NOSOCOMIAL OUTBREAK OF CRYPTOSPORIDIOSIS IN AIDS PATIENTS
NOSOCOMIAL OUTBREAK OF CRYPTOSPORIDIOSIS IN AIDS PATIENTS
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DOI：
10.1136/bmj.302.6771.277
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发表时间：
1991-02-02
影响因子：
105.7
通讯作者：
GAUB, J
中科院分区：
文献类型：
--
作者：
RAVN, P;LUNDGREN, JD;GAUB, J
描述1989年6月后4个月内隐孢子虫病医院内暴发的情况。地点-哥本哈根的一个传染病部门，观察丹麦约一半的艾滋病患者。对象-73名HIV抗体阴性受试者和60名抗体阳性受试者在暴发传播期间住院（6月20日至8月14日），其中18人（17人患有艾滋病，1人患有艾滋病相关综合征）患上隐孢子虫病。两个进一步的HIV阴性的主题（一个部门秘书，一个访问的亲戚）开发隐孢子虫病。主要结果measures-隐孢子虫在粪便样本，临床症状，CD 4细胞计数，HIV抗原浓度，化疗treatment.Results-The爆发的来源被确定为冰从制冰机在病房，污染的失禁，隐孢子虫病的精神病人挑选冰冷饮。平均潜伏期至少为13天，是HIV阴性患者的两倍。在18名患有隐孢子虫病的艾滋病患者中，5人康复，2人为无病毒携带者，3人死于无关原因，8人死于长期腹泻。在57例HIV抗体阳性住院病人中，（排除两名患者和在其他地方诊断的隐孢子虫病的指示病例），有症状的隐孢子虫病患者接受口服磺胺类药物的人数明显多于未接受口服磺胺类药物的患者。（91%，10/11-upper-48%，21/44，p < 0.05）。对隐孢子虫病的敏感性增加可能是艾滋病患者口服磺胺治疗的一个未被认识到的副作用。
Objective-To describe a nosocomial outbreak of cryptosporidiosis during four months after June 1989.Setting-A department of infectious diseases in Copenhagen, seeing about half the patients with AIDS in Denmark.Subjects-73 HIV antibody negative subjects and 60 antibody positive subjects admitted as inpatients during the transmission period of the outbreak (20 June-14 August), of whom 18 (17 with AIDS, one with AIDS related complex), developed cryptosporidiosis. Two further HIV negative subjects (one departmental secretary, one visiting relative) developed cryptosporidiosis.Main outcome measures-Cryptosporidia in stool samples, clinical symptoms, CD4 cell count, HIV antigen concentration, chemotherapeutic treatment.Results-The source of the outbreak was identified as ice from an ice machine in the ward, contaminated by an incontinent, psychotic patient with cryptosporidiosis picking out ice for cold drinks. The mean incubation time was at least 13 days-that is, twice that in HIV-negative patients. Of the 18 patients with AIDS who developed cryptosporidiosis, five recovered, two were symptomless carriers, three died of unrelated causes, and eight died after prolonged diarrhoea. Among the 57 exposed HIV antibody positive inpatients (excluding two patients and the index case with cryptosporidiosis diagnosed elsewhere), significantly more of those who developed symptomatic cryptosporidiosis received oral sulphonamides than those who did not (91%, 10/11-upsilon-48%, 21/44, p < 0.05).Conclusions-The clinical and epidemiological findings indicate that infection was the consequence of very small inocula. Increased sensitivity to cryptosporidiosis may be an unrecognised side effect of oral sulphonamide treatment in patients with AIDS.