Huang David B, Zhou Jing
Division of Infectious Diseases, New Jersey Veterans Affairs Medical Center, East Orange, NJ, USA.
Division of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, 535EE, Houston, TX 77030, USA.
J Med Microbiol. 2007 May;56(Pt 5):659-663. doi: 10.1099/jmm.0.46867-0.
Patients with AIDS frequently develop diarrhoeal illness. In this randomized, controlled study, 260 patients were screened for those who had not had diarrhoea in the preceding 3 months and who had received a stable highly active antiretroviral therapy regimen for at least 6 weeks prior to the study enrollment. A total of 148 patients met the inclusion criteria and were enrolled: 75 patients were randomly assigned to an intensive handwashing intervention (i.e. handwashing after defecation, after cleaning infants who had defecated, before preparing food, before eating, and before and after sex) and 73 patients were randomly assigned to the control group. Patients in both groups were called weekly by telephone to determine compliance with handwashing and to determine the number of diarrhoeal episodes for the preceding week. Patients were observed for 1 year. Patients assigned to the intensive handwashing intervention group washed their hands more frequently compared with the control group (seven vs four times a day, respectively; P <0.05) and developed fewer episodes of diarrhoeal illness (1.24+/-0.9 vs 2.92+/-0.6 new episodes of diarrhoea, respectively; P <0.001) during the 1 year observation. The most common pathogens identified in both groups in patients who developed diarrhoeal illness were Giardia lamblia, Cryptosporidium, Entamoeba histolytica and Shigella flexneri. These data suggest that intensive handwashing reduces diarrhoeal illness in patients with AIDS.
艾滋病患者经常出现腹泻疾病。在这项随机对照研究中，对260名患者进行了筛查，筛选条件为在过去3个月内未出现腹泻，且在研究入组前至少6周接受稳定的高效抗逆转录病毒治疗方案。共有148名患者符合纳入标准并被纳入研究：75名患者被随机分配至强化洗手干预组（即排便后、清洁排便婴儿后、准备食物前、进食前以及性行为前后洗手），73名患者被随机分配至对照组。两组患者每周通过电话随访，以确定洗手依从性以及前一周的腹泻发作次数。对患者进行了1年的观察。与对照组相比，分配至强化洗手干预组的患者洗手频率更高（分别为每天7次和4次；P<0.05），且在1年观察期内腹泻疾病发作次数更少（分别为1.24±0.9次和2.92±0.6次新的腹泻发作；P<0.001）。在出现腹泻疾病的两组患者中，最常见的病原体为蓝氏贾第鞭毛虫、隐孢子虫、溶组织内阿米巴和福氏志贺菌。这些数据表明，强化洗手可减少艾滋病患者的腹泻疾病。
