Invasive pneumococcal infections in children infected with HIV are not associated with splenic dysfunction.
Invasive pneumococcal infections in children infected with HIV are not associated with splenic dysfunction.
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感染艾滋病毒的儿童的侵袭性肺炎球菌感染与脾功能障碍无关。
DOI：
10.1089/apc.1996.10.336
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Pearson,HA
中科院分区：
文献类型：
--
作者：
Andiman,WA;Simpson,J;Holtkamp,C;Pearson,HA
目的与未感染hiv的同龄人相比，感染HIV-1的儿童更容易获得与儿童期包膜性细菌病原体相关的感染。当前研究的目的是确定hiv感染儿童中社区获得性侵袭性肺炎球菌疾病的比例可归因于脾功能障碍，通过枚举外周血中红细胞（rbc）的数量来测量。方法采用相位干涉显微镜对84例hiv感染母亲所生儿童的红细胞形态进行半定量评价。对医疗记录的监测和对耶鲁-纽黑文医院临床微生物学计算机数据库的审查显示，这些患者的血液和脑脊液的细菌培养均为阳性。结果84例患儿中，70例感染HIV（中位年龄66个月），14例未感染的血清逆转者（对照组）。70名感染艾滋病毒的儿童中有61名符合疾病预防控制中心关于中度或重度免疫缺陷和/或中度或重度症状条件的标准。70名感染艾滋病毒的儿童中有17名经历了23次侵袭性细菌感染。所有23例感染均由肺炎链球菌引起。这17名受试者首次感染时的中位年龄为20个月（范围10-58个月）。其余53名感染艾滋病毒的儿童和14名对照组均未发生侵袭性细菌感染。所有84名被研究的儿童，包括侵袭性肺炎球菌疾病的儿童，外周血中红细胞袋化比例正常（即<2%）。结论脾功能障碍不能解释感染HIV的儿童侵袭性肺炎球菌疾病发生率增加的原因。
ObjectivesChildren infected with HIV-1 are more likely to acquire infections associated with the encapsulated bacterial pathogens of childhood than their non-HIV-infected peers. The goal of the current study was to determine what proportion of community-acquired, invasive pneumococcal disease in HIV-infected children could be attributed to splenic dysfunction, as measured by enumerating the number of pocked red blood cells (RBCs) in peripheral blood.MethodsSplenic reticuloendothelial function was assessed semiquantitatively by examining the morphology of the RBCs of 84 children born to HIV-infected mothers using phase interference microscopy. Surveillance of medical records, and a review of the Yale—New Haven Hospital Clinical Microbiology computerized database, revealed that all of the bacterial cultures of blood and cerebrospinal fluid from these patients were positive.ResultsOf the 84 children assessed, 70 were infected with HIV (median age 66 months) and 14 were uninfected seroreverters (controls). Sixty-one of the 70 HIV-infected children met the CDC criteria for moderate or severe immunodeficiency and/or moderate or severe symptomatic conditions. Seventeen of the 70 HIV-infected children experienced 23 invasive bacterial infections.Streptococcus pneumoniaewas responsible for all 23 infections. The median age at the time of first infection among these 17 subjects was 20 months (range, 10-58 months). There were no episodes of invasive bacterial infections in the remaining 53 HIV-infected children nor among the 14 controls. All 84 children studied, including those with invasive pneumococcal disease, had normal proportions (i.e., <2%) of pocked erythrocytes in peripheral blood.ConclusionSplenic dysfunction, as measured by the pocked RBC count, does not account for the increased occurrence of invasive pneumococcal disease found in children infected with HIV.
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