Viral Intestinal Infections Research Articles

Возможности профилактики и медикаментозной терапии гастроэнтерологической патологии после вирусных кишечных инфекций у детей

Возможности профилактики и медикаментозной терапии гастроэнтерологической патологии после вирусных кишечных инфекций у детей

КЛИНИКО-ЛАБОРАТОРНАЯ ХАРАКТЕРИСТИКА СОЧЕТАННЫХ ВИРУСНЫХ КИШЕЧНЫХ ИНФЕКЦИЙ У ДЕТЕЙ В Г.БАКУ

Цель исследования заключалась в изучении эпидемиологических и клинических особенностей сочетанных вирусных кишечных инфекций среди детей. Этиологическая диагностика острых кишечных инфекций вирусной этиологии осуществлялась с помощью серологического метода (Метод иммунохроматографического анализа).Установлено, что сочетанные вирусные кишечные инфекции при первичном инфицировании регистрировались в основном у детей первых 2-х лет жизни. В возрастной структуре сочетанных вирусно-вирусных инфекций ротавирусно-аденовирусная ассоциация регистрировалась достоверно чаще, чем ротавирусно-астровирусная. Наши исследования показали, что наиболее частой клинической формой при сочетанных вирусных кишечных инфекциях является гастроэнтерит.

STAT1-dependent tolerance of intestinal viral infection

Abstract The diverse commensal ecosystem present in the mammalian intestine requires the host immune system to maintain a tolerogenic environment. The virome is an understudied component of the microbiota which promotes intestinal homeostasis and protection from injury, but the host mechanisms that regulate tolerance to viral commensals are poorly described. The antiviral signal transducer STAT1 has previously been shown to mediate tolerance to systemic viral pathogens by suppressing adaptive immune responses and protecting the host from immunopathology, but we sought to characterize its role in the context of a commensal intestinal viral infection. We used a persistent strain of murine norovirus (MNV CR6) to interrogate host mechanisms of viral tolerance and commensalism, as CR6 has previously been shown to promote intestinal homeostasis. While CR6 infections of wildtype mice were asymptomatic and limited to the colon, STAT1-deficient mice exhibited virus-induced weight loss and mortality accompanied by systemic viral spread, colonic bacterial dysbiosis, CD4+ T cell dysfunction and hyperaccumulation of CD8+ T cells. However, clinical manifestation of virus-induced disease in STAT1-deficient mice was independent of T cells and the bacterial microbiota. Instead, therapeutic control of viral replication was sufficient to prevent virus-induced disease despite ongoing T cell dysregulation. Collectively, our data indicate that STAT1 maintains tolerance to a viral component of the intestinal microbiota by control of viral replication rather than immunopathology, suggesting that STAT1 uses distinct strategies to tolerate pathogenic and commensal viruses.

Fecal Calprotectin as a Biomarker Distinguishing Infectious Cause in Acute Intestinal Infections, Comparing Different Age Groups of Children

BackgroundFecal calprotectin (FC) measurement has a potential in distinguishing the cause of acute intestinal infections, but its distribution is age dependent.ObjectivesWith this study we wanted to investigate FC values in different age groups of children with acute intestinal infections.MethodsOne hundred and three children with acute intestinal infections were enrolled in this study. Seventy two had viral pathogens, 31 bacterial test subjects were divided into 3 groups: ≤ 1 y, 1 - 3 y, 3 - 7 y. Stool samples from test and control subjects (n = 17) were tested for FC with fluorescence enzyme immunoassay.ResultsViral and bacterial pathogen groups had significantly greater FC concentrations, compared to healthy controls. Overall, bacterial pathogen group presented with greater FC values, compared to viral pathogen group (1299.0 mg/kg vs 297.0 mg/kg, P = 0.002). The cut-off value for acute viral intestinal infections was > 70.0 mg/kg (78.2% sensitivity and 100% specificity), bacterial intestinal infections: > 201.0 mg/kg (88% sensitivity and 100% specificity). There was no difference in FC concentration between bacterial and viral pathogen groups in children under one-year-old (391.0 mg/kg vs 399.5 mg/kg, P = 0.945). Differences were significant comparing bacterial and viral pathogen groups of children from 1 to 3 (316.0 mg/kg vs 1799.75 mg/kg, P = 0.001) and from 3 to 7 years old (99.0 mg/kg vs1299.0 mg/kg, P = 0.04).ConclusionsFC is a valuable biomarker for distinguishing bacterial and viral pathogens, except for children under one-year-old.

МОНИТОРИНГ ДОМИНИРУЮЩИХ КИШЕЧНЫХ ВИРУСОВ В СТОЧНОЙ ВОДЕ КАК ВОЗМОЖНОСТЬ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ ЭПИДЕМИОЛОГИЧЕСКОГО НАДЗОРА ЗА ВИРУСНЫМИ ОСТРЫМИ КИШЕЧНЫМИ ИНФЕКЦИЯМИ

Background. The monitoring of enteric viruses in wastewater is a new epidemiological approach allowing to detect the intensity of their circulation in humans. The aim of the study is to conduct and analyze parallel monitoring studies of wastewater and biological material from patients with acute viral intestinal infections (AEI) selected from different regions of the Republic of Belarus in terms of their actual pathogens. Material and methods. 403 samples of wastewater and 381 samples of feces from patients with AEI, collected in different regions of Belarus, were examined by real-time PCR. Results. In patients with AEI, rotaviruses A (20,4%) and noroviruses of the genogroup 2 (10,2%) were most often detected, while adenoviruses F (2,2%), enteroviruses (0,8%) and noroviruses 1 (0,3%) were found quite rarely. Adenoviruses F (25,9%), rotaviruses A (18,4%) and enteroviruses (13,4%) dominated in wastewater samples while noroviruses 2 (6,8%) and noroviruses 1 were detected much less frequently (1,5%). Certain differences were revealed in the percentage of viral AСI pathogens present in patients and those found in wastewater, that indicates active hidden circulation of some of them (adenoviruses F and enteroviruses). SARS-CoV-2 coronavirus was detected in one of the wastewater samples. The conducted sequencing and bioinformatic analysis of its nucleotide sequence showed 100% similarity with the sequences of isolates identifed in patients with COVID-19.Conclusions. The obtained data indicate the potential of the studies based on monitoring of intestinal viruses in wastewater in order to increase the effectiveness of epidemiological surveillance of known AEI pathogens circulation and to identify new and emerging ones.

Лечение острых кишечных инфекции вирусной этиологии у детей: результаты международного многоцентрового двойного слепого плацебо-контролируемого рандомизированного клинического исследования

Лечение острых кишечных инфекции вирусной этиологии у детей: результаты международного многоцентрового двойного слепого плацебо-контролируемого рандомизированного клинического исследования

IFN-Lambda 3 Mediates Antiviral Protection Against Porcine Epidemic Diarrhea Virus by Inducing a Distinct Antiviral Transcript Profile in Porcine Intestinal Epithelia.

Type III interferon-lambda (IFN-λ) plays a critical role against infection, particularly in mucosal infection in the respiratory and gastrointestinal tract. Our study and other previous studies have shown that porcine IFN-λ more efficiently curtails the infection of porcine epidemic diarrhea virus (PEDV) in the intestine epithelia than type I IFN, whereas IFN-λ3 exerts a more potent effect than IFN-λ1. However, the underlying mechanism remains elusive, and in particular, the transcriptional profile induced by IFN-λ3 has not been reported. Here, to resolve the mechanism responsible for the disparity between IFN-λ3 and type I IFN in anti-mucosal virus infection, we compared the transcription profiles induced by the two IFNs in porcine intestinal epithelial (IPEC-J2) cells by RNA-Seq. Our results showed that the pretreatment of IPEC-J2 cells with IFN-λ3 resulted in the differential expression of 983 genes. In contrast, IFN-α only modified the expression of 134 genes, and 110 of these genes were also observed in the response to IFN-λ3. A transcriptional enrichment analysis indicated that IFN-λ3 or IFN-α regulates multiple cellular processes and that IFN-λ3 activates more robust signaling pathways, particularly the antiviral Jak-STAT signaling pathway, than IFN-α. Furthermore, we verified the RNA-Seq results through an RT-qPCR analysis of IPEC-J2 cells and porcine enteroids. Moreover, transient expression of the porcine rsad2 and mx2 genes among the top 10 genes induced by IFN-λ3 significantly inhibited PEDV infection. Collectively, the data showed that IFN-λ3 induces a unique transcriptional profile that does not completely overlap with that induced by IFN-α and strongly elicits a set of genes responsible for the antiviral activity of IFN-λ3. These findings provide important knowledge regarding the elicited ISGs of type I and III IFNs in restricting porcine intestinal viral infection.

Clinical and epidemiological features of viral infections in the children's non-infectious multidisciplinary medical organization

The article presents generalized clinical and epidemiological features of viral infections in children's noninfectious multidisciplinary hospital based on the results of a multi-year comprehensive study. The study was conducted for 12 years (2006–2017), included 16615 patients, including those diagnosed with «Acute respiratory viral infection» – 6104 patients, with a diagnosis of «Acute intestinal viral infection» – 1934 patients. A total of 193017 microbiological studies were conducted, including molecular genetic studies. It was found that the overall incidence of viral infections in children's non-infectious multidisciplinary hospital was 21.1 [95% CI 20.3-21.9] per 1000 hospitalized patients (according to long-term average data). The main nosological groups of viral infections were respiratory infections, enteric infections, intrauterine infections and parenteral viral hepatitis. Viral infections in in children's non-infectious multidisciplinary hospital were characterized by the following clinical and epidemiological features: high incidence; age group at risk – children under 3 years; features of clinical picture with «masks» of noncommunicable pathology; presence of combined infections; high level of virus transmission; high frequency of infections, brought into the hospital; prevalence of healthcare-associated infections in the general structure of morbidity with outbreak and involvement in the epidemic process of children and adults; uneven distribution of morbidity and carriers in departments; presence of nosocomial circulation of viruses.

Пространственно-временная характеристика заболеваемости вирусными кишечными инфекциями в городах Архангельской области

Пространственно-временная характеристика заболеваемости вирусными кишечными инфекциями в городах Архангельской области

OPTIMIZATION OF TREATMENT TACTICS FOR ACUTE VIRAL GASTROENTERITIS IN IN-PATIENT CHILDREN

Acute intestinal infections (ACI) being a common form of pathology in children, 50-80% of cases are due to viral agents with a predominance of rotavirus. Patients Over a two-year period, 2556 children aged from 3 months and up to 18 years old were treated in the Department of acute intestinal infections. Two groups of children with viral intestinal infections without extraintestinal bacterial foci were selected. The main group consisted of 259 children who received diet therapy, oral rehydration (ORR) and, according to indications, infusion therapy (IT). 248 children included in the comparison group (CG) received ORP, nitrofurans, antibacterial drugs, enterosorbents, enzymes, probiotics, and, according to indications, IT. Results. In no case did the children of OG receive antibacterial drugs; Compliance with parents allowed IT to be minimized to 17.4% of cases (45 children). In CG, in 74.2% of cases (184 children), patients, in addition to nitrofurans, received III generation cephalosporins, in 81.9% of cases - IT, all children received probiotics, enzymes as symptomatic therapy. Following the recommendations of WHO and ESPGHAN allows avoiding polypharmacy and reduce the economic costs of treating in-patient children with viral gastroenteritis by 3.3 times.

IFN-I and IL-22 mediate protective effects of intestinal viral infection.

Products derived from bacterial members of the gut microbiota evoke immune signaling pathways from the host that promote immunity and barrier function in the intestine. How immune reactions to enteric viruses support intestinal homeostasis is unknown. Recently, we demonstrated that infection by murine norovirus (MNV) reverses intestinal abnormalities upon depletion of bacteria, indicating that an intestinal animal virus can provide cues to the host that are typically attributed to the microbiota. Here, we elucidate mechanisms by which MNV evokes protective responses from the host. We identify an important role for the viral protein NS1/2 in establishing local replication and a type I interferon (IFN-I) response in the colon. We further show that IFN-I acts on intestinal epithelial cells to increase the proportion of CCR2-dependent macrophages and IL-22 producing innate lymphoid cells (ILCs), which in turn promote pSTAT3 signaling in intestinal epithelial cells and protection from intestinal injury. Additionally, we demonstrate that MNV provides a striking IL-22 dependent protection against early life lethal infection by Citrobacter rodentium. These findings demonstrate novel ways in which a viral member of the microbiota fortifies the intestinal barrier during chemical injury and infectious challenges.

Multiplex PCR methods for detection of several viruses associated with canine respiratory and enteric diseases.

Viral respiratory and intestinal infections are the most common causes of canine viral illness. Infection with multiple pathogens occurs in many cases. Rapid diagnosis of these multiple infections is important for providing timely and effective treatment. To improve diagnosis, in this study, two new multiplex polymerase chain reactions (mPCRs) were developed for simultaneous detection of canine respiratory viruses (CRV) and canine enteric viruses (CEV) using two separate primer mixes. The viruses included canine adenovirus type 2 (CAV-2), canine distemper virus (CDV), canine influenza virus (CIV), canine parainfluenza virus (CPIV), canine circovirus (CanineCV), canine coronavirus (CCoV) and canine parvovirus (CPV). The sensitivity of the mPCR results showed that the detection limit of both mPCR methods was 1×104 viral copies. Twenty nasal swabs (NS) and 20 anal swabs (AS) collected from dogs with symptoms of respiratory disease or enteric disease were evaluated using the novel mPCR methods as a clinical test. The mPCR protocols, when applied to these respiratory specimens and intestinal samples, could detect 7 viruses simultaneously, allowing rapid investigation of CRV (CAV-2, CDV, CIV and CPIV) and CEV (CAV-2, CanineCV, CCoV and CPV) status and prompt evaluation of coinfection. Our study provides an effective and accurate tool for rapid differential diagnosis and epidemiological surveillance in dogs.

Comparison of vezikari and clark scale for determination of of viral intestinal infections sevitity and predicting their outputs in children

Introduction. To assess the severity of acute gastroenteritis in children, two scales of gravity are used: a 20-pointVesicari scale and a 24-point Clark scale. However, there are significant differences between these scales and there are practically no studies comparing their effectiveness in one representative group of patients. Material and methods: Complex clinical and laboratory examination of 143 children aged 1 to 7 with intestinal viral intestinal infections caused by rotavirus and norovirus was carried out. The severity of the patients’ condition was assessed using both Clark and Vesicary scale. Convalescences continued to be monitored for 12 months to open adverse outcomes. Results: In assessing the severity of viral intestinal infections using Clark and Vesicari scales, there were significant differences in children. The Vesicari scale significantly more accurately estimates the severity of intestinal infection in the acute period of the disease. At the same time, the use of the Clark scale contributes to the refinement of the prognosis for the development of post-infection gastroenterological pathology and its timely prevention. Conclusion: There is a need to create a new scale of universal assessment of the severity of viral intestinal infections that combines the advantages of both scales.

Clinico-laboratory efficacy of the drug Viferon® in viral lesions of the gastroin-testinal tract in children

In recent years, viral lesions of the gastrointestinal tract take the leading place in the etiological structure of acute intestinal infections. The study of the clinical course and treatment of viral diarrhea in children is an urgent task in modern conditions. We analyzed the disease of 2568 children aged 1 month to 17 years who were hospitalized in a Hospital No 3 in St. Petersburg in the period of 2016-2017. All patients underwent a standard laboratory examination. The etiological interpretation was carried out with the help of polymerase chain reaction, bacteriological and serological methods of investigation. Of the 2568 children in 1502 (58.5%) patients, the diagnosis was confirmed. The share of bacterial diarrhea was 31.8%, viral lesions of the gastrointestinal tract – 68.2%. Among the decoded viral lesions of the gastrointestinal tract, the share of rotavirus infection was 52.8%, norovirus infection – 24.8%, mixed infection – 19.6%. A high proportion of viral lesions of the gastrointestinal tract was established in children under 3 years of age (71.7%). The main reason for hospitalization of children under 5 years of age is rotavirus infection, from 5 to 12 years – norovirus infection. Almost always (87.6%), viral diarrhea proceeded in a moderate form. In infants, mixed viral infection was recorded in severe form. The use of Viferon® in the form of rectal suppositories to supplement the basic therapy of viral intestinal infections significantly reduces the duration of intoxication syndrome, fever, diarrhea, catarrhal syndrome, the duration elimination of viruses, and the length of stay in the hospital.

DETECTION OF HERPESVIRUS INFECTIONS IN CHILDREN OF THE FIRST SIX MONTHS OF LIFE

Aim. To evaluate a possible role of herpes viruses in the pathogenesis of various infectious diseases of children in the first six months of life, including acute gastroenteritis and identify the markers of herpesvirus infections which occur most frequently. Materials and methods. Samples of biological materials (blood serum and blood cells, breast milk, urine, feces) were studied in 35 children aged 14 days to 5 months who are being treated in MRRCI Vladimirsky with diagnoses of «acute infectious gastroenteritis of unspecified etiology» (n=24), «urinary tract infection» (n=6), «intrauterine infection» (n=5) and of their mothers. To determine the antibodies of IgM, IgG in serum, an enzyme immunoassay was used, to detect common antigens of viruses in blood cells, urine, breast milk - an indirect reaction of immunofluorescence, to detect early antigens of viruses and their reproduction - a rapid cultural method. Results. Infection with herpesviruses was found in 85% of children and 91% of mothers, with the most often identified markers of active forms of infection caused by the herpes simplex virus. In children with a diagnosis of acute infectious gastroenteritis of unspecified etiology, no pathogens of viral and bacterial intestinal infections were detected in a large number of active forms of herpesviral infections in both children and their mothers (33% and 91%, respectively). As well as mothers and their children, there have been cases of mixed infections caused by associations of herpesviruses, most often with HSV. Conclusion. Detection of active forms of herpesviral infections in the absence of positive results in studies on viral and bacterial intestinal infections make it possible to assume that herpesviruses can participate in the etiology of these diseases and cause infectious complications in this pathology, as well as often act as a co-infection. An important epidemiological importance has a large number of identified latent forms of herpesvirus infections, because when exposed to adverse factors they can go into active forms.

CLINICAL CHARACTERISTICS OF VIRAL GASTROENTERITIS OF MIXED ETIOLOGY IN YOUNG CHILDREN IN BAKU, AZERBAIJAN

The article presents the results of studying the etiological structure and clinical features of acute intestinal infections (AII) in young children in Baku, Azerbaijan. In most cases, the disease has a viral etiology and proceeds in the form of gastroenteritis. At the same time in the age groups 6—12 months and 1—3 years of life, viral intestinal infections in 72.72% of cases have a mixed etiology (usually viral-viral), with a predominance of rotavirus infection. Taking into account the obtained results, it is necessary for all children of early age with AII, in addition to routine diagnostics, to conduct research using modern methods for virus verification (Latex-test, PCR).

PIN21 - Estimation of Indirect Costs of The Children Viral Acute Intestinal Infections Therapy in Ukraine

Scientific pharmacoeconomical estimation of feasible indirect costs of itreatment of children viral Acute Intestinal Infections (AII) in Ukraine in 2017 based on retrospective data of 2016. Data of State Statistics Committee of Ukraine as average wage, nominal GDP, quantity of the population in Ukraine in 2016 had been used. Literature sources and our own research of medical cards of patients had allowed indicating of an average duration of in-patient with viral AII staying in health authorities. Official data of morbidity of children with viral AII given by Ministry of Health and growth index were used in calculations. It was established that the average wage for various economic activities amounted to 5070 UAH in Ukraine. The amount of a personal day loss had been made up 169 UAH. The average length of stay of children with viral AII in health care had been established as 6 bed-days. It had been calculated that the average costs of disability days per patient’ parent amounted to 1014 UAH. The value of nominal GDP per person per day had been calculated using the statistics (nominal GDP in Ukraine totaled 664.717 mln UAH in the third quarter of the year and the population of the country amounted to 42,620.007 ths. people), it had been 173.29 UAH. Loss of GDP as a result of disability per one patient totaled 1041.6 UAH. Thus, the estimated feasible indirect costs of budget for the treatment of viral diarrhea in children in 2017 may amount to 25,170,822 UAH or 93 572 $ (taking into account current rate of National Bank). Given research had allowed to estimate the feasible annual indirect costs for viral AII in children in Ukraine on 2017, which amounted to 93,57 ths. $.

Transcriptomic Analysis of the Innate Antiviral Immune Response in Porcine Intestinal Epithelial Cells: Influence of Immunobiotic Lactobacilli.

Lactobacillus rhamnosus CRL1505 and Lactobacillus plantarum CRL1506 are immunobiotic strains able to increase protection against viral intestinal infections as demonstrated in animal models and humans. To gain insight into the host–immunobiotic interaction, the transcriptomic response of porcine intestinal epithelial (PIE) cells to the challenge with viral molecular associated pattern poly(I:C) and the changes in the transcriptomic profile induced by the immunobiotics strains CRL1505 and CRL1506 were investigated in this work. By using microarray technology and reverse transcription PCR, we obtained a global overview of the immune genes involved in the innate antiviral immune response in PIE cells. Stimulation of PIE cells with poly(I:C) significantly increased the expression of IFN-α and IFN-β, several interferon-stimulated genes, cytokines, chemokines, adhesion molecules, and genes involved in prostaglandin biosynthesis. It was also determined that lactobacilli differently modulated immune gene expression in poly(I:C)-challenged PIE cells. Most notable changes were found in antiviral factors (IFN-α, IFN-β, NPLR3, OAS1, OASL, MX2, and RNASEL) and cytokines/chemokines (IL-1β, IL-6, CCL4, CCL5, and CXCL10) that were significantly increased in lactobacilli-treated PIE cells. Immunobiotics reduced the expression of IL-15 and RAE1 genes that mediate poly(I:C) inflammatory damage. In addition, lactobacilli treatments increased the expression PLA2G4A, PTGES, and PTGS2 that are involved in prostaglandin E2 biosynthesis. L. rhamnosus CRL1505 and L. plantarum CRL1506 showed quantitative and qualitative differences in their capacities to modulate the innate antiviral immune response in PIE cells, which would explain the higher capacity of the CRL1505 strain when compared to CRL1506 to protect against viral infection and inflammatory damage in vivo. These results provided valuable information for the deeper understanding of the host–immunobiotic interaction and their effect on antiviral immunity. The comprehensive transcriptomic analyses successfully identified a group of genes (IFN-β, RIG1, RNASEL, MX2, A20, IL27, CXCL5, CCL4, PTGES, and PTGER4), which can be used as prospective biomarkers for the screening of new antiviral immunobiotics in PIE cells and for the development of novel functional food and feeds, which may help to prevent viral infections.

Патогенетичне обґрунтування оптимізації лікування вірусних діарей у дітей за допомогою спороутворювальних бацил, здатних до самоелімінації

У статті продемонстровано ефективність Субаліну як пробіотика, що належить до групи антагоністів, які здатні до самоелімінації. Субалін є рекомбінантним бацилярним пробіотичним штамом, одна доза якого містить 1 • 109–8 • 109 живих мікробних клітин В.subtilis 23–35/105, що отриманий шляхом введення плазмідної ДНК. Це зумовлює посилений синтез позаклітинного α-2-інтерферону людини при збереженні високої антагоністичної активності вихідного штаму щодо патогенних та умовно-патогенних збудників. Завдяки противірусній ефективності, зумовленій інтерфероногенними властивостями, пробіотик Субалін виявився ефективним в офтальмології, у лікуванні вірусних гепатитів та гострих кишкових інфекцій у дітей. Лікувальну дію Субаліну визначають живі бактерії, що мають високу антагоністичну активність стосовно патогенних та умовно-патогенних мікроорганізмів і сприяють нормалізації якісного і кількісного складу кишкової мікрофлори. Призначення Субаліну оптимізує ефективність комплексного лікування вірусних захворювань у дітей, зокрема вірусних гастроентеритів.

ACUTE ENTERIC INFECTIONS POLYMERASE CHAIN REACTION ASSAY IN PEDIATRIC PRACTICE: OPPORTUNITIES AND CHALLENGES

The aim of the study is estimate the opportunities of local multi-prime PCR reagents kits in children enteric infections etiological diagnostics amongst the patients with diarrhoea vs traditional bacteriological methods. We used 4 kits of reagents that provide multiple pathogens simultaneous indication in one sample: 1) Rotavirus, Norovirus, Astrovirus; 2) Shigella spp./EIEC, Salmonella spp., Campylobacter spp.; 3) Yersinia enterocolitica and Yersinia pseudotuberculosis; 4) E. coli: EIEC (enteroinvasive), EPEC (enteropathogenic), ETEC (enterotoxigenic), EHEC (enterohaemorrhagic), EAgEC (enteroaggregative). It has been shown that the viral intestinal infections is increased by 14%, bacterial — in 2,5 times. PCR diagnostics identified in 62% of patients the viral gastroenteritis: Rotavirus (52%), Norovirus (9%), Astrovirus (1%). Detected bacterial pathogens PCR markers number proved up to 2.5 times high than according to bacteriological examination. The spectrum of bacterial agents increased due to E. coli and Y. enterocolitica. PCR diagnostics increased detection of Campylobacter up to 2 times. Detected E. coli DNA prevalence: EPEC — 66%, EAgEC, ETEC and EHEC were 31%, 9% and 4%, respectively. DNA Campylobacter spp. and E. coli constituted 2/3 of all findings: Campylobacter spp. (41%), E. coli (24%), Salmonella spp. (19%), Yersinia spp. (11%), Shigella spp./EIEC (5%). The positive results of bacteriological and serological methods duplicate the positive results of PCR diagnostics. In general, the positive results of PCR diagnosis of bacterial pathogens were detected in 46.35% of the examined patients. In 48.4% of patients identified PCR markers viral — bacterial infection, in 5.25% — of bacterial associations, in 11% of them were found the DNA 2–3 bacterial pathogens. The study was shown in children in St. Petersburg in 2012–2014 dominated rotavirus infection, campylobacteriosis and escherichiosis. The prevalence of viral-bacterial confections is more than 50% of all diagnosed cases.