Shah Siddharth, Kongre Vaishali, Kumar Varun, Bharadwaj Renu
Department of Orthopaedics, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai.
Department of Microbiology, B. J. Government Medical College & Sassoon General Hospitals, Pune.
Cureus. 2016 Sep 27;8(9):e807. doi: 10.7759/cureus.807.
Diarrhea is a common complication of acquired immune deficiency syndrome (AIDS), occurring in almost 90% of AIDS patients in developing countries like India. The present study was aimed to determine the prevalence and microbiological profile of pathogens associated with diarrhea in human immunodeficiency virus (HIV) positive patients and their relation to CD4 counts.
Forty-five successive HIV-positive patients, 27 with diarrhea (study group) and 18 without diarrhea (control group), were included in the three-month study. The HIV infection was confirmed by three different antibody detection tests. The stool samples were collected on two consecutive days and were examined for parasites by microscopy using wet mount and modified Ziehl-Neelsen stain. They were examined for bacteria by Gram stain and conventional Ziehl-Neelsen stain and were inoculated on appropriate culture media. The isolates were identified by standard biochemical tests, followed by antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method.
Twenty-four pathogens were detected in diarrheal HIV-positive patients, including 14 parasites (58.33%), seven bacteria (29.17%), and three fungi (12.50%). was the most common parasite (25.9%) followed by (14.8%). Other parasites included , and (3.7% each). (18.5%) was the most common bacterial isolate, of which, 80% were (ETEC) while 20% were (EPEC)Other isolates included and (3.7% each). The isolates were sensitive to furazolidone (94.11%), chloramphenicol (76.47%), and gentamicin (52.94%). The isolates from diarrheal patients showed resistance to norfloxacin (5.88% vs. 50%, p<0.05) as compared to those from non-diarrheal patients. The diarrheal HIV-positive patients had lower mean CD4 counts (202.6 cells/µL), as compared to those without diarrhea (239.28 cells/µL).
is the most common parasite and is the most common bacterium associated with diarrhea in HIV patients. The antibiotic sensitivity patterns should be monitored regularly to detect resistance to commonly used drugs. The prevalence of organisms in a region, various clinical manifestations, sensitivity patterns of isolates, and relation with CD4 count should be considered while instituting therapy in HIV patients with diarrhea.
腹泻是获得性免疫缺陷综合征（AIDS）的常见并发症，在印度等发展中国家，几乎90%的艾滋病患者会出现腹泻。本研究旨在确定人类免疫缺陷病毒（HIV）阳性患者腹泻相关病原体的患病率和微生物学特征，以及它们与CD4细胞计数的关系。
在为期三个月的研究中，纳入了45例连续的HIV阳性患者，其中27例有腹泻（研究组），18例无腹泻（对照组）。通过三种不同的抗体检测试验确诊HIV感染。连续两天采集粪便样本，通过湿片显微镜检查和改良齐尔-尼尔森染色法检测寄生虫。通过革兰氏染色和传统齐尔-尼尔森染色法检测细菌，并接种在合适的培养基上。通过标准生化试验鉴定分离株，随后使用 Kirby-Bauer 纸片扩散法进行抗生素敏感性试验。
在腹泻的HIV阳性患者中检测到24种病原体，包括14种寄生虫（58.33%）、7种细菌（29.17%）和3种真菌（12.50%）。 是最常见的寄生虫（25.9%），其次是 （14.8%）。其他寄生虫包括 、 和 （各占3.7%）。 （18.5%）是最常见的细菌分离株，其中80%为 （产毒性大肠杆菌，ETEC），20%为 （肠致病性大肠杆菌，EPEC）。其他分离株包括 和 （各占3.7%）。分离株对呋喃唑酮（94.11%）、氯霉素（76.47%）和庆大霉素（52.94%）敏感。与非腹泻患者相比，腹泻患者的分离株对诺氟沙星耐药（5.88%对50%，p<0.05）。腹泻的HIV阳性患者的平均CD4细胞计数（202.6个/微升）低于无腹泻患者（239.28个/微升）。
是HIV患者腹泻相关最常见的寄生虫， 是最常见的细菌。应定期监测抗生素敏感性模式，以检测对常用药物的耐药性。在对腹泻的HIV患者进行治疗时，应考虑该地区病原体的患病率、各种临床表现、分离株的敏感性模式以及与CD4细胞计数的关系。
