Strongyloides stercoralis hyper-infection syndrome in HIV+/AIDS patients in Iran
Strongyloides stercoralis hyper-infection syndrome in HIV+/AIDS patients in Iran
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DOI：
10.1007/s00436-007-0531-x
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发表时间：
2007-08-01
影响因子：
2
通讯作者：
Kia, E. B.
中科院分区：
文献类型：
--
作者：
Meamar, A. R.;Rezaian, M.;Kia, E. B.
粪圆线虫是一种人类肠道线虫，分布在世界的热带和亚热带地区。在大多数个体中，由于低水平的自身感染，感染具有慢性性质。加速自身感染，主要在免疫状态改变后，可引起严重过度感染综合征或潜在致命的播散性圆线虫病。由于伊朗免疫功能低下患者人数不断增加，类圆线虫病是该国一个新出现的公共卫生问题。本研究于2003年至2005年期间对HIV+/AIDS患者的类圆线虫病进行了调查，共对781例患者进行了琼脂平板培养、福尔马林醚浓度和粪便标本直接涂片制备的检查。结果显示，781例HIV+/AIDS患者中有2例感染粪球菌，但均处于艾滋病进展期，表现为严重的超感染综合征。在这两种情况下，在新鲜粪便直接涂片中发现大量横纹肌状和丝状幼虫，在琼脂平板培养中发现寄生虫快速而密集地发育。总之，在艾滋病的进展阶段，由于免疫抑制条件或化疗的背景下，粪球菌能够诱导压倒性的感染。
Strongyloides stercoralis is an intestinal nematode in humans, distributed through tropical and subtropical regions of the world. In most individuals, the infection has a chronic nature due to auto-infection at the low level. Accelerated auto-infection, mainly after an alteration in immune status, can cause a syndrome of severe hyper-infection or potentially fatal disseminated strongyloidiasis. Due to the increasing numbers of immunocompromised patients in Iran, strongyloidiasis is an emerging public health concern in the country. In the current study, which was carried out between 2003 and 2005, for the investigation on strongyloidiasis in HIV+/AIDS patients, a total of 781 patients were examined by agar plate culture, formalin ether concentration, and direct smear preparation of stool samples. According to the results, 2 out of 781 HIV+/AIDS patients were found infected with S. stercoralis, but both patients were at the progressive stage of AIDS and showing severe hyper-infection syndrome. In both cases, numerous rhabditiform and filariform larvae were found in fresh stool direct smears, and rapid and intensive development of parasite in agar plate cultures. In conclusion, in the progressive stages of AIDS, as a result of immunosuppression conditions or in the context of chemotherapy, S. stercoralis is capable of inducing overwhelming infection.