Gruenewald R, Blum S, Chan J
Enteric Bacteriology Laboratory, New York City Department of Health, New York 10016.
Clin Infect Dis. 1994 Mar;18(3):358-63. doi: 10.1093/clinids/18.3.358.
Among 20- to 59-year-old residents of New York City who have septicemia, gastroenteritis, urinary tract infection, and multiple site infections due to Salmonella, those listed in the New York City AIDS Registry were highly overrepresented. Among the patients listed in the registry, males outnumbered females by 4:1 (septicemia), 9:1 (multiple site infections), 5.6:1 (gastroenteritis), and 2.5:1 (urinary tract infection); among patients not listed, males outnumbered females by 2.7:1 (septicemia), 3:1 (multiple site infections), 1.2:1 (gastroenteritis), and 1.6:1 (urinary tract infection). These results strongly suggest that most nonlisted males with septicemia and multiple site infections, and a minority with gastroenteritis and urinary tract infection, were human immunodeficiency virus (HIV)-positive. Among individuals who were HIV-positive, or likely to be so, Salmonella enteritidis was more competent in causing septicemia and less competent in causing gastroenteritis than was Salmonella typhimurium; among HIV-negative individuals, the reverse was true. The different capacities for infection with and invasiveness of S. enteritidis, S. typhimurium, and other Salmonella serotypes in HIV-positive and HIV-negative individuals and the use of HIV testing for Salmonella-infected individuals are discussed.
在纽约市20至59岁患有败血症、肠胃炎、尿路感染以及由沙门氏菌引起的多部位感染的居民中,纽约市艾滋病登记处列出的人群占比过高。在登记处列出的患者中,男性与女性的比例在败血症患者中为4:1,在多部位感染患者中为9:1,在肠胃炎患者中为5.6:1,在尿路感染患者中为2.5:1;在未列出的患者中,男性与女性的比例在败血症患者中为2.7:1,在多部位感染患者中为3:1,在肠胃炎患者中为1.2:1,在尿路感染患者中为1.6:1。这些结果强烈表明,大多数未列出的患有败血症和多部位感染的男性,以及少数患有肠胃炎和尿路感染的男性,都是人类免疫缺陷病毒(HIV)阳性。在HIV阳性或可能为HIV阳性的个体中,肠炎沙门氏菌引起败血症的能力更强,引起肠胃炎的能力较弱,而鼠伤寒沙门氏菌则相反;在HIV阴性个体中,情况则相反。文中讨论了HIV阳性和HIV阴性个体对肠炎沙门氏菌、鼠伤寒沙门氏菌及其他沙门氏菌血清型的不同感染能力和侵袭性,以及对感染沙门氏菌的个体进行HIV检测的应用。