Research Institute of Children's Infections Polyclinic Department. Treatment of childhood infections. Acute respiratory viral infections

Research Institute of Children's Infections of the Federal Medical and Biological Agency of Russia in St. Petersburg is one of the world's leading scientific and medical specialized institutions dealing with the problems of infectious diseases various types mainly for the younger generation. is a large federal center under the jurisdiction of the medical and biological agency of the Russian Federation.

The Scientific Research Institute of Children's Infections (St. Petersburg) is located on Popova, 9 - in the historical center of the Northern capital, on Aptekarsky Island. The institution itself is a landmark, since it is located in the buildings of the former hospital for the mentally ill and nervous A. G. Konasevich.

On guard of health

The Research Institute of Children's Infections (St. Petersburg) is a unique institution for Russia in its own way. Within the walls of the historical complex, the best researchers and doctors of the country have created a unique system of study and search effective treatment the worst infections. Babies from all over the North-West region and other parts of the Russian Federation are delivered to the medical department with diagnoses that other clinics give in to.

The Institute is equipped with high-tech, currently the most modern medical equipment of an expert class, which is used for scientific activities, diagnostics, and treatment. The institution is different high level staff training. Recently, the clinic underwent a comprehensive renovation. Although the building is a century-old building, inside the staff tried to create maximum coziness and comfort for children and their parents.

Historical reference

For the Research Institute of Children's Infections, St. Petersburg became a home back in 1927. February 14 is considered the date of the "birth" of the Scientific and Practical Institute for the Protection of Adolescents (the former name of the institution) - on this day, by the decision of the Leningrad Provincial Health Department, the Children's Health Center No. 4 was transformed into a serious scientific institution. In 1930, the research institute was relocated to Popova Street (formerly Pesochnaya), where it operates to this day.

The Research Institute of Children's Infections in St. Petersburg has repeatedly changed its profile. During the Second World War, during the blockade, the institute performed the functions of a children's hospital, without stopping research work. In the 1940s and 1950s, hygiene standards, rational feeding systems, methods for organizing a health service, and rules for schools and kindergartens were developed here. There have also been global studies of physiological functions child's body, conditioned reflexes, physiology of the formation of children. In 1961, the institution was transformed into an infectious disease institution: research on the prevention and treatment of childhood infections has been conducted here since 1940.

Management team

The directors who led the Research Institute of Children's Infections (St. Petersburg) throughout the history of its existence made a significant contribution to the development of the institution. These are professors A. A. Matushak, A. Ya. Goldfeld, V. N. Ivanov, A. B. Volovik, L. S. Kutina, A. L. Libov, V. N. Bondarev, G. A. Timofeeva, Corresponding Member of the Russian Academy of Medical Sciences, Professor VV Ivanova. They contributed to the development of the domestic pediatric and infectious diseases services.

Under their leadership, the Scientific Research Institute of Children's Infections (Petersburg) developed the foundations for providing medical care to children suffering from various infections, determined continuity in the treatment of infectious patients, and scientifically substantiated the principles and methods of sanatorium treatment after infectious diseases for recovering children. The Institute was awarded in 1975 for services to the Fatherland with the Order of the Badge of Honor.

Newest time

In 2008, the Institute was headed by Honored Scientist, Academician of the Russian Academy of Sciences, Professor Yu.V. Lobzin, who was simultaneously appointed chief freelance specialist of the Ministry of Health for children infectious diseases. The primary task during this period was the restoration of the material and technical base. The scientific laboratories of the Research Institute of Children's Infections, the polyclinic department, and the medical building of the Institute have been updated.

The main achievements were the commissioning of the main clinical building for 350 beds after the overhaul (November 2010) and the administrative and clinical building, as well as equipping the institute with modern equipment, both for instrumental and for laboratory diagnostics.

Priority activities

Now the staff of the Research Institute of Children's Infections (St. Petersburg) mainly deals with the following problems:

  • improvement of organizational procedures for vaccination;
  • diagnosis of infectious diseases;
  • providing medical care to children suffering from infectious pathologies;
  • rehabilitation of convalescents;
  • the study of pathogenesis;
  • scientific rationale for therapeutic tactics.

Research institute structure

The Institute has sixteen scientific departments. The largest of them are engaged in the study of neuroinfections, congenital, drip, intestinal infections, organic pathology nervous system, liver diseases, prevention, intensive care of emergency conditions and other areas.

The departments for the organization of medical care and congenital infections have been newly created. The institution has five laboratory diagnostic units:

  • human microecology;
  • virology;
  • molecular microbiology, epidemiology;
  • laboratory diagnostics;
  • division of pathomorphological and tissue methods.

Medical staff

The Institute of Children's Infections (St. Petersburg) has highly professional scientific personnel. They include 20 doctors of science, including 11 professors, 5 associate professors, 1 academician of the Russian Academy of Sciences, 1 corresponding member of the Russian Academy of Medical Sciences, 2 honored scientists and 27 candidates of science.

Scientific activity

The following scientific and practical centers operate on the basis of the research institutes:

  • herpes virus infections;
  • multiple sclerosis;
  • congenital infections;
  • demyelinating diseases;
  • chlamydia;
  • tick-borne infections;
  • immunoprophylaxis of children and adults;
  • children's hepatology center.

Such a serious representation of scientific centers allows for specialized medical and advisory assistance to specialized patients in Russian Federation, to form a register of relevant patients and to coordinate scientific research on specialized problems.

The institution in its field is an advanced scientific and medical center, truly unique when it comes to providing highly qualified medical care using the latest treatment and diagnostic technologies.

The institute has built an interdisciplinary system that allows using the knowledge of doctors and a large team of scientists from various medical specialties to solve most problems related to children's health. For these purposes, scientifically based medical technologies are used, which in most cases are the results of their own scientific research held at the institute.

Treatment

The clinic of the Research Institute of Children's Infections, the polyclinic department, the intensive care unit are equipped with modern expert-class medical equipment, which makes it possible to provide resuscitation care to children with severe forms of infectious diseases and organic damage to the central nervous system. The Institute accepts children from all subjects of the Russian Federation for inpatient treatment, including patients with severe and complicated forms of infections that require a complex diagnostic search.

One of the activities of the institute is the specific prevention of infectious diseases. For the first time in St. Petersburg, a round-the-clock hospital was created, where it became possible to vaccinate children at risk with comorbidities, an unknown vaccination history under the supervision of qualified medical personnel.

Rehabilitation of children with cerebral palsy

For the first time in Russia, the Institute has created a system of complex medical rehabilitation of children with severe motor disorders, including the use of high-tech devices that combine robotic motor activity with biofeedback and functional electrical stimulation technologies. In addition to rehabilitation procedures, a diagnostic study was introduced using an optical topography system, which makes it possible to detect pathologies of the musculoskeletal system without radiation exposure.

Rehabilitation treatment, including robotic mechanotherapy, is accepted for children in the acute period of infectious diseases with dysfunction of the nervous systems (central and peripheral), as well as patients with residual symptoms of diseases.

Material and technical base

Comfortable conditions for the stay of patients have been created in the institute's clinic. Everywhere produced overhaul. The departments have three- and four-bed boxes, as well as one- and two-bed superior rooms. The rooms are equipped with ergonomic furniture, individual bedside tables, special beds with orthopedic mattresses. Each box has a staff button.

Within the framework of the federal targeted investment program and with the personal support of the head of the FMBA V.V. conditions for providing them with medical care.

The occurrence of infection in children.

Infections in children can cause quite serious complications of the body as a whole, so timely diagnosis of diseases in children is extremely important. There is rapid growth, the change of milk teeth to permanent ones, differences in the formation of the skeleton of boys and girls are determined, the mental development of the child makes a sharp jump.

The occurrence of infection in children at the moment is an extremely negative factor, because. a growing organism is already working at the limit of its capabilities, and any failure can lead to a disruption of the child's immunity, affecting its subsequent development during puberty.

In order to detect infection in children and start treatment in a timely manner, for the purpose of subsequent prevention, a general children's medical examination is carried out in our country.

Clinical examination is an active observation by a medical institution of the health of children throughout the entire period of childhood. The medical examination program includes constant monitoring of the child, timely diagnostic measures in order to identify infections in children, with their subsequent treatment.
The most common at this age are childhood infections and colds, because. children already socialize in relatively large communities where viral diseases are most easily spread. Unfortunately, children do not always follow the rules of personal hygiene, and quite often neglect them, and this negative factor contributes to the development of the disease among the rest of the team.

Early diagnosis of infection in children allows to isolate it from healthy children in a timely manner, preventing further spread of the infection. At the same time, the duration of the sick child's stay in the team also plays the main role, because. The incubation period for all diseases is different.

Infections in children and their frequent recurrence is extremely negative for the child's body, and only timely diagnosis can avoid these negative factors that cause risk, proper treatment and, of course, strengthening the immune system.

There are the following main infections in children:

- Acute respiratory viral infections.

This is a group of acute respiratory diseases that are characterized by damage to various parts of the respiratory tract, intoxication, and the addition of bacterial complications. SARS - acute respiratory viral infections are the most common diseases in children. Transferred SARS, as a rule, do not leave behind long-term and lasting immunity. This circumstance, as well as big number pathogen serotypes acute respiratory viral infections and the absence of cross-immunity determine the possibility of developing ARVI in the same child several times a year. Particularly susceptible to acute respiratory viral infections are young children who encounter viruses for the first time. Accession of ARVI to a particular chronic disease contributes to its exacerbation and more severe course.

- Measles- an acute highly contagious disease, accompanied by fever, inflammation of the mucous membranes, rash. The development of complications is facilitated by the nature of morphological changes in the cortex, as well as a decrease in immunological protection at a certain stage of the disease. Complications associated with damage to the respiratory and digestive tract are most characteristic of measles. Pneumonias, which can occur in any period of measles, are especially often observed.

-Rubella- an infectious disease, accompanied by a rash and an increase in the occipital lymph nodes, dangerous for pregnant women due to the possibility of developing embryo- and fetopathy.

-Chicken pox- a highly contagious infectious disease that occurs with a characteristic blistering rash. A blood test sometimes reveals leukopenia, lymphocytosis. ESR is not changed.

-Whooping cough- an acute infectious disease, which is characterized by a constantly growing convulsive cough. The pathogen enters the body through the upper respiratory tract and remains on the epithelium of the mucous membrane for 5-6 weeks. It is known that it produces endotoxin, which acts mainly on the receptors of the cough reflexogenic zone. The slight severity of catarrhal phenomena, combined with the persistence and strength of the cough, indicates the role of the nervous system in the pathogenesis of whooping cough, as pointed out by N. Filatov.

-Scarlet fever- one of the forms of streptococcal infection, accompanied by fever, tonsillitis, rash, often followed by lamellar peeling of the skin, giving complications of streptococcal and infectious-allergic genesis.
Scarlet fever differs from rubella in a smaller rash with typical localization on the folds (with rubella, a thickening of the rash is observed on the extensor surfaces of the arms, buttocks).

- Infectious mononucleosis- a low-contagious infectious disease characterized by fever, inflammation in the pharynx, enlarged lymph nodes, spleen, liver, mononuclear reaction from the blood. Caused by the Epstein-Barr virus.

-Meningococcal infection is an infectious disease caused by various serological strains of meningococcus.

-Spicy viral hepatitis - an infectious disease characterized by a predominant lesion of the liver, symptoms of intoxication and proceeding with jaundice, often without it and in a subclinical form. Acute viral hepatitis is one of the most common infectious diseases. In terms of the number of registered cases, it is in third place after SARS and gastrointestinal diseases. The average contagiousness index is 40%. From 60 to 80% of cases are children under 15 years of age. The peak incidence occurs at the age of 3-9 years and is explained by the insufficient observance of the rules of personal hygiene by this contingent of children. In children of the first year of life, hepatitis type B is predominantly observed. At an early age, an atypical, acyclic course of the disease, a tendency to relapse, a protracted course and the formation of chronic hepatitis are more often observed. The frequency of anicteric and subclinical forms leads to delayed diagnosis and treatment, contributes to a longer and more unfavorable course of the disease.

-Acute intestinal infections- a large group of diseases, including dysentery, salmonellosis, coli infection, the main clinical manifestations of which are dyspeptic disorders, symptoms of intoxication and dehydration. Acute intestinal infections are especially common in children, they account for 60-65% of all cases of the disease, a significant part of which is observed in children younger than age group(up to 2 years). This is due to the anatomical and physiological characteristics of the digestive organs, the imperfection of protective mechanisms and the lack of sanitary and hygienic skills in babies.
Diseases are caused by dysentery bacteria, salmonella, pathogenic E. coli, staphylococcus, proteus, enterococcus, viruses such as Coxsackie, ECHO, adeno-, reo-, and other pathogens. The causative agents of dysentery, salmonellosis, coli infections have much in common.
The main differential features individual representatives Enterobacteria family are differences in metabolism and antigenic structure. In this regard, the identification of microbes in bacteriological examination is carried out according to their ability to break down sugars and with the help of specific sera.
The causative agent of intestinal coli infection belongs to the species Escherichia coli, which is part of the genus Escherichia. The genus Salmonella includes serogroups A, B, C, D, E, and others, each of which is determined by the features of the H-antigen. Dysentery bacteria of the genus Shigella is subdivided into a large number of species with species- and type-specific immunity. Currently, in most of the territory of our country, a single serological species of the causative agent of dysentery prevails - Zonn
The main route of infection with rotaviruses (Proteus, Enterococcus) is oral-fecal, in contrast to the respiratory route for enterovirus and respiratory infections.

-Polio- (spinal infantile paralysis, Heine-Medin's disease) - an acute infectious disease characterized by damage to the gray matter of the spinal cord and brain stem with the development of flaccid paresis and paralysis, bulbar disorders. The causative agent is the polio virus, which belongs to the genus Enterovirus and can be of 3 types. Being a typical representative of the family of intestinal viruses, in its epidemic properties it is very close to the pseudopoliomyelitis viruses ECHO and Coxsackie, which can give a similar clinical picture with the non-paralytic form of poliomyelitis. The virus is quickly inactivated by boiling, autoclaving and ultraviolet irradiation, it is disinfected in 30 minutes when heated to 50 ºС, but tolerates cold well; under normal room temperature persists for several days, resistant to the action of digestive juices, antibiotics. Conventional disinfection methods are ineffective, free chlorine and formaldehyde have a neutralizing effect.
The source of infection is a patient with obvious or erased, abortive forms of poliomyelitis, as well as a virus carrier. Infection occurs mainly by the fecal-oral route. It has been established that, as with any intestinal infection, with the faeces of a patient with poliomyelitis in environment a large amount of virus enters, especially in the first 2 weeks from the onset of the disease. The spread of infection occurs through food products, including through milk, as well as through water, hands, with the help of flies in contact with infected human feces.
The virus also enters the environment from the discharge of the nasopharynx, starting from the 2-4th day after infection and within 1-2 weeks of illness.
The classification of poliomyelitis provides for variants of the disease both without damage to the nervous system, and with damage to it.
The initial period of poliomyelitis can be difficult to distinguish from SARS, influenza, tonsillitis, and in the presence of dyspeptic symptoms - from gastroenterocolitis of a different nature or dysentery.

Clinical laboratory diagnostics (blood test in a child) childhood diseases differs in many ways from clinical laboratory diagnostics (blood analysis) adult people. Diagnosis of infections is carried out by the Institute of General and clinical pathology RANS Clinic Professor M.Yu. Yakovleva Moscow.

So, first of all, it should be noted that children have normal values ​​of many laboratory parameters ( interpretation of a child's blood test) - morphological, biochemical, etc. are significantly different from those that occur in adults. For example, while hemoglobin levels in adults are 80-115%, in a newborn they range between 130 and 160%, in baby- between 80 and 100%, in 2-3-year-old children - between 65 and 75%, etc. Blood sugar in an adult contains 80-120 mg%, in a newborn - 50-60 mg%, in a 2-year-old child - 70-80 mg%. A similar picture of difference child's blood test And blood test of an adult give us almost all laboratory indicators. At deciphering a child's blood test laboratory parameters in children are more labile than in adults. Metabolic processes are also not yet strong and show great instability. Therefore, in childhood pathological changes can occur much more easily.

A typical example is ketonuria. Lability of laboratory parameters compared with normal blood count in children it is expressed not only in a greater frequency of positive samples, but also in large quantitative deviations.

For two days now, Lyonya and I have been in the hospital.

In a room measuring about 12-14 meters there are three children with infectious diseases and three adults who care for them. Children of different ages, which makes it difficult to comply with at least some kind of regimen. But this is not the biggest problem. Imagine the additional risk to the health of sick children in such a tight space! As a result of being in such conditions, a sick child, who already has a weakened immune system, has every chance of getting infections from his neighbors. The same, of course, applies to parents who are with their children.
Parents are forced to sleep with their children on the same bed, and the beds are the most ordinary single beds, measuring 180 by 70 cm. tall you can’t fit on this one, and there’s nowhere to hang your legs - the headboard rests against the next one. Yes, and imagine for yourself how you can fall asleep on such a bed with a child of 2-3 years old, who is constantly spinning in his sleep? One pillow and one blanket are provided.
For everyone in the ward, there is one small table that blocks the passage between the beds.
Of the three beds in the infectious box, one is metal, and two are wooden folding beds. After the first night spent in the ward, we tried to understand why the bed was uneven and found that, firstly, it was broken, and secondly, it simply did not fit in its entire length - the dimensions of the room did not allow. On a metal bed, the springs dig into the body.
It blows strongly from double-glazed windows, as a result, even those who were healthy get sick.
The food is of average quality, but the problem is that the diet in the hospital is completely different from the usual for toddlers and preschool children. At 10 o'clock breakfast, from 14 to 15 lunch (and usually this is already quiet time), no afternoon snack, dinner at 18 o'clock. It turns out that another dinner is needed, and this already creates additional difficulties.
It is amazing that with the cost of a single room at 4,300 rubles per day (!!!), the hospital is not even able to supply the bathrooms of all other rooms with toilet paper, soap and paper towels, although there are holders for them. I wonder what this money goes to? And what are they paying for? I made inquiries: in other children's hospitals, the cost of individual rooms varies from 1.5 to 2 thousand. By the way, this clinic mentions paid wards, but not a word about their cost. Or is it secret information and the amounts vary depending on who is asking the question?
The sink in the bathroom has not been washed for the third day - either someone vomited there, or traces of food debris, but it is very dirty. The toilet seat is broken. There is no need to dream about one-time paper seats, which are now even on trains.
It is believed that this medical institution has a good scientific and medical base - i.e. the hospital is good. I will not dispute this yet and I hope that I will have the opportunity to observe positive result from treatment. If only all of the above does not nullify the efforts of doctors and the suffering of children and parents.

The review left on the official website did not appear. Which says either that the ability to leave reviews is disabled, or that it has not passed moderation.

I will stylistically process all the above information and will use it to communicate with regulatory organizations and the media. The more we remain silent out of fear and uncertainty, the worse it is for us and our children.

Up