Human intestinal spirochetosis--a review.
Human intestinal spirochetosis--a review.
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DOI：
10.3205/000090
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发表时间：
2010-01-07
期刊：
影响因子：
--
通讯作者：
Gebbers, Jan-Olaf
中科院分区：
文献类型：
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作者：
Tsinganou, Efstathia;Gebbers, Jan-Olaf
人类肠道螺旋体病(IS)是一种组织学上由附着在大肠上皮尖细胞膜上的螺旋体微生物所定义的疾病。肠道螺旋体由一组异质细菌组成。在人类中，巴氏短螺旋体和毛细管状短杆螺旋体占主导地位。与IS普遍存在的欠发达地区相比，生活水平高的地区IS患病率较低。同性恋者和艾滋病毒感染者被殖民的风险很高。到目前为止，个别病例的临床意义尚不清楚。一篇文献综述认为，螺旋体侵入表面上皮以外可能与抗生素治疗(甲硝唑)有反应的胃肠道症状有关，而缺乏这一特征的人可能大多没有症状。出于未知的原因，同性恋和艾滋病毒阳性男子以及儿童更有可能出现症状，无论其是否受到侵袭。罕见的螺旋体血症和多器官功能衰竭在IS危重患者中已有报道。
Human intestinal spirochetosis (IS) is a condition defined histologically by the presence of spirochetal microorganisms attached to the apical cell membrane of the colorectal epithelium. Intestinal spirochetes comprise a heterogeneous group of bacteria. In humans, Brachyspira aalborgi and Brachyspira pilosicoli predominate. Prevalence rates of IS are low where living standards are high, in contrast to poorly developed areas where IS is common. Homosexuals and HIV-infected individuals are at high risk of being colonized. Clinical significance in individual cases has remained unclear up to now. A review of the literature assumes that invasion of spirochetes beyond the surface epithelium may be associated with gastrointestinal symptoms which respond to antibiotic treatment (metronidazole), whereas individuals lacking this feature may be mostly asymptomatic. Of unknown reason, homosexual and HIV-positive men as well as children are more likely to be symptomatic irrespective of invasion. Rare cases of spirochetemia and multiple organ failure have been reported in critically ill patients with IS.