Kuijper EJ, Snijders F, De Wever B, Danner S, Dankert J; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1996 Sep 15-18; 193 (abstract no. I36).
Academic Medical Center, Meibergdreef, Amsterdam.
Diarrhea is an important clinical problem in HIV-infected patients and a variety of organisms has been implicated. During a prospective study at the outpatients AIDS department, we examined all fresh stool specimens of HIV-infected patients for the presence of enteropathogenic bacteria and parasites and asked the patients to complete a questionnaire about symptoms of gastroenteritis. Stool specimens were processed using the ASM Clinical Microbiological Procedures with an additional membrane-filter technique (0.65 micrometers) for the isolation of campylobacters. Identification of campylobacters was performed using conventional biochemical tests and by PCR amplification of the interspecies variability of 23S rDNA genes for the group of C. jejuni subsp. jejuni and doylei, C. coli, C. lari and C. upsaliensis, and for each species separately of C. Hyointestinalis, C. fetus, C. mucosalis, C. sputorum and C. concisus. Of 201 HIV-patients, 43 (21%) suffered from diarrhea. Diarrhea was only observed in patients with CD4 cells less than 500 x 10(6)/L. Parasites were found in 7 of 43 patients with diarrhea and in 8 of 158 patients without diarrhea. Enteropathogenic bacteria were found in 10 (2 Salmonella species, 1 C. difficile and 7 Campylobacter species) of 43 patients with diarrhea and 5 (all Campylobacter species) of 158 patients without diarrhea. Campylobacter species were significantly associated with diarrhea (p is less than 0.01). Only 1 of 12 campylobacters (C. coli) was isolated with the selective plate containing antibiotics. Of 10 strains available for phenotypical and genetical identification, only 4 were correctly identified (2 C. upsaliensis, 1 C. jejuni subsp. jejuni, 1 C. jejuni subsp. doylei) by both methods. Of 6 strains phenotypically characterized as non-themophilic, 4 reacted with the primers developed for the group of C. jejuni, coli, lari and upsaliensis and were finally identified as C. upsaliensis. Remarkably, 2 of these strains were resistant to erythromycin whereas all other strains were susceptible. In conclusion, campylobacters other than C. jejuni or C. coli isolated by the filtration method only, are an important cause of diarrhea in HIV-infected patients and phenotypical tests are insufficient for Campylobacter species identification.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Campylobacter
- Campylobacter Infections
- Campylobacter jejuni
- DNA, Ribosomal
- Diarrhea
- HIV Infections
- HIV Seropositivity
- Humans
- Polymerase Chain Reaction
- Prospective Studies
Other ID:
UI: 102234985
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