Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus
Y. Germani et al., Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus, AM J TROP M, 59(6), 1998, pp. 1008-1014
Citations number
41
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
A study of the etiologies of diarrhea in adults in relation to their human
immunodeficiency virus (HIV) serostatus and number of CD4+ cells was carrie
d out in the Central African Republic. In cases and controls, multi-parasit
ism was observed. Salmonella spp. were identified mainly during acute diarr
hea, with 50% of the S. enteritidis isolated during the study being respons
ible for septicemia and/or urinary tract infection in immunodeficient patie
nts. Enteroaggregative Escherichia coli (EAggEC) were the most frequently i
dentified agent in HIV+ patients with persistent diarrhea; 42.8% of the pat
ients with EAggEC as sole pathogens had bloody diarrhea, and these strains
were negative for the presence of a virulence plasmid. Coccidia were found
in those with acute and persistent diarrhea. Blood was observed in 53.3% of
infections involving coccidia as the sole pathogen. Microsporidium spp. an
d Blastocystis hominis were found only in HIV+ patients with persistent dia
rrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were fo
und in HIV+ and HIV- dysenteric patients; bacteria resembling spirochetes t
hat could not be cultivated were identified only in HIV+ cases with dysente
ry. Shiga-like toxin-producing E. coli O157:N was isolated from two cases w
ith hemolytic-uremic syndrome. Fungi were identified as the sole pathogen i
n 6.4% of the HIV+ patients with persistent diarrhea. Most of enteropathoge
nic bacteria identified were resistant to ampicillin and trimethoprim-sulfa
methoxazole, remained susceptible to ampicillin plus clavulanic acid, and w
ere susceptible to amikacin, gentamicin, and ciprofloxacin.