加拿大北极地区的幽门螺杆菌：社区水样中的血清流行率及检测

Helicobacter pylori in the Canadian arctic: seroprevalence and detection in community water samples.

作者信息

McKeown I, Orr P, Macdonald S, Kabani A, Brown R, Coghlan G, Dawood M, Embil J, Sargent M, Smart G, Bernstein C N

机构信息

Department of Medicine, University of Manitoba, Canada.

出版信息

Am J Gastroenterol. 1999 Jul;94(7):1823-9. doi: 10.1111/j.1572-0241.1999.01212.x.

DOI:10.1111/j.1572-0241.1999.01212.x

PMID:10406242

Abstract

OBJECTIVE

Many North American arctic communities are characterized by risk markers associated with Helicobacter pylori (H. pylori) infection, including overcrowded housing and inadequate water supply and sanitation systems. Our aim was to determine the seroprevalence of H. pylori infection in two traditional Inuit communities in the central Canadian arctic and to test for the presence of H. pylori, by polymerase chain reaction (PCR), in local water supplies.

METHODS

Samples of venous whole blood from adults and capillary blood from children were collected and analyzed by enzyme immunoassay and Helisal Rapid Test, respectively, for IgG antibody to H. pylori. Antibodies to CagA were detected by enzyme immunoassay, and ABO and Lewis antigens were also determined. Demographic and clinical information were collected by questionnaire. Water samples from each community were tested for H. pylori by PCR.

RESULTS

One hundred-thirty (50.8%) of 256 subjects from the two communities were positive for H. pylori IgG antibodies. Seropositive subjects were more likely to be male, compared with seronegative individuals (p = 0.01). Antibody status did not differ with respect to age, community, alcohol or cigarette use, number of persons per household, gastrointestinal complaints or previous investigations, medications, or presence of blood group O, Lewis a-b+. CagA antibodies were detected in 78 (61.9%) of 126 H. pylori-seropositive subjects tested; however, 41 (35.3%) of 116 H. pylori-seronegative subjects were also CagA positive. Water samples taken from the water delivery truck in Chesterfield Inlet and two lakes near Repulse Bay were positive for H. pylori.

CONCLUSION

The seroprevalence of H. pylori in the study group was higher than rates in southern Canadian populations, but lower than the seroprevalence previously documented in a Canadian subarctic Indian (First Nations) community. The detection of H. pylori in local water supplies may indicate a natural reservoir for the organism or possible contamination from human sewage.

摘要

目的

许多北美北极地区社区的特征是存在与幽门螺杆菌（H. pylori）感染相关的风险指标，包括住房拥挤以及供水和卫生系统不足。我们的目的是确定加拿大北极中部两个传统因纽特社区中幽门螺杆菌感染的血清流行率，并通过聚合酶链反应（PCR）检测当地供水系统中是否存在幽门螺杆菌。

方法

分别采集成人静脉全血样本和儿童毛细血管血样本，通过酶免疫测定法和Helisal快速检测法分析幽门螺杆菌IgG抗体。通过酶免疫测定法检测CagA抗体，并确定ABO和Lewis抗原。通过问卷调查收集人口统计学和临床信息。通过PCR检测每个社区的水样中是否存在幽门螺杆菌。

结果

来自这两个社区的256名受试者中有130名（50.8%）幽门螺杆菌IgG抗体呈阳性。与血清阴性个体相比，血清阳性受试者更可能为男性（p = 0.01）。抗体状态在年龄、社区、饮酒或吸烟情况、每户人数、胃肠道不适或既往检查、用药情况或O血型、Lewis a-b+的存在方面没有差异。在126名检测的幽门螺杆菌血清阳性受试者中有78名（61.9%）检测到CagA抗体；然而，在116名幽门螺杆菌血清阴性受试者中有41名（35.3%）CagA也呈阳性。从切斯特菲尔德因莱特的送水车以及雷普利湾附近的两个湖泊采集的水样中幽门螺杆菌呈阳性。