycloferon at the background of vaccination was shown to provide inhibition of the autoimmune processes causing postvaccinal complications in frequently ill children. The results of the use of cycloferon in the treatment of gastrointestinal tract and intestinal infections of both the viral and bacterial genesis are discussed. Cycferon is recommended to be used for correction of the intestine dysbiosis (the microflora level came to normal in 95% of the children). The use of the drug in surgical pathology and in particular in appendicular peritonitis for decreasing the postoperative complications and correction of the immune disturbances due to chronic viral hepatitis C and B in children under the complex therapy is described. The cycloferon safety and efficacy were confirmed by the postmarketing randomized trials.

The case of diagnostics and differential diagnostics of a case of a visceral leushmaniosis at the child of early age with development an infectionassociated hemophagocytosis is provided. This complication demands carrying out broad diagnostic search, and therapy in our country represents considerable difficulties as drugs for treatment of a visceral leushmaniosis in Russia are unregistered.

Infectious diarrheas are a current problem of children’s age. Despite prevalence in structure of acute intestinal infections at children of a viral gastroenteritis dysentery keeps the relevance owing to development of severe forms of a disease and serious complications. The choice of drug for etiotropic treatment of bacterial diarrheas at children’s age taking into account the existing international and Russian recommendations is difficult and ambiguous. The efficiency of many modern antibacterial drugs which are traditionally used for treatment of a shigellosis and others infectious diarrheas decreases because of high prevalence of polyresistant strains. It is known that so far, at infectious diarrheas unreasonably long antibacterial therapy with change of 3–4 medicines is carried out, repeated courses of germicides at a reconvalescents bacterioexcretion of activators of infectious diarrheas are widely appointed, unfairly short antimicrobial therapy takes place less often. Despite existence modern diagnostic the test of systems antibiotic-associated diarrheas are often late diagnosed that lead to development of severe forms of a disease or complications. The negative C. difficile toxins test does not allow to exclude the antibiotic-associated nature of diarrhea completely. The clinical case of dysentery of Fleksneri at the child caused by a strain with a multiple antimicrobial resistance and which led to development of antibioticassociated colitis and dynamic intestinal impassability is given as an example in article. Therefore, when choosing antimicrobial drug means for treatment of infectious diarrheas it is necessary to consider regional features of the circulating activator strains.

Specific features of the course of acute intestinal infections of viral and bacterial etiology in children are described, features of the syndrome of endogenous intoxication in children carrying infectious diarrhea are characterized. As a result of the study, the efficacy and safety of gelatin tannate (LLC «YADRAN», Croatia) with intestinal infections of bacterial and viral etiology in children has been confirmed.

Th article provides data on frequency of acute infectious diseases among children, the attention is focused on the frequently ungrounded choice of the therapeutic tactics with use of antibacterial, antiviral or antihistamine drugs, which leads to intensification of the polypragmasy trend. Authors described in detail the issue of dehydration syndrome development in children in variouspathologic states, reasons of occurrence of this state and ways to correct liquid deficiency with the help of the oral rehydratation

Rotavirus infection is the second after pneumococcal cause in the incidence of diseases and mortality in children under 5 years. That has defined the who’s recommendation for the introduction of vaccination against rotavirus infection in the vaccination schedules of all countries of the world. In our country that vaccination recommended for epidemic indications for introduction into the regional program. However, vaccination is carried out only in certain regions. One of the reasons for low uptake of this vaccine is the underestimation of the burden of disease.The aim the study. To assess the significance of rotavirus gastroenteritis in the structure of acute gastroenteritis in children under 5 years receiving treatment in outpatient clinics, to study the genetic diversity of rotaviruses, to compare the costs associated with the treatment of acute rotavirus and non-rotavirus gastroenteritis.Methods. Prospective, observational, epidemiological study. The inclusion of participants under the age of 5 years with the symptoms of acute gastroenteritis who meet the criteria of inclusion/exclusion. Examination, medical history, samples of faeces were carried out in the first day of treatment (day of inclusion in the study). Parents were given a questionnaire for 14 days. The severity of the disease was determined according to the scale of Vesicare, the disease dynamics was assessed by the answers of the questionnaire. Examination of feces samples was carried out centrally by PCR. Rotavirus positive samples were genotypically PCR and in case of detection of rare genotypes have been sequenced genomic RNA.Results. The study included 501 baby — boys — 286 (57,1%), girls — 215 (42,9%). The average age was 22.6 ± 15.2 months. 50 children (10.0 per cent) mentioned various background pathology, the others were deemed healthy. Rotavirus was diagnosed in 151 patients 31.4% (95% CI: 26.9 percent - 35.3 percent), which accounted 66,52% (151 of 227) among all cases with confirmed etiology. Genotyping was prevalent G1P [8] to 34.5%, and G4P[8] — 39,2%. Clinical manifestations in rotavirus gastroenteritis was more severe, severe course observed in 65.5% of cases in the comparison group -at 30.4%. Significantly more often than in the comparison group (Р χ2 < 0,001) was observed vomiting (140cases из151 — 93,3%, compared to 239 of 336 -71,1%) and elevated temperature (146 of 151 — 97,3% compared with 254 of 336 — 75,6%). The average temperature was 38,5 ± 0,6 OS in the comparison group — 38,0 ± 2,2 OS, remained 3,1 ± 1,4 and 2.5 ± 1.2 day, respectively. The frequency of episodes of diarrhoea in the first day of illness was 6.4 ± 2.7 times, in comparison with 5.2 ± 2.8, duration of diarrhea was 6.3 ± 3.2 days and 4.5 ± 2.6 days. The costs for parents of patients with acute rotavirus gastroenteritis was (M ± SD) 2873.4 ± 2276.4 rubles, against 2007.4 ± 2150.4 rubles in the comparison group (t = 3.965; p= < 0,001, as amended by Starlite for inequality of variances).Conclusion. The introduction of routine vaccination of children in the first year of life will reduce by more than a third of the number of appeals to medical institutions about intestinal infections and partially prevent the costs associated with the treatment of this pathology.

The article presents modern approaches to rational pathogenetic therapy of intestinal infections in children based on existing national and international protocols for the treatment of infectious diarrhea. Approaches to carrying out oral rehydration using solutions with reduced osmolarity are described in detail. The use of solutions with osmolarity 225–240 mOsm/l allows reduction of the diarrhea duration and contributes to improvement of outcomes.

Acute intestinal infection (AII) is the 2nd most widespread infectious disease in children after acute respiratory infection, and a relevant healthcare problem. The incidence of infectious diarrhea in Russia varies greatly: for example, in St. Petersburg, the incidence of rotavirus gastroenteritis in children under the age of 14 is more than 700 per 100 thousand of the same age, and the incidence of norovirus gastroenteritis in 2014 reached 110 per 100 thousand children younger than 14 years (Rospotrebnadzor St. Petersburg). In Europe, from 0.5 to 1.9 episodes of infectious diarrhea in children under the age of 3 are registered annually [1, 2].

Recently the actual direction is development of programs of rehabilitation of the second stage of recovering of infectious diseases children. The purpose of this work is justification of need of the organization of offices of rehabilitation in a children's infectious hospital according to Order of the organization of medical rehabilitation. The retrospective analysis of clinical records of the patients who have arrived on treatment in clinical divisions of Federal State Budgetary Institution of Research of Children's Infections of Russia in 2011—2012 is carried out. It is established, that among surveyed 14 363 for 2 years of patients (in a year on the average more than 7000 children) — about 40% (2800 patients a year) children for whom rehabilitation actions of the second stage in the conditions of a hospital, including carrying out a diet therapy, physiotherapy exercises, physical therapy and pharmacotherapy are necessary. On a profile of infectious patients for rendering the rehabilitation help it is expedient to organize 2 offices on 30 beds: for treatment of children with consequences of neuroinfections and children with somatic pathology. The organization of two offices for carrying out medical rehabilitation of the second stage to recovering infectious diseases children taking into account recommended standards on equipment, according to the Order of the organization of medical rehabilitation, will allow to give high-tech help to patients and to prevent development of complications.

In the past decade the proportion of mixed infections has increased. The clinical aspects of mixed infections can be atypical, and the course of the disease depends on the type of pathogen-associants, their biological properties, relationships with each other and with the host. A clinical case, showing the possibility of mixed associations of Yersinia ana Listeria infections, caused the meningoencephalitis, is given. It is described the experience of the authors on neuroinfection diseases, according to which, a parallel study of blood and cerebrospinal fluid in molecular-genetic, serological as well as immunohistochemical diagnostic methods is required for the detection of mixed infection or co-infection in order to clarify the etiology of the disease.

Viral intestinal infections play an important role in infectious diseases in children of different ages.Aim of this study was to investigate the etiological structure and characteristics of viral diarrhea in hospitalized children in 2009–2013.Materials and Methods: 5535 children’s medical histories were analyzed, in which algorithm survey polymerase chain reaction using primers production «AmpliSens ® Rotavirus / Norovirus / Astrovirus-FL» or «OCI screen AmpliSens ® -FL», «AmpliSens ® Enterovirus-FL» production «InterLabService» (Moscow) was included.Results: we found that with using the polymerase chain reaction etiologic diagnosis was deciphered in 3241 cases (59,8%) and the part of diarrhea of viral genesis of decrypted acute intestinal infections was 77,35 %. Results have shown that the virus diarrhea predominantly affects children under 3 years old (45%). Revealed the prevalence of rotavirus infection (40,44%) also a high proportion of norovirus gastroenteritis (21,18%) have been founded. We found that rotavirus have the first place in importance in the age group of children up to 6 years (56%); however in patients of school age the first place was the norovirus (45,2%). The incidence of rotavirus infection remained high throughout the study period (44,6-58,9%), incidence of norovirus gastroenteritis increased from 24 % in 2010 to 32% in 2012 . In most cases (82%) of viral gastroenteritis was moderate, major complication was dehydration syndrome of 1–2 stage.Conclusion: results have proved that using of modern methods of diagnosis help to decrypt at least 60% of cases of infectious diarrhea, and the main etiological agents are rotaviruses and noroviruses . Our results are fully consistent with the data on the epidemiology in foreign sources of acute intestinal infections in children prior to mass vaccination rotavirus.