Microbiological assessment reveals that Salmonella, Shigella and Campylobacter infections are widespread in HIV infected and uninfected patients with diarrhea in Mozambique.

Autor:	Hlashwayo DF; Department of Biological Sciences, Faculty of Sciences, Universidade Eduardo Mondlane, Maputo, MZ.; Department of Animal Health & Epidemiology, Faculty of Veterinary Medicine, Universidade Eduardo Mondlane, Maputo, MZ., Noormahomed EV; Department of Microbiology, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, MZ.; Division of Infectious Diseases, Department of Medicine, University of California, San Diego (UCSD), La Jolla, CA, United States of America.; Mozambique Institute for Health Education and Research (MIHER), Maputo, MZ., Bahule L; Department of Biological Sciences, Faculty of Sciences, Universidade Eduardo Mondlane, Maputo, MZ., Benson C; Division of Infectious Diseases, Department of Medicine, University of California, San Diego (UCSD), La Jolla, CA, United States of America., Schooley RT; Division of Infectious Diseases, Department of Medicine, University of California, San Diego (UCSD), La Jolla, CA, United States of America., Sigaúque B; Manhiça Health Research Center (CISM), Manhiça, MZ., Barrett KE; Department of Physiology and Membrane Biology, University of California Davis School of Medicine, Sacramento, CA, United States of America., Bila CG; Department of Animal Health & Epidemiology, Faculty of Veterinary Medicine, Universidade Eduardo Mondlane, Maputo, MZ.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 May 22; Vol. 3 (5), pp. e0001877. Date of Electronic Publication: 2023 May 22 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001877
Abstrakt:	Diarrhea is an important cause of hospitalizations in Mozambique. However, little attention has been paid to the impact HIV infection on the prevalence or clinical manifestations of enteric bacterial infections. This study aimed to determine the prevalence of Salmonella spp., Shigella spp. and Campylobacter spp. in HIV-infected and HIV-uninfected patients with diarrhea, identify risk factors for infection, and explore the association between HIV status, viral load, and bacterial prevalence. We conducted a case-control study at the Centro de Saúde de Mavalane and Centro de Saúde 1° de Maio in Maputo, Mozambique, from November 2021 to May 2022. We recruited 300 patients, including 150 HIV-infected (cases) and 150 HIV-uninfected patients (controls), aged between 0-88 years, presenting with diarrhea. Stool samples were collected for bacterial isolation through culture, and for each HIV-infected patient, 4 ml of venous blood were obtained for viral load detection through PCR. A total of 129 patients (43.0%) had at least one bacterial infection. The prevalence of Salmonella spp., Shigella spp. and Campylobacter spp. was 33.0% (n = 99), 15.0% (n = 45) and 4.3% (n = 13), respectively. The prevalence of any bacterial infection did not differ significantly between HIV-infected (45.3%, n = 68) and HIV-uninfected patients (40.7%, = 61) (p = 0.414). Overall, having 2-3 symptoms of enteric disease (p = 0.008) and a basic education (p = 0.030) were factors associated with bacterial infection. Of the 148 patients for whom HIV-1 RNA levels were available, 115 had copy numbers ≤ 75. Another 13 had levels between 76 and 1,000 and the remaining 20 had an average of 327,218.45 copies/ml. Bivariate logistic regression found that Shigella spp. were associated with HIV (p = 0.038), although no association was found in the multivariate analysis. Enteric infections are common in both HIV-infected and -uninfected patients. Low schooling influences the occurrence of enteric infections, which highlights the need to raise awareness about their prevention. Competing Interests: The authors have declared that no competing interests exist. (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze:	MEDLINE
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