Mukhopadhya A, Ramakrishna B S, Kang G, Pulimood A B, Mathan M M, Zachariah A, Mathai D C
Wellcome Trust Research Laboratory, Department of Gastrointestinal Sciences, Christian Medical College Hospital, Vellore.
Indian J Med Res. 1999 Mar;109:85-9.
This study was undertaken to determine the carriage rate of various enteric pathogens in southern Indian patients with HIV infection, both with and without diarrhoea. Stool from 111 consecutive HIV-positive patients (50 without and 61 with diarrhoea) was examined by microscopy and culture. Jejunal biopsy and fluid examination were carried out if diarrhoea persisted, with negative stool examination. Enteric pathogens were detected from stool in 57.4 per cent of diarrhoeal patients compared to 40 per cent of those without diarrhoea (P > 0.05). Jejunal biopsy and fluid examination provided 11 additional diagnoses. Protozoa accounted for 71.8 per cent of all pathogens isolated. Isospora was significantly more common in patients with (11/61) than in those without (2/50) diarrhoea (P < 0.05). Bacterial pathogens were isolated more commonly from patients with diarrhoea (12/61 compared to 2/50, P < 0.05). Isolation rate of pathogens was higher from patients with diarrhoea for more than 2 wk, compared to those with less than 2 wk duration. Remission of diarrhoea either spontaneously or with symptomatic therapy was observed in 22 patients with acute diarrhoea. A high enteric carriage of a number of pathogens was noted in HIV patients without diarrhoea, but I. belli and bacterial enteropathogens were more likely to be associated with diarrhoea.
本研究旨在确定印度南部感染HIV的患者（无论有无腹泻）中各种肠道病原体的携带率。对111例连续的HIV阳性患者（50例无腹泻，61例有腹泻）的粪便进行了显微镜检查和培养。如果腹泻持续且粪便检查阴性，则进行空肠活检和液体检查。腹泻患者粪便中检出肠道病原体的比例为57.4%，无腹泻患者为40%（P>0.05）。空肠活检和液体检查又提供了11例诊断。原生动物占所有分离出的病原体的71.8%。等孢球虫在有腹泻的患者（11/61）中比无腹泻的患者（2/50）中明显更常见（P<0.05）。腹泻患者中分离出细菌病原体的情况更常见（腹泻患者12/61，无腹泻患者2/50，P<0.05）。腹泻持续超过2周的患者病原体分离率高于腹泻持续时间少于2周的患者。22例急性腹泻患者的腹泻无论是自发缓解还是经对症治疗后缓解。在无腹泻的HIV患者中发现多种病原体的肠道携带率较高，但贝氏等孢球虫和细菌性肠道病原体更可能与腹泻有关。
