Halitim Fairouz, Vincent Pascal, Michaud Laurent, Kalach Nicolas, Guimber Dominique, Boman Françoise, Turck Dominique, Gottrand Frederic
Clinique de Pédiatrie, Hôpital Jeanne de Flandre, CHRU de Lille et Faculté de Médecine, Université de Lille II, Lille, France.
Helicobacter. 2006 Jun;11(3):168-72. doi: 10.1111/j.1523-5378.2006.00396.x.
Primary Helicobacter pylori infection occurs predominantly in childhood. The aims of this study were to establish the rate of H. pylori reinfection after successful eradication in children and adolescents and to determine the risk factors associated with reinfection.
This retrospective study involved 45 children (20 girls, 25 boys) who met the following criteria: eradication of H. pylori confirmed at least 4 weeks after the completion of therapy, and the search for reinfection at least one year after control of eradication of H. pylori. Demographic data, socioeconomic status and living conditions were recorded.
Forty-five children aged 1.2-17.6 years (median, 10.9 years) at the time of H. pylori treatment were reviewed 1 to 9 years after H. pylori eradication. Eight children (18%) had been reinfected (5.4% to 6% per patient-year). Six of 25 (24%) children older than 10 years at the time of diagnosis became reinfected. None of the studied risk factors was associated with reinfection. However, having a sibling younger than 5 years was found in four of seven (57%) reinfected children versus five of 24 (21%) nonreinfected children (p = .08).
Children become reinfected more frequently than adults. Adolescents become reinfected, whereas acquisition of primary H. pylori infection occurs predominantly in early childhood. Close contact with young children, especially siblings, younger than 5 years could be a more important risk factor than the age of the patient at the time of treatment for the high rate of reinfection in childhood.
幽门螺杆菌原发性感染主要发生在儿童期。本研究的目的是确定儿童和青少年幽门螺杆菌成功根除后的再感染率，并确定与再感染相关的危险因素。
这项回顾性研究纳入了45名儿童（20名女孩，25名男孩），他们符合以下标准：治疗完成后至少4周确认幽门螺杆菌已根除，并且在幽门螺杆菌根除控制后至少一年进行再感染检测。记录人口统计学数据、社会经济状况和生活条件。
对45名在幽门螺杆菌治疗时年龄为1.2 - 17.6岁（中位数为10.9岁）的儿童在幽门螺杆菌根除后1至9年进行了复查。8名儿童（18%）发生了再感染（每位患者每年5.4%至6%）。诊断时年龄大于10岁的25名儿童中有6名（24%）发生了再感染。所研究的危险因素均与再感染无关。然而，在7名再感染儿童中有4名（57%）有5岁以下的兄弟姐妹，而在24名未再感染儿童中有5名（21%）有5岁以下的兄弟姐妹（p = 0.08）。
儿童比成人更容易发生再感染。青少年会发生再感染，而幽门螺杆菌原发性感染主要发生在幼儿期。与5岁以下幼儿，尤其是兄弟姐妹密切接触，对于儿童期高再感染率而言可能是比治疗时患者年龄更重要的危险因素。
