[Incidence of enteropathogens in patients with human immunodeficiency virus infection].
BACKGROUND
To establish the incidence of diarrhea and its evolution over time, the causal microorganisms, recurrence and associated mortality in patients with AIDS or severe immunologic alterations (CD4 lymphocytes lower than 0.5 x 10(9)/l).


METHODS
A prospective longitudinal study was carried out from 1984 to 1992. The following patients were included in the study: 1) all those patients with diarrhea in whom a pathogenic microorganism was identified in the stools, and 2) patients with fever and positive blood cultures for enteropathogenic bacteria. The patients belonged to a series of 1,456 patients with infection by HIV.


RESULTS
Of the 1,456 controlled patients, 253 (17%) had infection by enteropathogenic microorganisms. The incidence was greater in homosexual patients (26%) than in drug addicts (12%). The most frequent germs were Cryptosporidium, in 104 episodes and Salmonella sp. in 78 episodes (31 as isolated bacteria). The mortality in the 15 days following isolation was 2%, the referred microorganisms being the most frequent responsible for the deaths. The mean of CD4 lymphocytes in the patients with enteropathogens was 0.17 x 10(9)/l). SD 0.14 x 10(9)/l). In patients with infection by Cryptosporidium the CD4 lymphocyte count was lower than that observed in the cases of infection by Isospora belli. Prior to 1988, 21% of the patients had infection by enteropathogenic bacteria and 23% by parasites, those percentages being 3% and 6%, respectively in 1991.


CONCLUSIONS
Infections by enteropathogenic microorganisms in patients with infection by the human immunodeficiency virus in an advanced stage are frequent, particularly, in homosexuals. The patients with enteritis by Cryptosporidium have a greater grade of immunosuppression (CD4 lymphocytes lower than 0.1 x 10(9)/l) than patients with infection by other enteropathogenic microorganisms. In the last few years, the incidence of enteropathogenic bacteria, especially Salmonella sp. and protozoa has decreased [corrected].
Moreno
A
A
Servicio de Enfermedades Infecciosas, Hospital Clínic i Provincial, Barcelona.
Gatell
J M
JM
Mensa
J
J
Valls
M E
ME
Vila
J
J
Claramonte
X
X
Miró
J M
JM
Mallolas
J
J
Zamora
L
L
Lozano
L
L
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D003457:Cryptosporidiosis / Q000150:complications*; D003967:Diarrhea / Q000382:microbiology; D004751:Enteritis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000469:parasitology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D011446:Prospective Studies; D012480:Salmonella Infections / Q000150:complications*
Incidencia de enteropatógenos en pacientes con infección por el virus de la immunodeficiencia humana.