Opportunistic Intestinal Protozoan Parasitic Infection in HIV Positive Patient in Jamnagar, Gujarat

Gupta, Manjula K.; Sinha, Mala; Raizada, N

doi:10.3126/saarctb.v5i1.3079

Cited by 10 publications

(11 citation statements)

References 8 publications

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“…Isosporais infrequently associated with diarrhea due to AIDS in the USA and Europe (about 2%), but is commonly isolated in patients with AIDS and chronic diarrhea in Brazil (9.9%), Zaire (12%), Zambia (16%), and Haiti (12%) [24]. Detection rate of Cyclospora in this study found to be 1.0% in HIV patients which correlates with the studies done in Chennai (0.6 %) [23] and in Gujrat (1%) [17]. Higher rates of infection by Cyclospora have been reported by Mohandas et al [14] (3.3%) and Soave R [25] (11%).…”

Section: Discussionsupporting

confidence: 86%

“…Difference in the incidence of intestinal protozoal parasitic infection reported by different workers can be attributed to the difference in geographical distribution of parasites, sanitary practices and different selection of cases. Various studies from India and other countries have reported a high prevalence of intestinal parasite, ranging from 25 to 60 percent [11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

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Intestinal Protozoa in Immunosuppression: A Medical Hassle

Ballani¹,

Shujatullah²,

Khan³

2012

J Bacteriol Parasitol

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Introduction: Immunity forms the backbone of our very existence and opportunistic infections have plagued the immunosuppressed since long. A significant morbidity and mortality is attributable to intestinal parasitosis in the immunocompromised population. Objectives:This study aims to study the prevalence of intestinal protozoa in various immunosuppressed groups and to correlate degree of immunosuppression with protozoal infections. Material and Methods:The study was conducted on 400 patients divided into 4 groups: Group I (HIV patients), Group II (patients on chemotherapy/chemotherapy and radiotherapy for various malignancies), and Group III (diabetes patients) and Group IV included children presenting with diarrhea. Group I, II and III included patients with and without gastrointestinal symptoms. Stool samples were investigated microscopically for cysts/trophozoites after concentration with formol-ether method. Iodine wet mount and Modified acid fast staining methods were used. Result:Intestinal protozoa were detected in 40.75% (163/400); more commonly in patients with higher degree of immunosuppression (CD4 count <200/µl in HIV patients: 62.5%, malignancy patients on both chemotherapy and radiotherapy: 71.1%, higher levels of HbA1c >7: 95.3% in diabetics and moderate to severe malnutrition: 61.8%. Most common protozoa associated was Cryptosporidium in 66 patients (40.5%) followed by, Entamoeba histolytica in 48 (29.4%), Giardia lamblia in 35 (21.5%), Isosporabelliin 9 (5.5%), Blastocystis hominis in 4 (2.5%), Cyclospora cayetenensis in 1 (0.61%). Conclusion:High prevalence of intestinal protozoa was seen in all groups of immunosuppressed patients and a significant association seen between degree of immune suppression and protozoal infection. Focus needs to be on routine screening of all immunosuppressed patients and their immune reconstitution.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Ballani¹,

Shujatullah²,

Khan³

2012

J Bacteriol Parasitol

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“…Earlier studies from Northern India have found Cryptosporidium to be the most common parasite, while the prevalence of Isospora was found to be much lower [26-27]. Studies from Southern India, on the other hand, reported a higher prevalence of Isospora belli rather than Cryptosporidium [3, 23].…”

Section: Discussionmentioning

confidence: 99%

A Study of Parasitic and Bacterial Pathogens Associated with Diarrhea in HIV-Positive Patients

Shah¹,

Kongre²,

Kumar³

et al. 2016

Cureus

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IntroductionDiarrhea is a common complication of acquired immune deficiency syndrome (AIDS), occurring in almost 90% of AIDS patients in developing countries like India. The present study was aimed to determine the prevalence and microbiological profile of pathogens associated with diarrhea in human immunodeficiency virus (HIV) positive patients and their relation to CD4 counts.Materials and methodsForty-five successive HIV-positive patients, 27 with diarrhea (study group) and 18 without diarrhea (control group), were included in the three-month study. The HIV infection was confirmed by three different antibody detection tests. The stool samples were collected on two consecutive days and were examined for parasites by microscopy using wet mount and modified Ziehl-Neelsen stain. They were examined for bacteria by Gram stain and conventional Ziehl-Neelsen stain and were inoculated on appropriate culture media. The isolates were identified by standard biochemical tests, followed by antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method.Results Twenty-four pathogens were detected in diarrheal HIV-positive patients, including 14 parasites (58.33%), seven bacteria (29.17%), and three fungi (12.50%). Isospora sp. was the most common parasite (25.9%) followed by Cryptosporidium sp. (14.8%). Other parasites included Cyclospora sp., Strongyloides stercoralis, and Entamoeba histolytica (3.7% each). Escherichia coli (18.5%) was the most common bacterial isolate, of which, 80% were Enterotoxigenic E. coli (ETEC) while 20% were Enteropathogenic E. coli (EPEC). Other isolates included Shigella flexneri and Mycobacterium tuberculosis (3.7% each). The isolates were sensitive to furazolidone (94.11%), chloramphenicol (76.47%), and gentamicin (52.94%). The isolates from diarrheal patients showed resistance to norfloxacin (5.88% vs. 50%, p<0.05) as compared to those from non-diarrheal patients. The diarrheal HIV-positive patients had lower mean CD4 counts (202.6 cells/µL), as compared to those without diarrhea (239.28 cells/µL).Conclusion Isospora sp. is the most common parasite and Escherichia coli is the most common bacterium associated with diarrhea in HIV patients. The antibiotic sensitivity patterns should be monitored regularly to detect resistance to commonly used drugs. The prevalence of organisms in a region, various clinical manifestations, sensitivity patterns of isolates, and relation with CD4 count should be considered while instituting therapy in HIV patients with diarrhea.

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“…[1315] I. belli was found as the commonest parasite by Gupta at Jamnagar (17.24%) and Kumar at Chennai (18%). [417] Differences in the incidence of intestinal parasitic infections can be attributed to the differences in geographical distribution of parasites, sanitary practices and different selection of cases.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Knowledge of the pattern of opportunistic infections can often guide therapy when resource limitations hamper the exact diagnosis of the etiological agent. [4] HIV/AIDS may not be curable but most of the opportunistic infections can be effectively treated. Prophylaxis against some of these infections will not only prolong the life of an HIV infected individual but also improve the quality of life.…”

Section: Introductionmentioning

confidence: 99%

Clinico-microbiological study of opportunistic infection in HIV seropositive patients

Patel

Kinariwala

Javadekar

2011

Indian J Sex Transm Dis

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Objectives:The present study was undertaken to determine the prevalence of respiratory, gastrointestinal and other pathogens in 100 Human Immunodeficiency Virus (HIV) seropositive patients.Settings:This study was carried out on randomly selected 100 HIV seropositive patients from S. S. G. Hospital during the period from Jan 2006 to Jan 2007.Materials and Methods:Sputum samples, stool samples and oral swabs were collected from all the patients and cerebrospinal fluid (CSF) was collected from symptomatic patients and processed as per the standard protocol. Sputum samples were examined by microscopy and cultured for bacterial respiratory pathogens. Stool samples were concentrated and examined by microscopy for enteric parasites. Oral swabs and CSF were also examined microscopically and cultured for fungal pathogens. CSF was also examined for bacterial pathogens.Results:A total of 101 pathogens were detected in 60 patients. More than one pathogen was observed in 30 patients. Candida was the commonest isolate (32.67%), followed by Mycobacterium tuberculosis (22.71%) and Cryptosporidium parvum (19.8%).Conclusions:Since opportunistic infections are a major cause of mortality and morbidity in HIV seropositive patients, an early diagnosis and effective treatment are required to tackle them. The type of pathogens infecting HIV patients varies from region to region, and therefore such patients should be constantly screened for these pathogens.

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Opportunistic Intestinal Protozoan Parasitic Infection in HIV Positive Patient in Jamnagar, Gujarat

Cited by 10 publications

References 8 publications

Intestinal Protozoa in Immunosuppression: A Medical Hassle

Intestinal Protozoa in Immunosuppression: A Medical Hassle

A Study of Parasitic and Bacterial Pathogens Associated with Diarrhea in HIV-Positive Patients

Clinico-microbiological study of opportunistic infection in HIV seropositive patients

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