A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterial (NTM) infections in HIV-infected patients. A total of 627 patients' data were reviewed, and 102 (16.3%) patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection (48/102, 47.1%). The overall rates of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.
AIDS-Related Opportunistic Infections ; epidemiology ; microbiology ; Adult ; Beijing ; Coinfection ; Extensively Drug-Resistant Tuberculosis ; epidemiology ; microbiology ; Female ; HIV Infections ; epidemiology ; microbiology ; Hospitals, Urban ; Humans ; Male ; Mycobacterium Infections, Nontuberculous ; epidemiology ; microbiology ; Mycobacterium tuberculosis ; isolation & purification ; Nontuberculous Mycobacteria ; isolation & purification ; Prevalence ; Retrospective Studies ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; microbiology

BACKGROUND/AIMS: In this study, the sensitivity-specificity of galactomannan-enzyme immunoassay (GM-EIA) with a cut-off value of 0.5 for a single, two, or three consecutive positivity in the diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients with hematological malignancy was investigated. METHODS: IPA was classified as "proven," "probable," or "possible" as described in the guidelines prepared by the European Organization for Research and Treatment of Cancer and Mycoses Study Group." Serum samples were collected from the patients twice a week throughout their hospitalization. A total of 1,385 serum samples, with an average of 8.3 samples per episode, were examined. RESULTS: Based on the 165 febrile episodes in 106 patients, 80 (48.5%) were classified as IPA (4 proven, 11 probable, 65 possible) and 85 (51.5%) as non-IPA. The sensitivity/ specificity was 100%/27.1% for a single proven/probable IPA with the cut of value of GM-EIA > or = 0.5, 86.7%/71.8% for two consecutive positive results, and 73.3%/85.9% for three consecutive positive results. CONCLUSIONS: With the galactomannan levels measured twice a week, consecutive sensitivity decreased and specificity increased. Therefore, an increase may be obtained in sensitivity-specificity by more frequent monitoring of GM-EIA starting from the first day of positivity is detected.
Adult ; Aged ; Antineoplastic Agents/*adverse effects ; Biomarkers/blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Hematologic Neoplasms/diagnosis/*therapy ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/*adverse effects ; Invasive Pulmonary Aspergillosis/*blood/diagnosis/immunology/microbiology ; Male ; Mannans/*blood ; Middle Aged ; Opportunistic Infections/*blood/diagnosis/immunology/microbiology ; Predictive Value of Tests ; Reproducibility of Results ; Time Factors

70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study. M. tuberculosis and non-tuberculosis mycobacterium (NTM) were identified by using multi-locus PCR. M. tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards. Meanwhile, the drug susceptibilities of the strains to the four first-line anti TB drugs (rifampin, isoniazid, streptomycin, and ethambutol) and the four second-line anti-TB drugs (capreomycin, kanamycin, ofloxacin, and ethionanide) were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.
AIDS-Related Opportunistic Infections ; microbiology ; Antitubercular Agents ; pharmacology ; China ; Humans ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; classification ; drug effects ; isolation & purification ; Phylogeny ; Tuberculosis ; complications ; microbiology

Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-alpha and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm3, 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-alpha and ribavirin.
Antifungal Agents/therapeutic use ; Antiviral Agents/*adverse effects ; Cryptococcus neoformans/immunology/*pathogenicity ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic/diagnosis/*drug therapy/immunology ; Humans ; Immunocompromised Host ; Interferon-alpha/*adverse effects ; Meningitis, Cryptococcal/drug therapy/immunology/*microbiology ; Middle Aged ; Opportunistic Infections/diagnosis/drug therapy/immunology/*microbiology ; Polyethylene Glycols/*adverse effects ; Recombinant Proteins/adverse effects ; Ribavirin/*adverse effects ; Time Factors ; Treatment Outcome

No abstract available.
Antibiotics, Antitubercular/*adverse effects ; Female ; Humans ; Kidney Transplantation/*adverse effects ; Middle Aged ; Neutropenia/blood/*chemically induced/diagnosis ; Opportunistic Infections/microbiology/*prevention & control ; Recurrence ; Rifabutin/*adverse effects ; Severity of Illness Index ; Time Factors ; Tuberculosis/microbiology/*prevention & control

OBJECTIVETo describe clinical signs, pathology, diagnosis and treatment of Cape vultures in which Aspergillus fumigatus (A. fumigatus) and mixed species of bacteria were isolated.

METHODSSix Cape vultures sourced from South Africa for exhibition at Al Ain Zoo developed illness manifesting as anorexia, dyspnea, polyuria and lethargy. Three vultures died manifesting "pneumonia-like syndrome". These three vultures were necropsied and gross lesions recorded, while organ tissues were collected for histopathology. Internal organs were swabbed for bacteriology and mycology. From live vultures, blood was collected for hematology and biochemistry, oropharyngeal and cloacal swabs were collected for mycology and bacteriology.

RESULTSA. fumigatus was isolated from the three dead vultures and two live ones that eventually survived. One of the dead vulture and two live vultures were co-infected with A. fumigatus and mixed species of bacteria that included Clostridium perfringens, Pseudomonas, Staphylococcus, Escherichia, Proteus, Enterococcus and Enterbacter. One of the Cape vulture and a Lappet-faced vulture, however, were free of Aspergillus or bacterial infections. At necropsy, intestinal hemorrhages were observed and the lungs were overtly congested with granulomas present on caudal air sac. Histopathological examinations demonstrated granulomatous lesions that were infiltrated by mononuclear cells and giant cells.

CONCLUSIONSAspergillosis is a persistent threat to captive birds and we recommend routine health assessments so that early diagnosis may prompt early treatment. It is likely that prompt prophylaxis by broad spectrum antibiotics and antifungals medication contributed to the survival of some of the vultures.

Animals ; Animals, Zoo ; Aspergillosis ; veterinary ; Aspergillus ; Bacteria ; Bacterial Infections ; veterinary ; Bird Diseases ; diagnosis ; microbiology ; Birds ; microbiology ; Granuloma ; pathology ; Necrosis ; Opportunistic Infections

AIDS-Related Opportunistic Infections ; complications ; microbiology ; Acquired Immunodeficiency Syndrome ; complications ; microbiology ; Adult ; Humans ; Male ; Penicillium ; pathogenicity ; Pharyngeal Neoplasms ; complications ; microbiology ; Pharynx ; microbiology ; pathology

AIDS-Related Opportunistic Infections ; diagnosis ; microbiology ; Acquired Immunodeficiency Syndrome ; diagnosis ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Female ; Humans ; Immunohistochemistry ; Male ; Methenamine ; Pneumocystis carinii ; isolation & purification ; Pneumonia, Pneumocystis ; diagnosis ; microbiology ; Polymerase Chain Reaction ; Silver Staining ; methods

OBJECTIVETo observe the effect of xiaomi granules (XMG) for treatment of HIV/AIDS oral candidiasis.

METHODSForty patients in the treated group were treated by XMG and 40 patients in the control group were treated with anticandine. The therapeutic course for both groups was two weeks. Changes of clinical symptoms, oral candida microscopic examination and cultured before and after treatment as well as the safety of treatment were observed, and a follow-up study was implemented two weeks after ending medication to compare the relapse rate between groups.

RESULTSSymptoms as oral greasy-sticky, thirsty, asthenia, abdominal distension and anorexia were improved after treatment in both groups (P < 0.05). The improvements of oral greasy-sticky and thirsty in the treated group were better than those in the control group (P < 0.05). The effective rate and relapse rate in the treated group was 90.0% (36/40) and 11.1% (4/36) respectively, while in the control group, 72. 5% (29/40) and 31.0% (9/29) respectively.

CONCLUSIONXMG could improve the clinical symptoms with high efficacy and low relapse rate, shows a better effect than that of anticandine in treating HIV/AIDS oral candidiasis.

AIDS-Related Opportunistic Infections ; drug therapy ; Acquired Immunodeficiency Syndrome ; microbiology ; Adult ; Candidiasis, Oral ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; HIV Infections ; microbiology ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo analyze Helicobacter pylori infection in the gastric mucosa of patients with HIV/AIDS in different clinical stages.

METHODSThis study involved 170 patients with HIV/AIDS and 34 HIV-negative patients. All the patients underwent upper endoscopy and antral gastric biopsy to determine the status of Helicobacter pylori infection using aniline red staining and rapid urease test. The patients with HIV/AIDS were stratified based on CD4(+)T lymphocyte counts and clinical setting into asymptomatic HIV infection (A1, A2) group, symptomatic HIV infection (B1, B2) group and AIDS (A3, B3, C1-3) group.

RESULTSThe prevalence of Helicobacter pylori infection in HIV/AIDS patients was 16.5% (28/170), and in the 3 groups classified, the infection rates were 23.4% (11/47), 14.0% (8/57), and 13.6% (9/66), respectively; the infection rate was 47.1% (16/34) in the control group. Helicobacter pylori infection rate in the gastric mucosa of the patients with HIV/AIDS in different clinical stages was significantly lower than that of the control group (P<0.05); the infection rates in symptomatic HIV-infected (B1, B2) group and AIDS (A3, B3, C1-3) group were significantly lower than that in asymptomatic HIV-infected (A1, A2) group (P<0.05).

CONCLUSIONThe low Helicobacter pylori infection rate in HIV/AIDS patients may result from severe immunodeficiency in the gastric mucosa.

AIDS-Related Opportunistic Infections ; microbiology ; pathology ; Acquired Immunodeficiency Syndrome ; microbiology ; pathology ; Adult ; Female ; Gastric Mucosa ; microbiology ; Gastroscopy ; HIV Infections ; microbiology ; pathology ; Helicobacter Infections ; epidemiology ; pathology ; Helicobacter pylori ; Humans ; Male ; Middle Aged