Kumar Dinesh, Goel Varun, Meena Suneeta, Mathur Purva, Kabra Sushil Kumar, Lodha Rakesh, Singh Sarman
Division of Clinical Microbiology & Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India.
J Lab Physicians. 2023 Mar 27;15(3):443-449. doi: 10.1055/s-0043-1764482. eCollection 2023 Sep.
Human microsporidiosis presents as an important and rapidly emerging opportunistic infection. However, the exact burden of this infection especially in the pediatric population of Northern India remains unknown. In this study, we investigated the prevalence of microsporidia among human immunodeficiency virus (HIV)-positive and HIV-negative pediatric patients who presented with diarrhea. A total of 263 children were recruited consisting of 98 HIV seropositive with diarrhea and 165 HIV seronegative but with diarrhea. Morning stool samples were collected and both direct and formol ether concentrated samples were examined for the presence of intestinal parasites. The modified acid-fast staining was done for coccidian parasites and trichrome stain for microsporidia detection. Further, the species were detected using a real-time polymerase chain reaction (PCR) targeting a conserved region of the small ribosomal subunit rRNA gene of , , , and . Overall, one or more parasites were detected in 52.04% (51/98) of HIV seropositive and 53.33% (88/165) of seronegative children ( = 0.8391). However, coccidian parasites were detected in a significantly huge number of HIV seropositive children (21.43% [21/98]) as compared with HIV seronegative children (4.24% [7/165]). Microsporidial DNA could be detected in HIV seropositive with diarrhea children (17.35% [17/98]) by PCR. A significant correlation between low CD4 count (≤ 200/μL) and intestinal parasite positivity could be established. Microsporidia is a significant cause of diarrhea in HIV seropositive pediatric patients and should be kept in mind as one of the differential diagnoses in such patients.
人类微孢子虫病是一种重要且迅速出现的机会性感染。然而，这种感染的确切负担，尤其是在印度北部的儿科人群中，仍然未知。在本研究中，我们调查了出现腹泻的人类免疫缺陷病毒（HIV）阳性和HIV阴性儿科患者中微孢子虫的患病率。
总共招募了263名儿童，其中98名HIV血清阳性且有腹泻症状，165名HIV血清阴性但有腹泻症状。收集早晨的粪便样本，对直接样本和经甲醛乙醚浓缩的样本进行肠道寄生虫检测。对球虫寄生虫进行改良抗酸染色，对微孢子虫进行三色染色检测。此外，使用针对 、 、 和 小核糖体亚基rRNA基因保守区域的实时聚合酶链反应（PCR）检测物种。
总体而言，在52.04%（51/98）的HIV血清阳性儿童和53.33%（88/165）的血清阴性儿童中检测到一种或多种寄生虫（ = 0.8391）。然而，与HIV血清阴性儿童（4.24% [7/165]）相比，在大量HIV血清阳性儿童（21.43% [21/98]）中检测到球虫寄生虫。通过PCR可在有腹泻症状的HIV血清阳性儿童（17.35% [17/98]）中检测到微孢子虫DNA。低CD4细胞计数（≤ 200/μL）与肠道寄生虫阳性之间存在显著相关性。
微孢子虫是HIV血清阳性儿科患者腹泻的重要原因，在这类患者的鉴别诊断中应将其作为考虑因素之一。
