Brindle R J, Nunn P P, Batchelor B I, Gathua S N, Kimari J N, Newnham R S, Waiyaki P G
Kenya Medical Research Institute, Nairobi.
AIDS. 1993 Nov;7(11):1469-74. doi: 10.1097/00002030-199311000-00010.
To examine the role of acute infection as a cause of morbidity in patients with tuberculosis.
Cross-sectional documentation of predefined acute morbid events.
Infectious Diseases Hospital, Nairobi, Kenya.
Adults (> or = 15 years), inpatients and outpatients with a diagnosis of tuberculosis presenting with one or more of a series of clinical features. A new event was defined as one occurring at least 1 week after the initial event.
Patients' treatment was modified depending on the results of laboratory investigations.
There were 642 events from 398 patients, 235 HIV-positive patients had 438 events and 163 HIV-negative patients had 204 events (P < 0.0001). Forty-two out of the 235 (18%) HIV-positive patients were bacteraemic compared with nine out of the 163 (6%) HIV-negative patients (P = 0.0003). The most common isolates from blood were Salmonella typhimurium and Streptococcus pneumoniae.
Faecal specimens were obtained more commonly from HIV-positive patients (P < 0.001), and often contained bacterial pathogens.
Many of the causes of morbidity in patients with tuberculosis and HIV are not due to tuberculosis or antituberculous therapy, and will not be identified without microbiological investigation.
探讨急性感染在结核病患者发病中的作用。
对预先定义的急性发病事件进行横断面记录。
肯尼亚内罗毕传染病医院。
年龄≥15岁的成人，诊断为结核病的住院和门诊患者，伴有一系列临床特征中的一种或多种。新事件定义为在初始事件至少1周后发生的事件。
根据实验室检查结果调整患者治疗方案。
398例患者发生642起事件，235例HIV阳性患者发生438起事件，163例HIV阴性患者发生204起事件（P<0.0001）。235例（18%）HIV阳性患者中有42例血行感染，而163例（6%）HIV阴性患者中有9例血行感染（P=0.0003）。血液中最常见的分离菌为鼠伤寒沙门菌和肺炎链球菌。
HIV阳性患者更常采集粪便标本（P<0.001），且粪便中常含有细菌病原体。
结核病和HIV患者发病的许多原因并非由结核病或抗结核治疗引起，未经微生物学调查无法确定。
