背景:机会性感染是人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者普遍存在的并发症。隐孢子虫。,十二指肠贾第虫,肠孢子虫是人类常见的机会性肠道病原体。在中国,尽管艾滋病毒/艾滋病患者的数量非常多,只有少数研究调查了该患者人群中由肠道病原体引起的机会性感染。本研究旨在阐明隐孢子虫的发生和遗传特征。,G.十二指肠,艾滋病毒/艾滋病患者的E.bieneusi。
方法:我们收集了155名HIV/AIDS患者的粪便标本(每位患者一名)。通过使用聚合酶链反应进行基因分型并对隐孢子虫的小亚基核糖体RNA基因进行测序,检查了所有标本中病原体的存在。;磷酸丙糖异构酶,十二指肠G的β-giardin和谷氨酸脱氢酶基因;和E.bieneusi的rRNA基因的内部转录间隔区。通过聚合酶链反应和60kDa糖蛋白基因的测序,对隐孢子虫阳性标本进行了进一步的分型。
结果:六个(3.9%),三人(1.9%),8例(5.2%)HIV/AIDS患者的隐孢子虫属阳性。,G.十二指肠,和E.Bieneusi,分别。两组之间的发生率无统计学差异。临床症状(腹泻),和CD4+细胞计数。确定了四种隐孢子虫:人隐孢子虫(n=2),微小隐孢子虫(n=1),隐孢子虫(n=1),和隐孢子虫(n=2)。此外,检测到两种人型C.hominis亚型(IeA12G3T3和IaA28R4)。成功扩增了三个十二指肠G.阳性标本,并在磷酸丙糖异构酶和β-giardin基因座处进行了测序,这导致了组合C和B的鉴定,分别。七个基因型(D,IV型,EbpC,Peru11EbpD,A,和I)在E.bieneusi阳性标本中鉴定。
结论:我们的发现应提高对艾滋病相关机会性肠道病原体的认识,并指出在临床实践中需要进行常规检查以检测隐孢子虫。,G.十二指肠,还有E.Bieneusi.在核苷酸和/或氨基酸水平上对三种肠道病原体的同源性分析表明它们具有人畜共患的潜力。
BACKGROUND: Opportunistic infections are a ubiquitous complication in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are common opportunistic intestinal pathogens in humans. In
China, despite the number of HIV/AIDS patients being extremely large, only a few studies have investigated opportunistic infections caused by intestinal pathogens in this patient population. The aims of this study were to elucidate the occurrence and genetic characteristics of Cryptosporidium spp., G. duodenalis, and E. bieneusi in HIV/AIDS patients.
METHODS: We collected fecal specimens from 155 HIV/AIDS patients (one from each patient). All of the specimens were examined for the presence of the pathogens by genotyping using polymerase chain reaction and sequencing of the small subunit ribosomal RNA gene for Cryptosporidium spp.; the triosephosphate isomerase, β-giardin and glutamate dehydrogenase genes for G. duodenalis; and the internal transcribed spacer region of the rRNA gene for E. bieneusi. The Cryptosporidium-positive specimens were further subtyped by polymerase chain reacion and sequencing of the 60-kDa glycoprotein gene.
RESULTS: Six (3.9%), three (1.9%), and eight (5.2%) HIV/AIDS patients were positive for Cryptosporidium spp., G. duodenalis, and E. bieneusi, respectively. No statistical differences were observed in occurrence rate between the groups by gender, clinical symptom (diarrhea), and CD4+ cell count. Four Cryptosporidium species were identified: Cryptosporidium hominis (n = 2), Cryptosporidium parvum (n = 1), Cryptosporidium meleagridis (n = 1), and Cryptosporidium andersoni (n = 2). Furthermore, two C. hominis subtypes (IeA12G3T3 and IaA28R4) were detected. Three G. duodenalis-positive specimens were successfully amplified and sequenced at the triosephosphate isomerase and β-giardin loci, which led to the identification of assemblages C and B, respectively. Seven genotypes (D, Type IV, EbpC, Peru11, EbpD, A, and I) were identified in E. bieneusi-positive specimens.
CONCLUSIONS: Our findings should increase awareness of AIDS-related opportunistic intestinal pathogens, and indicate the need for routine examination in clinical practice for the detection of Cryptosporidium spp., G. duodenalis, and E. bieneusi. Homology analyses of the three intestinal pathogens at the nucleotide and/or amino acid levels indicated their zoonotic potential.