Solnick Jay V, Chang Kikuko, Canfield Don R, Parsonnet Julie
Department of Internal Medicine, California National Primate Research Center, University of California-Davis, California 95616, USA.
J Clin Microbiol. 2003 Dec;41(12):5511-6. doi: 10.1128/JCM.41.12.5511-5516.2003.
Helicobacter pylori infection is usually acquired in childhood, but precise estimates of the age of acquisition are difficult to obtain in young children. Since serial endoscopic biopsies are not feasible in human infants, we examined acquisition of H. pylori infection that is known to occur in socially housed nonhuman primates. By 12 weeks of age, 8 of 20 newborns (40%) were culture positive for H. pylori, and prevalence reached 90% by 1 year of age. Newborns from infected dams were more commonly infected than those from uninfected dams, particularly during the peripartum period, suggesting that close contact during this time may facilitate transmission. Transient infection was uncommon and occurred only after the first positive culture. These results suggest that in a high-prevalence environment, persistent H. pylori infection may be acquired at an earlier age than was previously thought. Since clean, potable water was readily available, contamination of water supply is not essential for widespread infection at an early age in areas where hygiene is otherwise poor. Furthermore, breastfeeding seems to offer little protection, since newborn macaques breastfeed during the first year of life and typically are fully weaned only when another newborn arrives the following spring.
幽门螺杆菌感染通常在儿童期获得,但难以精确估计幼儿的感染年龄。由于对人类婴儿进行连续的内镜活检不可行,我们研究了群居的非人灵长类动物中已知会发生的幽门螺杆菌感染情况。到12周龄时,20只新生动物中有8只(40%)幽门螺杆菌培养呈阳性,到1岁时患病率达到90%。来自感染母猴的新生动物比未感染母猴的新生动物更易感染,尤其是在围产期,这表明此时的密切接触可能促进传播。短暂感染并不常见,仅在首次培养呈阳性后出现。这些结果表明,在高流行环境中,幽门螺杆菌持续感染可能比之前认为的年龄更早获得。由于清洁的饮用水随时可得,在卫生条件较差的地区,水源污染对于早期广泛感染并非必不可少。此外,母乳喂养似乎几乎没有保护作用,因为新生猕猴在出生后的第一年进行母乳喂养,通常只有在次年春天有另一只新生猕猴出生时才完全断奶。