Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095, India.
Department of Medicine, University College of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095, India.
Adv Exp Med Biol. 2018;1057:85-94. doi: 10.1007/5584_2017_97.
Diarrhea is a debilitating condition in HIV infected individuals and with the finding that almost 1/4 cases of diarrhea in HIV are due to microsporidia, there is a dire need to institute measures for its detection on a regular basis. Keeping this in mind the study aims to determine the burden of intestinal microsporidiosis in HIV seropositive patients presenting with and without diarrhea and to compare the ability of microscopy and PCR in its detection.The study group consisted of 120 patients divided into four groups HIV seropositive with/without diarrhea, and HIV seronegative with/without diarrhea. Performance of four staining techniques including Modified Trichrome, Calcofluor White, Gram Chromotrope and Quick hot Gram Chromotrope stains were evaluated against PCR in diagnosing enteric microsporidiosis from stool samples.Overall prevalence of intestinal microsporidiosis was 10.83%. The same for HIV seropositive patients with diarrhea was 23.33%, HIV seropositive patients without diarrhea and in immune-competent hosts with diarrhea was 10% each. Enterocytozoon bieneusi was found to predominate. Calcofluor white stain detected maximum microsporidia in stool samples (76.92%), followed by Modified Trichrome stain (61.5%), PCR (46.15%) and Gram Chromotrope and Quick hot Gram Chromotrope stains (38.4% each). PCR exhibited the best performance with a sensitivity and specificity of 100%. Our data suggests screening of stool samples with either Modified Trichrome or Calcofluor white stain followed by PCR confirmation thus leading to maximum detection along with speciation for complete cure.
腹泻是 HIV 感染者的一种使人虚弱的病症，而且发现 HIV 相关性腹泻病例中有近 1/4 是由微孢子虫引起的，因此迫切需要定期采取措施进行检测。考虑到这一点，本研究旨在确定有腹泻和无腹泻的 HIV 血清阳性患者中肠微孢子虫病的负担，并比较显微镜检查和 PCR 在其检测中的能力。研究组包括 120 名患者，分为四组：有/无腹泻的 HIV 血清阳性患者，有/无腹泻的 HIV 血清阴性患者。评估了包括改良三色染色、Calcofluor White、革兰氏 Chromotrope 和快速热革兰氏 Chromotrope 染色在内的四种染色技术的性能，以检测粪便样本中的肠微孢子虫病。肠微孢子虫病的总患病率为 10.83%。有腹泻的 HIV 血清阳性患者为 23.33%，无腹泻的 HIV 血清阳性患者和免疫功能正常的腹泻患者各为 10%。发现肠微孢子虫病以 Enterocytozoon bieneusi 为主。Calcofluor White 染色在粪便样本中检测到最多的微孢子虫（76.92%），其次是改良三色染色（61.5%）、PCR（46.15%）和革兰氏 Chromotrope 和快速热革兰氏 Chromotrope 染色（各为 38.4%）。PCR 表现出最佳的性能，其敏感性和特异性均为 100%。我们的数据表明，用改良三色或 Calcofluor White 染色筛查粪便样本，然后进行 PCR 确认，可以最大程度地提高检测率，并进行专门的治疗。
