A Prospective Study of Diarrhea and HIV-1 Infection among 429 Zairian Infants

Thea, Donald M.; Me, St Louis; U, Atido; Kanjinga, K; Kembo, B; Matondo, M; Tshiamala, T; Kamenga, C; Davachi, Farzin; Brown, Cynthia L.

doi:10.1056/nejm199312023292304

Cited by 144 publications

(104 citation statements)

References 15 publications

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“…12 In this study, the frequency of EAEC in HIV-infected children with diarrhea was 6%, which is much lower than previously reported in children and adults from South Africa (29%), 18 and infants from Zaire (41%). 17 Enteroaggregative and EPEC are important pathogens in the pediatric population because of their high morbidity and mortality rates. 28 The ETEC is usually associated with dehydrating diarrhea, caused by the presence of the heat-stable (ST) and/or heat-labile (LT) enterotoxin.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15] However, there are few studies on the prevalence of diarrheagenic E. coli in pediatric HIV patients. [16][17][18][19][20] The aims of this study were 1) to determine the prevalence of diarrheagenic E. coli in Peruvian children infected with HIV with and without diarrhea, 2) to determine its association with viral load and immunosuppression, and 3) to determine the antimicrobial resistance patterns of diarrheagenic E. coli isolated from these patients.…”

Section: Introductionmentioning

confidence: 99%

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Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Medina¹,

Rivera²,

Romero³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted a prospective study in three hospitals in Lima in human immunodeficiency virus (HIV) children to determine the frequency of diarrheagenic Escherichia coli. Five E. coli colonies/patients were studied by a multiplex real-time polymerase chain reaction to identify the six currently recognized groups of diarrhea-associated E. coli . We have analyzed 70 HIV-associated diarrheal and 70 control samples from HIV-infected children without diarrhea. Among the diarrheal episodes 19% were persistent, 3% dysenteric, and 33% were associated with moderate or severe dehydration. The diarrheagenic E. coli were the most commonly isolated pathogens in diarrhea (19%) and control samples (26%) ( P = 0.42), including enteroaggregative (6% versus 10%), enteropathogenic (6% versus 10%), and enterotoxigenic E. coli (4% versus 3%), respectively. The HIV-infected children with diarrhea had the worse age-related immunosuppression, higher viral loads, and were on highly active antiretroviral treatment (HAART) less often than HIV-infected children without diarrhea . Diarrheagenic E. coli were highly resistant to ampicillin (74%) and cotrimoxazole (70%).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Medina¹,

Rivera²,

Romero³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…The prevalence of coccidia is similar to that observed in other developing African countries. [31][32][33][34][35][36][37] The prevalence of Cryptosporidium spp. in control patients is high.…”

Section: Discussionmentioning

confidence: 99%

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Germani¹,

Minssart²,

Vohito³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. A study of the etiologies of diarrhea in adults in relation to their human immunodeficiency virus (HIV) serostatus and number of CD4ϩ cells was carried out in the Central African Republic. In cases and controls, multiparasitism was observed. Salmonella spp. were identified mainly during acute diarrhea, with 50% of the S. enteritidis isolated during the study being responsible for septicemia and/or urinary tract infection in immunodeficient patients. Enteroaggregative Escherichia coli (EAggEC) were the most frequently identified agent in HIVϩ patients with persistent diarrhea; 42.8% of the patients with EAggEC as sole pathogens had bloody diarrhea, and these strains were negative for the presence of a virulence plasmid. Coccidia were found in those with acute and persistent diarrhea. Blood was observed in 53.3% of infections involving coccidia as the sole pathogen. Microsporidium spp. and Blastocystis hominis were found only in HIVϩ patients with persistent diarrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were found in HIVϩ and HIVϪ dysenteric patients; bacteria resembling spirochetes that could not be cultivated were identified only in HIVϩ cases with dysentery. Shiga-like toxin-producing E. coli O157:HϪ was isolated from two cases with hemolytic-uremic syndrome. Fungi were identified as the sole pathogen in 6.4% of the HIVϩ patients with persistent diarrhea. Most of enteropathogenic bacteria identified were resistant to ampicillin and trimethoprim-sulfamethoxazole, remained susceptible to ampicillin plus clavulanic acid, and were susceptible to amikacin, gentamicin, and ciprofloxacin.

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“…Studies from Africa have investigated HIV-associated diarrhoeal disease but have been limited either to specific populations, for example, children [4,5] or to an extensive search for a particular organism or group of organisms [6,7]. Investigations into the microbiology of systemic sepsis have been limited in much the same way as with diarrhoeal disease, with searches for specific pathogens, for example mycobacteria [8,9].…”

Section: Introductionmentioning

confidence: 99%

Microbiology of HIV associated bacteraemia and diarrhoea in adults from Nairobi, Kenya

1996

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SummaryWe undertook a retrospective descriptive comparison of the spectrum of pathogens responsible for bacteraemia and diarrhoea in HIV antibody positive and negative patients over 4 years (1988–92), in Nairobi, Kenya. The study population was recruited from primary to tertiary centers of clinical care and consisted of 2858 adults (15 years or older). There were 415 significant blood culture isolates, 192 from 1785 HIV negative patients and 223 from 953 HIV positive patients. There were 233 significant faecal isolates, 22 from 115 HIV negative patients and 211 from 531 HIV positive patients. The most common pathogens detected in blood were Streptococcus pneumoniae and Salmonella typhimurium and in faeces Shigella flexneri, S. typhimurium and Cryptosporidium parvum. The agents causing illness in HIV positive patients in Nairobi are similar to those prevalent in the HIV negative community and the investigation of a febrile illness with or wothout diarrhoea in an HIV positive patient should reflect this.

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A Prospective Study of Diarrhea and HIV-1 Infection among 429 Zairian Infants

Cited by 144 publications

References 15 publications

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.

Microbiology of HIV associated bacteraemia and diarrhoea in adults from Nairobi, Kenya

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