Sinha Samir K, Martin Bruce, Gold Benjamin D, Song Qunsheng, Sargent Michael, Bernstein Charles N
Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Helicobacter. 2004 Feb;9(1):59-68. doi: 10.1111/j.1083-4389.2004.00199.x.
We have previously reported that Wasagamack, a Canadian First Nations community has a seroprevalence rate of Helicobacter pylori of 95% and a prevalence rate among children aged 0-12 years as measured by stool antigen testing of 56%. We aimed to determine the rate of infection acquisition and possible modes of transmission of childhood Helicobacter pylori infection in this Canadian First Nations community.
Children who were previously negative for H. pylori by stool antigen testing in August 1999 were eligible for enrollment in August 2000; 50 (77%) eligible children underwent stool collection. H. pylori stool antigen status was tested using the Premier Platinum HpSA test. Drinking water samples, maternal saliva, breast milk, local berries and flies were tested by three complementary H. pylori-specific PCR assays. Soothers or bottle nipples, collected from 16 children whose H. pylori stool antigen status was determined, were bathed in sterile water and this water was tested by PCR.
Stool was positive for H. pylori in 16% (8/ 50) of children retested. Five had no other siblings infected and three had infected siblings. The mothers of all children infected were positive for H. pylori. The median age of newly infected children was 6 years (range 1-13 years). By PCR, 78% (18/23) mothers' saliva samples, 69% (11/16) soother water samples and 9% (1/11) water samples from infected homes tested positive. All of 24 sequenced PCR-produced DNA fragments from samples showed 99% homology with that from ATCC type strain H. pylori.
The rate of childhood H. pylori acquisition was 16% over 1 year, and was not dependent on number of siblings infected. The finding of homologous H. pylori DNA in saliva and in soother water suggests the possibility of human to human transmission, particularly via an oral-oral route. Thus, there is the potential for further investigations in this population and other endemic communities that are directed at prevention of infection transmission via this modality.
我们之前报道过，加拿大第一民族社区瓦萨加马克的幽门螺杆菌血清流行率为95%，通过粪便抗原检测测得0至12岁儿童的流行率为56%。我们旨在确定该加拿大第一民族社区儿童幽门螺杆菌感染的获得率以及可能的传播方式。
1999年8月粪便抗原检测幽门螺杆菌呈阴性的儿童符合2000年8月的入组条件；50名（77%）符合条件的儿童接受了粪便采集。使用普瑞米尔铂金幽门螺杆菌粪便抗原检测试剂盒检测幽门螺杆菌粪便抗原状态。通过三种互补的幽门螺杆菌特异性聚合酶链反应（PCR）检测饮用水样本、母亲唾液、母乳、当地浆果和苍蝇。从16名已确定幽门螺杆菌粪便抗原状态的儿童处收集的安抚奶嘴或奶瓶奶嘴，用无菌水冲洗，冲洗后的水进行PCR检测。
重新检测的儿童中，16%（8/50）的粪便幽门螺杆菌呈阳性。5名儿童没有其他受感染的兄弟姐妹，3名儿童有受感染的兄弟姐妹。所有受感染儿童的母亲幽门螺杆菌检测均为阳性。新感染儿童的中位年龄为6岁（范围1至13岁）。通过PCR检测，78%（18/23）母亲的唾液样本、69%（11/16）安抚奶嘴冲洗水样本以及9%（1/11）受感染家庭的水样检测呈阳性。从样本中测序得到的所有24个PCR产生的DNA片段均显示与ATCC幽门螺杆菌标准菌株的DNA片段有99%的同源性。
儿童幽门螺杆菌的获得率在1年内为16%，且不依赖于受感染兄弟姐妹的数量。在唾液和安抚奶嘴冲洗水中发现同源的幽门螺杆菌DNA表明存在人传人传播的可能性，尤其是通过口口途径。因此，有必要针对该人群以及其他流行社区进一步开展研究，以预防通过这种方式传播感染。
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