title: No relationship between gastric pH, small bowel bacterial colonisation, and diarrhoea in HIV-1 infected patients.
abstract: OBJECTIVE
  Conclusive studies of small bowel bacterial overgrowth in patients with HIV-1 infection are limited. The relation was therefore determined between the quantity and species of bacteria in the proximal small intestine of HIV-1 infected patients and the presence of diarrhoea, gastric acidity, severity of immune deficiency, and clinical outcome.
  
  
  METHODS
  Bacteria in the duodenal fluids obtained endoscopically from 32 HIV-1 infected patients, 21 of whom had diarrhoea, and seven control subjects without HIV-1 risk factors were quantified and speciated. Gastric pH was determined at the time of endoscopy. Clinical follow up was performed to assess outcome.
  
  
  RESULTS
  Oropharyngeal Gram positive cocci were present in fluids from 28 patients (88%). Gram negative aerobic or facultatively anaerobic bacteria were present in fluids from 12 patients (38%), and strict anaerobes were detected in six patients (19%), but for both groups colony counts infrequently exceeded 10(4) colony forming units/ml. The number and species of bacteria did not correlate with the presence of diarrhoea, gastric pH, or CD4 lymphocyte count.
  
  
  CONCLUSIONS
  Small bowel bacterial overgrowth is not common in HIV-1 infected patients, regardless of the presence of diarrhoea, and is not associated with hypochlorhydria
authors.affiliation: Departments of Medicine (Gastroenterology and Hepatology) and Pathology, University of Alabama at Birmingham, Birmingham, AL 39294-0007, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Wilcox
authors.forename: K B
authors.initials: KB
authors.lastname: Waites
authors.forename: P D
authors.initials: PD
authors.lastname: Smith
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology; D000328:Adult; D000465:Algorithms; D001419:Bacteria / Q000302:isolation & purification; D018791:CD4 Lymphocyte Count; D003967:Diarrhea / Q000382:microbiology*; D004386:Duodenum / Q000382:microbiology*; D005500:Follow-Up Studies; D005750:Gastric Juice / Q000378:metabolism*; D015658:HIV Infections / Q000276:immunology / Q000382:microbiology*; D015497:HIV-1; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011446:Prospective Studies