喀麦隆西部地区Banka Ad-Lucem医院艾滋病毒感染患者肠道细菌的抗生素耐药性

O. J. T. Ngalani, A. Mbaveng, Wiliane J T Marbou, Roland Y. Ngai, V. Kuete
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引用次数: 8

摘要

人类免疫缺陷病毒(HIV)感染是全世界特别是发展中国家的一个严重问题。本研究旨在确定在AD-Lucem Banka医院就诊的hiv血清阳性患者肠道疾病的细菌病原学及其与CD4+ t淋巴细胞计数和血清hs-CRP的关系。采用不同的诊断技术对100例HIV阳性肠道疾病患者和40例HIV阴性肠道疾病患者的粪便样本进行细菌检测。采用流式细胞术和ELISA固相直接夹心法分别检测hiv阳性和hiv阴性患者CD4+ t淋巴细胞计数和血清hs-CRP。其中男性39人(26.35%),女性109人(73.65%)。hiv血清阳性患者的平均年龄(43.79岁)明显高于hiv血清阴性患者(27.13岁)(p < 0.000)。HIV -患者CD4+ t细胞计数(p < 0.0001)、淋巴细胞计数(p=0.0258)、单核细胞计数(p=0.0317)和白细胞总数(p=0.0277)的平均值均显著高于HIV -患者。HIV阳性患者5(83.33)、18(75.00)、37(71.15)分别比HIV阴性患者1(16.67)、6(25.00)、15(28.85)分离出更多的沙门氏菌、大肠杆菌和肺炎克雷伯菌。大多数分离株对IPM、NOR和CIP敏感。在HIV阳性患者中,肺炎克雷伯菌对AMC的耐药率为45.95%,而在HIV阴性患者中,产气肠杆菌和志贺氏菌对AMC的耐药率分别为80.00%和85.71%,对CFM的耐药率分别为80.00%和57.14%。产气肠杆菌(40.00%)和志贺氏菌(14.29%)在HIV -患者中表现为多药耐药,而大肠杆菌(5.56%)和肺炎克雷伯菌(2.70%)在HIV+患者中表现为多药耐药。了解本研究显示的HIV患者细菌性疾病负担对于规划有效的控制方案以全面减少HIV感染患者细菌性疾病具有重要意义。
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Antibiotic Resistance of Enteric Bacteria in HIV-Infected Patients at the Banka Ad-Lucem Hospital, West Region of Cameroon
Human immunodeficiency virus (HIV) infection is a serious problem throughout the world and especially in developing countries. This study was conducted to define the bacterial aetiologies of enteric disorders and their association with CD4+ T-lymphocyte cell count and serum hs-CRP in HIV-seropositive patients coming for consultation at the AD-Lucem Banka Hospital. Stool samples from one-hundred HIV-positive patients with enteric disorders and forty HIV negative patients with enteric disorders were examined for the presence of bacteria by different diagnostic techniques. CD4+ T-lymphocyte count and serum hs-CRP of HIV-positive and HIV-negative patients were examined, respectively, by flux cytometry and the ELISA solid-phase direct sandwich method. Among all the participants, 39 (26.35%) were males and 109 (73.65%) were females. HIV-seropositive mean age (43.79 years) was significantly higher compared to HIV-seronegative (27.13 years) patients (p < 0.000). The average values of CD4+ T-cell count (p < 0.0001), lymphocytes (p=0.0258), monocytes (p=0.0317), and total WBC count (p=0.0277) were significantly higher in HIV− patients compared to HIV+ patients. Salmonella sp., Escherichia coli, and Klebsiella pneumoniae were more isolated in HIV+ patients 5 (83.33), 18 (75.00), and 37 (71.15) compared to HIV− patients 1 (16.67), 6 (25.00), and 15 (28.85), respectively. Majority of isolates were susceptible to IPM, NOR, and CIP. Klebsiella pneumoniae, the most prevalent isolate, showed resistance to AMC (45.95) in HIV+ patients, whereas in HIV− patients, Enterobacter aerogenes and Shigella sp. showed resistance to AMC (80.00% and 85.71%, respectively) and to CFM (80.00% and 57.14%, respectively). Enterobacter aerogenes (40.00%) and Shigella sp. (14.29) isolates showed multidrug resistance in HIV− patients, whereas Escherichia coli (5.56%) and Klebsiella pneumoniae (2.70%) showed multidrug resistance in HIV+ patients. Understanding the burden of bacteria disease in HIV patients as shown in the present study is important for planning effective control programs for the overall reduction of bacteria diseases in HIV-infected patients.
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