Bern Caryn, Kawai Vivian, Vargas Daniel, Rabke-Verani Jennifer, Williamson John, Chavez-Valdez Raul, Xiao Lihua, Sulaiman Irshad, Vivar Aldo, Ticona Eduardo, Navincopa Marco, Cama Vitaliano, Moura Hercules, Secor W Evan, Visvesvara Govinda, Gilman Robert H
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
J Infect Dis. 2005 May 15;191(10):1658-64. doi: 10.1086/429674. Epub 2005 Apr 11.
We studied microsporidiosis in human immunodeficiency virus-positive patients in 2 Lima hospitals. Of 2652 patients, 66% were male, 6% received antiretroviral therapy (ART), and the median CD4 lymphocyte count was 131 cells/microL. Sixty-seven patients (3%) had microsporidiosis; stool specimens from 56 were identified as having Enterocytozoon bieneusi of 10 different genotypes. The 2 most common genotypes, Peru-1 and Peru-2, were not associated with significant increases in chronic diarrhea; other genotypes were associated with a 4-fold increased risk. Risk factors for E. bieneusi infection segregated by genotype: contact with duck or chicken droppings and lack of running water, flush toilet, or garbage collection with genotype Peru-1 and watermelon consumption with other genotypes. Shortened survival was associated with low CD4 lymphocyte count (P<.0001), no ART (P<.0001), and cryptosporidiosis (P=.004) but not with microsporidiosis (P=.48). Our data suggest the possibility of zoonotic E. bieneusi transmission and an association with poor sanitary conditions.
我们在利马的两家医院对人类免疫缺陷病毒呈阳性的患者的微孢子虫病进行了研究。在2652名患者中，66%为男性，6%接受抗逆转录病毒疗法（ART），CD4淋巴细胞计数中位数为131个细胞/微升。67名患者（3%）患有微孢子虫病；56名患者的粪便标本被鉴定含有10种不同基因型的比氏肠微孢子虫。两种最常见的基因型，即秘鲁-1和秘鲁-2，与慢性腹泻的显著增加无关；其他基因型与风险增加4倍相关。比氏肠微孢子虫感染的风险因素按基因型分类：与鸭或鸡粪便接触以及缺乏自来水、冲水马桶或垃圾收集与基因型秘鲁-1相关，而食用西瓜与其他基因型相关。生存时间缩短与CD4淋巴细胞计数低（P<0.0001）、未接受抗逆转录病毒疗法（P<0.0001）和隐孢子虫病（P=0.004）相关，但与微孢子虫病无关（P=0.48）。我们的数据表明存在比氏肠微孢子虫人畜共患传播的可能性，并与卫生条件差有关。
