Fernández-Martín J I, Dronda F, Chaves F, Alonso-Sanz M, Catalán S, González-López A
Unidad de Enfermedades Infecciosas-Microbiología Clínica, Hospital General Penitenciario, Madrid.
Rev Clin Esp. 1996 Jan;196(1):16-20.
Campylobacter jejuni is a common etiological agent of diarrhea in the general population. In recent years it has also been involved as etiological agent of intestinal and extraintestinal infections in patients infected with the human immunodeficiency virus (HIV). The clinical and microbiological features in a series of HIV+ patients infected with C. jejuni in a correctional facility are here reported.
Retrospective analysis of clinical records of patients who had C. jejuni recovered from clinical samples diagnosed at the Hospital General Penitenciario (HGP), Madrid, for 2 years (10-1-1991 to 9-30-1993). C. jejuni strains were identified at the Clinical Microbiology Department at the HGP following standard methods. Antibiotic sensitivity testing was performed by the agar dilution and microdilution methods.
Twenty-eight patients were diagnosed as being infected with C. jejuni. The mean age was 32.4 years (95% CI: 30.1-34.7). Twenty-seven patients (96%) were males. Twenty-five patients (90%) were intravenous drug users (IVDU). Sixty-one percent of cases clustered in the september and october months. The main clinical symptoms were diarrhea with no pathological products and fever. Mean lymphocyte CD4+ count was 103/mm3 (95% CI: 45-162). Blood cultures were obtained from 13 patients, and bacteremia was detected in three of them (23%), with no associated mortality. Forty-eight percent of C. jejuni strains were resistant to fluorquinolones, and all of them were susceptible to erythromycin. The latter antibiotic was used as therapy in 82% of patients and clinical and microbiological cure was achieved in all 17 patients who were evaluated at follow-up.
Campylobacter jejuni is an important enteropathogen in correctional facility population infected with HIV, which in this study involved severely immunosuppressed patients. The main clinical presentation was acute enterocolitis and bacteremia (detected in 23%), a higher percentage than that reported in the literature. An increased quinolone-resistance rate was detected (48%). Erythromycin, and possibly the new macrolides, are currently the antibiotics of choice.
空肠弯曲菌是普通人群腹泻的常见病原体。近年来，它也被认为是人类免疫缺陷病毒（HIV）感染患者肠道和肠道外感染的病原体。本文报告了一所惩教机构中一系列感染空肠弯曲菌的HIV阳性患者的临床和微生物学特征。
对马德里总医院（HGP）诊断的临床样本中分离出空肠弯曲菌的患者临床记录进行回顾性分析，时间跨度为2年（1991年1月10日至1993年9月30日）。HGP临床微生物科按照标准方法鉴定空肠弯曲菌菌株。采用琼脂稀释法和微量稀释法进行抗生素敏感性试验。
28例患者被诊断为空肠弯曲菌感染。平均年龄为32.4岁（95%可信区间：30.1 - 34.7）。27例患者（96%）为男性。25例患者（90%）为静脉吸毒者（IVDU）。61%的病例集中在9月和10月。主要临床症状为无病理产物的腹泻和发热。平均淋巴细胞CD4 +计数为103/mm³（95%可信区间：45 - 162）。13例患者进行了血培养，其中3例（23%）检测到菌血症，无相关死亡病例。48%的空肠弯曲菌菌株对氟喹诺酮耐药，所有菌株对红霉素敏感。82%的患者使用后者作为治疗药物，在随访评估的所有17例患者中均实现了临床和微生物学治愈。
空肠弯曲菌是感染HIV的惩教机构人群中的重要肠道病原体，本研究中的患者免疫抑制严重。主要临床表现为急性小肠结肠炎和菌血症（检出率为23%），高于文献报道的比例。检测到喹诺酮耐药率增加（48%）。红霉素以及可能的新型大环内酯类药物目前是首选抗生素。
