CHLAMYDIAL INFECTION IN CHILDREN: THE CURRENT STATE OF THE PROBLEM

Zhuk L. А.

LITERATURE REVIEWS

Scentific article

The article presents the data of literary sources, which reflect the relevance of the problem of chlamydial infection in children. The obtained data on the influence of Ch.pn. on the formation of chronic somatic pathology in childhood have been analyzed. In recent years, many foreign and domestic authors have observed significant changes in the microbial spectrum of pathogens that cause diseases of the upper and lower respiratory tract. Chlamydia persist in epithelial cells and fibrocytes of infected mucous membranes, as well as in monocytes and tissue macrophages, which contributes to their systemic spread throughout the body. Persistence contributes to the development of immunosuppression, which unfavourably affects the course of chronic non-infectious pathology (bronchial asthma, oncological processes). The greatest tropism of chlamydia is experienced in the cylindrical epithelium of various organs and tissues. At the present time, they are among the main pathogens in the structure of acute respiratory diseases. In this case, the combined infection of the respiratory tract with viruses, pneumococcus and its associations, streptococcus and hemophilus influenza is found. It has been proved that in a number of cases, chlamydial infection in children does not affect the nature of clinical manifestations of acute respiratory viral infection, with the exception of obstructive syndrome. Chlamydial infection is one of the problems that arose sharply in the end of the twentieth century. This is due to its significant distribution in different age groups of the population, ranging from newborns, with a unique ability to strike various organs and systems, often with a chronic course. The number of children with combined pathology is increasing. First of all, this is a combination of chlamydia-cytomegalovirus, herpes simplex virus-chlamydia, toxoplasmosischlamydia-giardiasis-helminthic invasion. It has been proved that chlamydia is changing the adequacy of physiological reactions in an organism. Based on literature data, the prevalence and clinical manifestations of chlamydial infection in children are shown. The interrelation of chlamydial infection with the course of respiratory diseases, bronchial asthma, which have protracted and recurrent nature is stated. The role of chlamydial infection in stimulation of lymphoid tissue hyperplasia has been proved. The value of chlamydial infection in the genesis of bronchial asthma has not yet been studied, but researchers note high rates of infection with this pathogen. It has been proved that intracellular pathogens increase the inflammatory process in the respiratory tract, which leads to the development of structural rearrangements and activation of the process of remodelling the wall of the bronchial wall. It has been demonstrated that among patients with stable bronchial asthma, a high level of serological evidence of clinically asymptomatic chlamydial infections has been reported. It has been discovered in modern studies that chlamydia pneumoniae DNA has been detected in sputum in children, both in the form of a mono infection, and in association with a pneumococcus or a hemophilus influenza. The role of chlamydia in the development of atherosclerosis and other cardiovascular pathology has been established. The connection of the development of myocardial infarction with chlamydial infection is revealed. Atherosclerosis in hypercholesterolemia develops faster in the presence of not only viable but inactivated chlamidophyll in the body. It has been shown that the presence of chlamydia in the renal tissue affects the development and course of IgA nephropathy (Berger’s disease). The reason for the development of reactive arthritis in children may also be chlamydia. The most common pathogens of arthritis in children nowadays are intracellular infections, as well as various combinations of listed above pathogens, which should be taken into account at the stage of diagnosis of the disease and in the choice of therapeutic tactics. The role of chlamydial infection in the development of granulomatosis has been proved. Ch. рn. is considered as a possible infectious agent with the development of a number of neurological diseases, primarily Alzheimer’s, sometimes acute meningitis.

children, chlamydial infection, chlamydia

1. Kapustina TA, Belova EV, Kin TI. FGBU Nauchno-issledovatelskiy institut meditsinskih problem Severa SORAMN, Krasnoyarsk. Chastota vyiyavleniya hlamidiy v nosoglotke u shkolnikov s pomoschyu metoda pryamoy immunoflyuorestsentsii. Detskie infektsii. 2013;2:39-42. [in Russian].
2. Abramova NA, Savenkova MS, Abramov AD. Rol vnutrisemeynogo infitsirovaniya chastoboleyuschih detey. Detskiei nfektsii. 2014;1:52-8. [in Russian].
3. Yeloieva ZV, Akinina MN, Belovodskaya IV. Atipichno protekayuschaya infektsionnaya patologiya u detey, vyizvannaya vnutrikletochnyimi vozbuditelyami. Harkivskiy medichniy zhurnal. 2013;1:31-5. [in Russian].
4. Yeloieva ZV, Akinina MN, Belovodskaya IV. Znachenie vnutrikletochnyih vozbuditeley pri LNP u detey. Epidemiolohiia, hihiiena, infektsiinik hvorob. 2013;1(8):55-8. [in Russian].
5. Bogadelnikov IV, Kryuger EA, Bobryisheva AV. Infektsiyu v karman ne spryachesh. Zdorov’e rebenka. 2012;8(43):143-5. [in Russian].
6. Barron K, Athreya B, Kastner D. Periodic fever syndromes and other inherited auto inflammattory diseases. Textbook of pediatric rheumatology. Elsevier Saunders. 2011:642-60.
7. Akinina MN, Yeloieva ZV, Kuznetsova VM. Rol streptokokkovoy infektsii v vozniknovenii lihoradok neyasnogo geneza u detey. Materiali nauk.prakt. konf. z mizhnar. uchastyu 12–13 bereznya, 2015 r., Harkiv, Ukraina, prisvyachenoi 210-y richnitsi HNMU. Harkiv. Schedra sadiba plyus. 2015:17-9. [in Russian].
8. Yulish EI. Paradigma formirovaniya i razvitiya hronicheskih somaticheskih zabolevaniy na fone persistiryuschih infektsiy. Zdorov’e rebenka. 2010;6(27):92-101. [in Russian].
9. Yeloieva ZV, Matviienko SO, Diachenko MS. Diahnostychne i prohnostychne znachennia vnutrishnoklitynnykh zbudnykiv u vypadku atypovoi infektsiinoi patolohii u ditei. Problemy bezperevnoi medychnoi osvity. 2017;1. [in Ukrainian].
10. Etiopatohenetychna terapiia retsydyvuiuchykh obstruktyvnykh bronkhitiv u ditey z persystuiuchymy infektsiiamy. Donetskyi natsionalnyi medychnyi universytetim M. Horkoho MOZ Ukrainy. 2009. (Metodychni rekomendatsii). [in Ukrainian].
11. Mazankova LN, Grigorev KI. Rossiyskiy natsionalnyiy issledovatelskiy meditsinskiy universitet im. N. I. Pirogova, Moskva. Infektsionnyie zabolevaniya u detey: rol’ v vozniknovenii somaticheskoy patologi. Detskie infektsii. 2013;3:3-8. [in Russian].
12. Abramova NA, Savenkova MS, Abramov AD. Rol vnutrisemeynogo infitsirovaniya chastoboleyuschih detey. Detskiei nfektsii. 2014;1:52-8. [in Russian].
13. Levina AS, Babachenko IV. Persistiruyushchie infekcii u chasto i dlitel’no boleyushchih detey, vozmozhnosti ehtiopatogeneticheskoy terapii. Detskie infekcii. 2014;4:41-5. [in Russian].
14. Shkarin VV, Sergeeva AV. Epidemiologicheskie i klinicheskie osobennosti sochetannyh respiratornyh infekcij u detey. Detskie infekcii. 2017;1:51-6. [in Russian].
15. Santalova GV, Gasilina ES, Kondorova EA. Immuno-moduliruyushchaya terapiya hlamidijnoj infekcii u detey. Detskie infekcii. 2010;4:61-3. [in Russian].
16. Cinzerling VA, Chuhlovina ML. Infekcionnye porazheniya nervnoj sistemy: voprosy ehtiologii, patogeneza i diagnostiki. EHlbi-SPb.: 2011. 583 s. [in Russian].
17. Lobzin YV, Pozdnyak AL, Sidorchuk SN. Hlamidijnye infekcii: diagnostika, lechenie, klinika, diagnostika. SPb.; «Foliant». 2010. 275 s. [in Russian].
18. Volanen I. Increased aortic intima-media thicknessin 11-year-old healthy children with persistent Chlamydia pneumonia eseropositivity. Arterioscler. Thromb. Vasc. Biol. 2006;3(26):649-55.
19. Miyashita M. Association of chronic infection of Chlamydia pneumoniae and coronary heart disease in Japan. Internal Medicine. 1998;11(37):913-6. 20.
20. Poznyak AL, Sidorchuk SN, Tarasov AV. Chlamydophila pneumoniae – infekciya kak faktor riska razvitiya ateroskleroza. Zhurnal infektologii. 2013;1(5):18-27. [in Russian].
21. Rakityanskaya IA, Ryabova TS. Rol’ chlamydia trachomatis pochechnoj tkani v patogeneze IGA-nefropatii s uchetom vozrasta bol’nogo zhurnal infektologii. 2012;1(4):29-35. [in Russian].
22. Shima Javadi Nia, Vida Zarabi, Samileh Noor Bakhsh, Mohammad Farhadi, Sahar Ghavidel Darestani. Chlamydophila pneumoniae Infection Assessmentin Children With Adenoid Hypertrophy Concomitant With Rhino Sinusitis. Jundishapur J Microbiol. 2014;7(8).
23. Bielicka A, Zielnik-Jurkiewicz B, Podsiadły E. Chlamydia pneumoniae and typical bacteria occurrence in adenoid in children qualified for adenoidectomy. Int J Pediatr. Otorhinolaryngol. 2014;78(5):828-31.
24. Yulish EI. Paradigma formirovaniya i razvitiya hronicheskih somaticheskih zabolevaniy na fone persistiruyuschih infektsiy. Zdorov’e rebenka. 2010;6(27):92-101. [in Russian].
25. Matviienko SO, Diachenko MS. Tryherne znachennia persystuiuchykh vnutrishnoklitynnykh zbudnykiv pry tryvalykh lykhomankakh z podalshym rozvytkom somatychnoi patolohii u ditei. Scientific Journal «ScienceRise: Medical Science». 2017;9(17). [in Ukrainian].
26. Kapustina TA, Belova EV. Osobennosti techeniya verhnechelyustnogo sinusita u detey s verifitsirovannoy hlamidiynoy infektsiey. (Vestnik Rossiiskoi Akademii Meditsinskikh Nauk – Annals of the Russian Academy of Medical Sciences. 2013;10:22-5. [in Russian].
27. Voznyuk IA, Gnevyishev EN, Onischenko LS, Gaykova ON, Nuralova IV, Samartsev IN, i dr. Diagnostika hlamidiynogo entsefalita s ispolzovaniem biopsii mozga. Zhurnal infektologii. 2017;2(9):121-7. [in Russian]. 
28. Grayston JT. Infection with Chlamydia pneumoniaeas a cause of coronary heart disease: the hypothesis is still untested. Patholog. Dis. 2015;73(1):1-9.
29. Lebets IS, Panko NO. Osoblyvosti perebihu ta debiutu reaktyvnykh artrytiv u ditei. Zdorov’e rebenka. 2013;6(49):37-42. [in Ukrainian].
30. Chernyshova OY. Dyferentsiiovanyi pidkhid do likuvannia y vtorynnoi profilaktyky ditei, khvorykh na bronkhialnu astmu, na tli persystuiuchykh infektsii [dysertatsiia]. K.; 2016. [in Ukrainian].
31. Chernyishova OY. Vliyanie persistiruyuschih vnutrikletochnyih infektsiy na protsessyi remodelirovaniya dyihatelnyih putey pri bronhialnoy astme u detey. Zdorov’e rebenka. 2014;2(61):77-82. [in Russian].
32. Patel KK, Anderson E, Paula PS, Webley W. The prevalence and identity of Chlamydia-specific IgE in children with asthma and other chronic respiratory symptoms. Respir. Res. 2012;13(1):32.
33. Novosad DI, Bychkova NH, Khaitovych MV. Imunnyi status ditey, khvorykh na bronkhialnu astmu, pry persystentsii Chlamydia Pneumoniae. Ukrainskyi naukovo-medychnyi molodizhnyi zhurnal. 2016;1(93):53-8. [in Ukrainian].
34. Hamitov RF, Paliova LY, Novozhenov VG. Znachenie antibakterialnoy terapii pri Chlamydophila Pneumoniae infektsii u bolnyih bronhialnoy astmoy. Ter. Arh. 2004;76(10):91-4. [in Russian].
35. Katosova LK, Spichak TV, Kim SS. Etiologicheskaya diagnostika ostryih pnevmoniy u detey. Laboratornaya diagnostika v pediatrii. 2009;2(1):2731. [in Russian].
36. Kozlov RS, Pertseva TO, Dmytrychenko VV, Simonov SS. Nehospitalna pnevmoniia: standarty diahnostyky, suchasna antybakterialna terapiia. Ukrainskyi medychnyi chasopys. 2011;6:59-63. [in Ukrainian].
37. Haritonova LA, Israfilova OE, Romantsov MG. Korrektsiya immunnogo disbalansa u detey, chasto boleyuschih povtornimi respiratornyimi infektsiyami. Antibiotiki i himioterapiya. 2013;58(11-12):19-22. [in Russian].
38. Schock BC, Young JS, Brown V. Antioxidants and Protein Carbonylsin Bronchoalveolar Lavage Fluid of Children: NormalData. Pediatric Research. 2011;2(49):155-61.
39. Yulish EI, Chernyishova OE, Krivushev BI. Novyie tehnologii v provedenii ratsionalnoy antibiotikoterapii bakterialnyih respiratornyih infektsiy u detey. Zdorov’e rebenka 2013;7(50):74-8. [in Russian].
40. Ostrovskaya OV, Morozova NV, Morozova OI. Respiratornyiy hlamidioz u detey. Byulleten. 2012;45:62-8. [in Russian].

«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 27-32 pages, index UDK 616.983-053.2

10.29254/2077-4214-2018-4-2-147-27-32