Cozart J C, Kalangi S S, Clench M H, Taylor D R, Borucki M J, Pollard R B, Soloway R D
Division of Gastroenterology, University of Texas Medical Branch, Galveston 77555.
J Clin Gastroenterol. 1993 Apr;16(3):192-4. doi: 10.1097/00004836-199304000-00004.
We reviewed the hospital charts of 17 patients with AIDS and Clostridium difficile diarrhea to determine antibiotic use before C. difficile infection, methods of treatment for C. difficile diarrhea, and response of diarrhea to treatment. Left shift and total white blood cell count before and after treatment for C. difficile were also determined. Non-HIV-infected patients with C. difficile diarrhea served as controls. In the patients with AIDS, resolution of diarrhea was noted in 15 (88%) patients. In 25 (76%) control patients, diarrhea resolved with treatment. The patients with AIDS also had a significant decrease (p < 0.05) in left shift in white blood cell count with treatment; the controls did not. Our study therefore suggests that C. difficile diarrhea is at least as likely to resolve with antibiotic therapy in patients with AIDS as it is in those with the non-AIDS-related disorder. We also found that patients with AIDS and C. difficile diarrhea are more likely than patients without AIDS to have a decreased left shift in white blood cell count after antibiotic therapy.
我们查阅了17例患有艾滋病合并艰难梭菌腹泻患者的医院病历，以确定艰难梭菌感染前的抗生素使用情况、艰难梭菌腹泻的治疗方法以及腹泻对治疗的反应。同时还测定了艰难梭菌治疗前后的核左移和白细胞总数。非艾滋病感染的艰难梭菌腹泻患者作为对照。在艾滋病患者中，15例（88%）腹泻症状得到缓解。在25例（76%）对照患者中，腹泻经治疗后缓解。艾滋病患者经治疗后白细胞计数的核左移也显著下降（p<0.05）；而对照组没有。因此，我们的研究表明，艾滋病患者的艰难梭菌腹泻通过抗生素治疗缓解的可能性至少与非艾滋病相关疾病患者相同。我们还发现，与无艾滋病的患者相比，患有艾滋病合并艰难梭菌腹泻的患者在抗生素治疗后白细胞计数核左移减少的可能性更大。
