253例HIV感染合并慢性腹泻患者粪便标本的病原微生物检测分析

Detection and analysis of pathogenic microorganism in the stool specimens from 253 chronic diarrhea patients with HIV infection

目的探讨HIV感染者慢性腹泻的病原学种类及其特点,使患者得到及时的预防和治疗。方法对253例慢性腹泻HIV感染者的粪便标本首先进行了涂片及染色检测,直接涂片检测蓝氏贾第鞭毛虫,采用革兰染色检测真菌孢子及菌丝,抗酸染色(萋-尼氏染色法)检测分枝杆菌,用改良抗酸染色法检测隐孢子虫,采用常规粪便培养检测志贺菌、沙门菌、肠侵袭性大肠埃希菌及真菌,采用微需氧培养检测空肠弯曲菌,采用金标法检测难辨梭状芽孢杆菌毒素(A+B)。结果本研究共检测出各种病原微生物159株,其中真菌最多,占45%(114/253),隐胞子虫占12.6%(32/253),结核分枝杆菌占2.4%(6/253),难辨梭状芽孢杆菌占1.58%(4/253),空肠弯曲菌占0.8%(2/253),沙门菌占0.4%(1/253)。结论真菌、隐胞子虫、分枝杆菌、难辨梭状芽孢杆菌等是HIV感染者慢性腹泻的主要病原菌,积极寻找病原,以期使患者得到及早的预防和治疗。

Objective To investigate the pathogenic profiles of chronic diarrhea patients with AIDS, for the better prevention and treatment. Methods The stool specimens in AIDS patients with chronic diarrhea were analyzed by the smear and dyeing detection method. Detection methods included direct smear for the detection of Giardia lamblia stiles, Grain stain method for fungi and mold, acid fast stain （Ziehl-Neelsen） for Mycobacterium, improved acid fast stain for the detection of Cryptosporidium. Stool isolation culture to identify Shigella dysenteriae, Salmonella Typhi, enteroinvasive E.coli and fungi; aerobic culture to identify campylobacter, gold-labeled antibodies method for the detection of C.difficile. Results Total of 159 strains of bacteria were identified, including fungi 45% （114/253） and Cryptosporidium 12.6% （32/253）, Mycobacterium 2.4% （6/253）, C.difficile 1.58% （4/253）, campylobacter 0.8% （2/253）, salmonella 0.4% （1/253）. Conclusions Fungi, Cryptosporidium, Mycobacterium, C.difficile. are the major pathogens for chronic diarrhea in patients with AIDS. The identification of pathogen could make the prevention and treatment proceeding faster and better.