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[Persistent infections in the children presenting with chronic ENT diseases: the potential of etiotropic therapy]
A S Levina1, I V Babachenko1, A A Vozhik2
1Research Institute of Childhood Infections, Russian Federal Medico-Biological Agency, St. Petersburg, Russia, 195022; St.-Petersburg State Pediatric Medical University, Russian Ministry of Health, St. Petersburg, Russia, 194100.
Insights
Chronic ENT diseases in children are often caused by herpes viruses (types 4, 5, 6) and bacteria like Staphylococcus aureus. Treatment effectiveness declines significantly after two years.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
- Virology
Context:
- Chronic ear, nose, and throat (ENT) diseases affect children, with varying durations of illness.
- Understanding the etiological factors is crucial for effective treatment.
Purpose:
- To diagnose the causes of chronic ENT diseases in children aged 2-12 years.
- To evaluate etiotropic therapy for these conditions based on disease duration.
Summary:
- Identified herpes viruses (types 4, 5, 6), Staphylococcus aureus, Streptococcus pyogenes, and Candida as common pathogens.
- Recombinant interferon and combined therapies were used.
- Therapy effectiveness decreased from 78% within one year to 30% after two years.
Impact:
- Highlights the significant role of specific herpes virus types in chronic pediatric ENT conditions.
- Demonstrates a decline in treatment efficacy over time, emphasizing the need for timely intervention.
Abstract:
The objective of the present study that involved 176 children at the age varying from 2 to 12 years presenting with chronic ENT diseases was etiological diagnostics and etiotropic therapy of these pathologies taking into consideration the duration of the disease of less than one year (n=72), from 1 to 2 years (n=54), and over 2 years (n=50). The bacteriological method was employed to identify microflora from the upper respiratory tract and the molecular-biological methods for the detection of Epstein-Barr virus DNA, cytomegalovirus, and 6 types of human herpes virus in the blood and saliva. All the children were treated with the recombinant interferon preparations given for 1-1.5 months. For 41% of the children this treatment was combined with antibacterial therapy followed by immunocorrective therapy with interferon inducers (in 79.4% of the patients) or bacterial lysates (20.6%). The study revealed the predominant role of types 4, 5, and 6 type herpes viruses in the development of chronic ENT pathologies in the children with the gradual lowering of activity of these infections over 2 years. Staphylococcus aureus and Streptococcus pyogenes as well as fungi of the genus Candida were the commonest bacterial and fungal pathogenic agents isolated from the naso- and oropharynx of the children suffering from chronic ENT pathology.The effectiveness of etiotropic therapy was shown to decrease with time, from 78% during 1 year after the onset of the disease to 30% within the next 2 years.
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