title: Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.
abstract: A study of the etiologies of diarrhea in adults in relation to their human immunodeficiency virus (HIV) serostatus and number of CD4+ cells was carried out in the Central African Republic. In cases and controls, multi-parasitism 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 HIV+ 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 HIV+ patients with persistent diarrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were found in HIV+ and HIV- dysenteric patients; bacteria resembling spirochetes that could not be cultivated were identified only in HIV+ cases with dysentery. Shiga-like toxin-producing E. coli O157:H- was isolated from two cases with hemolytic-uremic syndrome. Fungi were identified as the sole pathogen in 6.4% of the HIV+ 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.
authors.affiliation: Institut Pasteur de Bangui, Hôpital Communautaire, Central African Republic.
authors.forename: Y
authors.initials: Y
authors.lastname: Germani
authors.forename: P
authors.initials: P
authors.lastname: Minssart
authors.forename: M
authors.initials: M
authors.lastname: Vohito
authors.forename: S
authors.initials: S
authors.lastname: Yassibanda
authors.forename: P
authors.initials: P
authors.lastname: Glaziou
authors.forename: D
authors.initials: D
authors.lastname: Hocquet
authors.forename: P
authors.initials: P
authors.lastname: Berthélémy
authors.forename: J
authors.initials: J
authors.lastname: Morvan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D002488:Central African Republic; D003044:Coccidia / Q000302:isolation & purification; D004403:Dysentery / Q000209:etiology*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests