Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru.
Am J Trop Med Hyg. 2010 Jul;83(1):158-63. doi: 10.4269/ajtmh.2010.09-0596.
We conducted a prospective study in three hospitals in Lima in human immunodeficiency virus (HIV) children to determine the frequency of diarrheagenic Escherichia coli. Five E. coli colonies/patients were studied by a multiplex real-time polymerase chain reaction to identify the six currently recognized groups of diarrhea-associated E. coli. We have analyzed 70 HIV-associated diarrheal and 70 control samples from HIV-infected children without diarrhea. Among the diarrheal episodes 19% were persistent, 3% dysenteric, and 33% were associated with moderate or severe dehydration. The diarrheagenic E. coli were the most commonly isolated pathogens in diarrhea (19%) and control samples (26%) (P = 0.42), including enteroaggregative (6% versus 10%), enteropathogenic (6% versus 10%), and enterotoxigenic E. coli (4% versus 3%), respectively. The HIV-infected children with diarrhea had the worse age-related immunosuppression, higher viral loads, and were on highly active antiretroviral treatment (HAART) less often than HIV-infected children without diarrhea. Diarrheagenic E. coli were highly resistant to ampicillin (74%) and cotrimoxazole (70%).
我们在利马的三家医院进行了一项前瞻性研究，以确定人类免疫缺陷病毒 (HIV) 儿童中致腹泻性大肠杆菌的频率。通过多重实时聚合酶链反应研究了 5 个大肠杆菌菌落/患者，以鉴定目前公认的 6 组与腹泻相关的大肠杆菌。我们分析了 70 例 HIV 相关性腹泻和 70 例 HIV 感染儿童无腹泻对照样本。在腹泻发作中，19%为持续性，3%为痢疾样，33%与中度或重度脱水有关。致腹泻性大肠杆菌是腹泻（19%）和对照样本（26%）中最常见的分离病原体（P=0.42），包括肠聚集性（6%比 10%）、肠致病性（6%比 10%）和肠毒性大肠杆菌（4%比 3%）。腹泻的 HIV 感染儿童的年龄相关免疫抑制程度更严重，病毒载量更高，接受高效抗逆转录病毒治疗 (HAART) 的频率低于无腹泻的 HIV 感染儿童。致腹泻性大肠杆菌对氨苄西林（74%）和复方新诺明（70%）高度耐药。
