CHRONIC BACTERIAL ENTEROPATHY IN PATIENTS WITH AIDS

被引:53
作者
KOTLER, DP
GIANG, TT
THIIM, M
NATARO, JP
SORDILLO, EM
ORENSTEIN, JM
机构
[1] COLUMBIA UNIV, ST LUKES ROOSEVELT HOSP CTR, DEPT PATHOL, NEW YORK, NY 10025 USA
[2] COLUMBIA UNIV, COLL PHYS & SURG, NEW YORK, NY USA
[3] UNIV MARYLAND, CTR VACCINE DEV, BALTIMORE, MD 21201 USA
[4] GEORGE WASHINGTON UNIV, SCH MED, DEPT PATHOL, WASHINGTON, DC USA
关键词
D O I
10.1093/infdis/171.3.552
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Enteric infection with adherent bacteria has been seen in a person with chronic diarrhea who was infected with the human immunodeficiency virus. In this study, adherent bacteria were seen in 17% of all patients with AIDS evaluated during a 1-year period. The infection was centered in the cecum and right colon. Three distinct histopathologic patterns of adherence were observed: attaching and effacing lesions, bacteria intercalated between microvilli, and aggregates of bacteria more loosely attached to the damaged epithelium. The infections were associated with weight loss (P < .005) and peripheral blood CD4(+) cell of counts <100/mm(3) (P < .05). Eight of 9 patients treated with antibiotics had symptomatic improvement. Bacterial cultures of rectal biopsies frozen at endoscopy yielded Escherichia coli in 12 of 18 cases; aggregative adherence was seen in 6. Isolates from 2 cases hybridized with a DNA probe encoding aggregative properties. These results suggest that chronic infection with adherent bacteria may produce a syndrome of AIDS-associated diarrhea and wasting.
引用
收藏
页码:552 / 558
页数:7
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