三级保健医院hiv阳性和hiv阴性儿童腹泻患者中的微孢子虫

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-09-01 DOI:10.1055/s-0043-1764482
Dinesh Kumar, Varun Goel, Suneeta Meena, Purva Mathur, Sushil Kumar Kabra, Rakesh Lodha, Sarman Singh
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摘要

人类微孢子虫病是一种重要且迅速出现的机会性感染。然而,这种感染的确切负担,特别是在印度北部的儿科人群中,仍然未知。在这项研究中,我们调查了人类免疫缺陷病毒(HIV)阳性和HIV阴性儿童腹泻患者中微孢子虫的患病率。方法收集儿童263例,其中HIV血清阳性伴腹泻者98例,HIV血清阴性伴腹泻者165例。收集晨便样本,并检查直接和浓缩福尔摩醚样本是否存在肠道寄生虫。对球虫进行改良抗酸染色,对微孢子虫进行三色染色。此外,利用实时聚合酶链式反应(PCR)检测了bieneusenterocytozoon bieneusi、hellem encephalitzoon hellem、enterphalitzoon ininalis和encephalitzoon cucululi的小核糖体亚基rRNA基因的保守区域。结果HIV血清阳性儿童中检出一种或多种寄生虫的比例为52.04%(51/98),血清阴性儿童中检出一种或多种寄生虫的比例为53.33% (88/165)(p = 0.8391)。但在HIV血清阳性儿童中检出球虫的比例(21.43%[21/98])明显高于HIV血清阴性儿童(4.24%[7/165])。在HIV血清阳性的腹泻患儿中,PCR可检出微孢子虫DNA(17.35%[17/98])。CD4计数低(≤200/μL)与肠道寄生虫阳性呈显著相关。结论小孢子虫是HIV血清阳性儿童腹泻的重要病因,应作为鉴别诊断之一予以重视。
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Microsporidia in HIV-Positive and HIV-Negative Pediatric Patients with Diarrhea at a Tertiary Care Hospital.

Background  Human microsporidiosis presents as an important and rapidly emerging opportunistic infection. However, the exact burden of this infection especially in the pediatric population of Northern India remains unknown. In this study, we investigated the prevalence of microsporidia among human immunodeficiency virus (HIV)-positive and HIV-negative pediatric patients who presented with diarrhea. Methods  A total of 263 children were recruited consisting of 98 HIV seropositive with diarrhea and 165 HIV seronegative but with diarrhea. Morning stool samples were collected and both direct and formol ether concentrated samples were examined for the presence of intestinal parasites. The modified acid-fast staining was done for coccidian parasites and trichrome stain for microsporidia detection. Further, the species were detected using a real-time polymerase chain reaction (PCR) targeting a conserved region of the small ribosomal subunit rRNA gene of Enterocytozoon bieneusi , Encephalitozoon hellem , Encephalitozoon intestinalis , and Encephalitozoon cuniculi . Results  Overall, one or more parasites were detected in 52.04% (51/98) of HIV seropositive and 53.33% (88/165) of seronegative children ( p  = 0.8391). However, coccidian parasites were detected in a significantly huge number of HIV seropositive children (21.43% [21/98]) as compared with HIV seronegative children (4.24% [7/165]). Microsporidial DNA could be detected in HIV seropositive with diarrhea children (17.35% [17/98]) by PCR. A significant correlation between low CD4 count (≤ 200/μL) and intestinal parasite positivity could be established. Conclusion  Microsporidia is a significant cause of diarrhea in HIV seropositive pediatric patients and should be kept in mind as one of the differential diagnoses in such patients.

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Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
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99
审稿时长
31 weeks
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