Sperber S J, Schleupner C J
Infectious Diseases Section, Veterans Administration Medical Center, Salem, Virginia 24153.
Rev Infect Dis. 1987 Sep-Oct;9(5):925-34. doi: 10.1093/clinids/9.5.925.
Salmonella bacteremia is being identified with increasing frequency in persons infected with the human immunodeficiency virus. Salmonellosis may occur in patients with an established diagnosis of acquired immunodeficiency syndrome (AIDS), or it may be the first manifestation of this disorder. In patients with AIDS, salmonellosis is characterized by recurrent bacteremia despite treatment and a relative paucity of gastrointestinal manifestations. Treatment regimens may be limited by antimicrobial resistance, poor penetration of antibiotics into phagocytes, and drug intolerance; optimal therapy remains to be established. Possible mechanisms to account for this increased frequency and severity of salmonellosis include altered cell-mediated immunity, hemolysis, prior use of antibiotics, and increased exposure to the pathogen. Salmonellae should be considered among the pathogens associated with human immunodeficiency virus infection.
在感染人类免疫缺陷病毒的人群中，沙门氏菌血症的确诊频率日益增加。沙门氏菌病可能发生在已确诊为获得性免疫缺陷综合征（艾滋病）的患者中，也可能是该疾病的首发表现。在艾滋病患者中，沙门氏菌病的特征是尽管接受了治疗仍反复出现菌血症，且胃肠道表现相对较少。治疗方案可能受到抗菌药物耐药性、抗生素进入吞噬细胞的穿透性差以及药物不耐受的限制；最佳治疗方案仍有待确定。沙门氏菌病发病率和严重程度增加的可能机制包括细胞介导免疫改变、溶血、先前使用抗生素以及接触病原体增加。沙门氏菌应被视为与人类免疫缺陷病毒感染相关的病原体之一。
