Langenberg W, Rauws E A, Oudbier J H, Tytgat G N
Department of Medical Microbiology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
J Infect Dis. 1990 Mar;161(3):507-11. doi: 10.1093/infdis/161.3.507.
Three instances of subclinical reinfection with Campylobacter pylori were observed in two successfully treated patients during follow-up of C. pylori gastritis. The reinfections occurred 1 month and 21 months (patient 1) and 32 months (patient 2) after the completion of antibacterial treatment. Sequential measurement by ELISA of serum IgG antibody levels to the microorganism showed a significant increase in two of the three instances of reinfection. Patient-to-patient transmission was proved by restriction enzyme analysis of bacterial DNA. Between patients the endoscope had been mechanically cleaned using a detergent and treated with 70% ethanol. The risk of gastroscopic cross-infection with C. pylori was estimated by retrospective analysis of the data of 281 negative examinations (107 in 47 initially negative patients and 174 in 37 cured patients). The frequency in uninfected patients of documented endoscopic transmission of C. pylori infection was 1.1% in this study, corresponding with three iatrogenic acquisitions of manifest infection for every 1000 gastroduodenoscopies in our clinic.
在幽门螺杆菌胃炎患者的随访过程中，我们观察到两例成功治疗的患者出现了3次幽门螺杆菌亚临床再感染。再感染分别发生在抗菌治疗结束后的1个月和21个月（患者1）以及32个月（患者2）。通过酶联免疫吸附测定法（ELISA）对血清中针对该微生物的IgG抗体水平进行连续测量，结果显示在3次再感染中有2次抗体水平显著升高。通过对细菌DNA进行限制性酶切分析，证实了患者之间的传播。在患者之间，内镜已使用洗涤剂进行机械清洁，并经70%乙醇处理。通过对281次阴性检查数据（47例初始阴性患者中的107次以及37例治愈患者中的174次）进行回顾性分析，评估了胃镜检查导致幽门螺杆菌交叉感染的风险。在本研究中，未感染患者中记录到的内镜传播幽门螺杆菌感染的频率为1.1%，相当于在我们诊所每1000次胃十二指肠镜检查中有3例医源性显性感染。
