艾滋病慢性腹泻患者肠道细菌及真菌感染的研究

Enterobacteria and fungal infection in AIDS patients with chronic diarrhea

目的调查艾滋病合并慢性腹泻患者肠道细菌及真菌感染的情况,为临床艾滋病腹泻患者选用合理的抗菌药物、降低腹泻的发生率和死亡率提供依据。方法艾滋病患者便标本常规检测;便标本涂片革兰染色与改良抗酸染色;便常规培养与微需氧培养;难辨梭菌毒素A/B检测;BD FACAS Calibur艾滋流式细胞仪检测患者CD4+T淋巴细胞值。结果便标本涂片中,52.8%可见真菌孢子;2.8%难辨梭菌毒素A/B阳性;36例艾滋病慢性腹泻患者CD4+T淋巴细胞<400个/ml达80.0%,其中CD4+T淋巴细胞<200个/ml达37.0%。结论艾滋病慢性腹泻患者应长期监测肠道病原学,及早发现腹泻病原菌,有利于临床合理应用抗菌药物、降低死亡率。

OBJECTIVE To investigate enterobacteria and fungal infection in AIDS combined chronic diarrhea in order to provide scientific evidence for choosing rational antibacterials,lowering the incidence rates of diarrhea and mortality.METHODS Stool routine tests were done in AIDS;Gram′s stain and modified acid fast stain were done in stool smear;stool routine culture and mini-aerobic cultivation were done;Clostridium difficile toxin A/B were detected.CD4＋ T lymphocyte values were detected by BD FACAS Calibur flow cytometry.RESULTS 52.8% stool specimen smears could be seen fungal spore.2.8% clostridium difficile toxin A/B was postive.80.0% CD4＋T cells were less than 400 piece/ml.37% CD4＋Tcells were less than 200 pieces/ml.CONCLUSIONS Intestinal tract etiology should be monitored regularly in AIDS combined chronic diarrhea to find the pathogenic bacterium for using rational antibacterials and decrease mortality.