Dowsett S A, Archila L, Segreto V A, Gonzalez C R, Silva A, Vastola K A, Bartizek R D, Kowolik M J
Indiana University School of Dentistry, Indianapolis, Indiana 46202, USA.
J Clin Microbiol. 1999 Aug;37(8):2456-60. doi: 10.1128/JCM.37.8.2456-2460.1999.
Helicobacter pylori infection remains one of the most common in humans, but the route of transmission of the bacterium is still uncertain. This study was designed to elucidate possible sources of infection in an isolated, rural population in Guatemala. A total of 242 subjects in family units participated in the study. A medical history, including a history of dyspepsia, was taken by a physician and immunoglobulin G antibodies to H. pylori were detected with the QuickVue (Quidel, San Diego, Calif.) onsite serology test. Overall, 58% of subjects were seropositive, with a positive relationship between mother and child (P = 0.02) and a positive correlation between the serostatuses of siblings (intraclass correlation coefficient = 0.63). There was no association between serostatus and gastric symptoms. Oral H. pylori was detected from periodontal pockets of various depths and the dorsum of the tongue by nested PCR. Eighty-seven percent of subjects had at least one oral site positive for H. pylori, with the majority of subjects having multiple positive sites. There was no association between periodontal pocket depth and the detection of H. pylori. Nested PCR was also used to detect H. pylori from beneath the nail of the index finger of each subject's dominant hand. Overall, 58% of subjects had a positive fingernail result, with a significant positive relationship between fingernail and tongue positivity (P = 0.002). In conclusion, the results of this study suggest that oral carriage of H. pylori may play a role in the transmission of infection and that the hand may be instrumental in transmission.
幽门螺杆菌感染仍是人类最常见的感染之一，但该细菌的传播途径仍不确定。本研究旨在阐明危地马拉一个与世隔绝的农村人群中可能的感染源。共有242个家庭单位的受试者参与了该研究。由医生采集包括消化不良病史在内的病史，并使用QuickVue（Quidel，加利福尼亚州圣地亚哥）现场血清学检测法检测幽门螺杆菌的免疫球蛋白G抗体。总体而言，58%的受试者血清呈阳性，母亲与孩子之间呈正相关（P = 0.02），兄弟姐妹的血清状态之间呈正相关（组内相关系数 = 0.63）。血清状态与胃部症状之间无关联。通过巢式PCR从不同深度的牙周袋和舌背检测到口腔幽门螺杆菌。87%的受试者至少有一个口腔部位幽门螺杆菌呈阳性，大多数受试者有多个阳性部位。牙周袋深度与幽门螺杆菌检测之间无关联。巢式PCR还用于从每个受试者优势手食指的指甲下检测幽门螺杆菌。总体而言，58%的受试者指甲检测结果呈阳性，指甲与舌部阳性之间存在显著正相关（P = 0.002）。总之，本研究结果表明，幽门螺杆菌的口腔携带可能在感染传播中起作用，并且手可能在传播中起作用。
