Chandwani Jyotsna, Vyas Nitya, Hooja Saroj, Sharma Babita, Maheshwari Rakesh
Resident, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
Senior Professor, Department of Microbiology, S.M.S. Medical College , Jaipur, Rajasthan, India .
J Clin Diagn Res. 2016 Sep;10(9):DC28-DC31. doi: 10.7860/JCDR/2016/21601.8585. Epub 2016 Sep 1.
Fungal respiratory infections are important cause of mortality and morbidity among HIV positive individuals. They account for up to 70% of illness in Acquired Immunodeficiency Disease Syndrome cases (AIDS). The range of illness varies from asymptomatic mucosal candidiasis to overwhelming disseminated infections. In these patients dissemination of fungus leads to very serious outcomes hence, it is important to have the knowledge of prevailing profile of fungus causing infections, so that it can be treated at the onset. Low CD4+ T lymphocyte count is an excellent indicator of decreased immunity and can also be helpful to predict opportunistic fungal respiratory infections and other complications.
To define the fungal aetiology of lower respiratory tract infections in HIV positive patients and to correlate the occurrence of different fungi with CD4+ T lymphocyte count.
This was a cross sectional study conducted between May 2014 to April 2015, on 180 treatment naive HIV seropositive patients with lower respiratory tract infections attending the Integrated Counselling and Testing Centre, SMS Medical College, Jaipur, Rajasthan. Early morning expectorated and induced sputum samples were collected and processed for isolation and identification of fungal species. CD4+ T lymphocyte count estimation was done by BD FACS Calibur.
Fungal species were isolated from 155 (86.1%) patients. The most common isolate was (31.7%), followed by (17.7%) and (10%). The fungal species were most commonly isolated from patients with CD4+ T lymphocyte cell less than 200 cells/μl.
Fungal infections were seen in 86.1% of HIV positive patients with lower respiratory tract infections hence, high level of clinical suspicion for fungal aetiology of respiratory infections in HIV positive patients should be kept in mind.
真菌性呼吸道感染是艾滋病毒阳性个体死亡和发病的重要原因。在获得性免疫缺陷综合征（艾滋病）病例中，它们占疾病的比例高达70%。疾病范围从无症状的黏膜念珠菌病到严重的播散性感染。在这些患者中，真菌的播散会导致非常严重的后果，因此，了解引起感染的真菌的流行情况很重要，以便在发病时进行治疗。低CD4+T淋巴细胞计数是免疫力下降的一个很好指标，也有助于预测机会性真菌性呼吸道感染和其他并发症。
确定艾滋病毒阳性患者下呼吸道感染的真菌病因，并将不同真菌的发生情况与CD4+T淋巴细胞计数相关联。
这是一项横断面研究，于2014年5月至2015年4月在拉贾斯坦邦斋浦尔市SMS医学院综合咨询与检测中心对180例初治的患有下呼吸道感染的艾滋病毒血清阳性患者进行。收集清晨咳出的痰液和诱导痰液样本，进行处理以分离和鉴定真菌种类。通过BD FACS Calibur进行CD4+T淋巴细胞计数评估。
从155例（86.1%）患者中分离出真菌种类。最常见的分离株是（31.7%），其次是（17.7%）和（10%）。真菌种类最常从CD4+T淋巴细胞少于200个细胞/μl的患者中分离出来。
在86.1%的患有下呼吸道感染的艾滋病毒阳性患者中发现了真菌感染，因此，应牢记对艾滋病毒阳性患者呼吸道感染的真菌病因保持高度临床怀疑。
