Kaindi Dasel W M, Kogi-Makau Wambui, Lule Godfrey N, Kreikemeyer Bernd, Renault Pierre, Bonfoh Bassirou, Schelling Esther, Zinsstag Jakob, Lacroix Christophe, Meile Leo, Jans Christoph, Hattendorf Jan
Department of Food Science, Nutrition and Technology, University of Nairobi, P. O. Box 29053 - 00625, Nairobi, Kenya.
School of Medicine, University of Nairobi, P. O. Box 19676, Nairobi, Kenya.
Acta Trop. 2018 Feb;178:10-18. doi: 10.1016/j.actatropica.2017.10.018. Epub 2017 Oct 25.
Consumption of traditional fermented dairy products (tFDP) in Africa leads to the ingestion of up to 10Streptococcus infantarius subspecies infantarius (Sii) per millilitre of spontaneously fermented milk. Sii is a member of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) for which some members are associated particularly with colorectal cancer or endocarditis. The extent of health risks to tFDP consumers is largely unknown. A hospital-based unmatched case-control study was conducted at Kenyatta National Hospital, Nairobi (Kenya) on 80 cases and 193 controls that were selected exhaustively from patients attending colonoscopy at the hospital. Logistic regression models adjusted for age, sex and residency were used in the statistical analysis. Consumption of tFDP was not associated with CRC (odds ratio (OR) 1.4; 95% Confidence interval (CI) 0.7-2.7; p=0.34). Risk factors associated with CRC included age above 40 years, and consumption of processed meat and alcohol. Faecal carriage of Sii was significantly higher in persons with colon tumours and polyps compared to controls (8.4% vs 21.6%: OR: 4.6; CI 1.3-15.9). Patients with haemorrhoids represented an unexpected carrier group with significantly higher Sii faecal carriage (30.4%, CI: 17.7-45.8). Consumption of tFDP does not represent risk factors for CRC whereas Sii seems to be associated with CRC. However, there is urgent need to assess this finding also in the general population, investigate the causality of SBSEC, Sii and CRC as well as compare the phylogenetic, functional and genomic relationship between human and dairy Sii with regards to the ongoing application of Sii in FDP production.
在非洲，食用传统发酵乳制品（tFDP）会导致每毫升自然发酵牛奶中摄入多达10个婴儿链球菌婴儿亚种（Sii）。Sii是牛链球菌/马链球菌复合体（SBSEC）的成员之一，该复合体的一些成员尤其与结直肠癌或心内膜炎有关。tFDP消费者面临的健康风险程度在很大程度上尚不清楚。在内罗毕（肯尼亚）的肯雅塔国家医院开展了一项基于医院的非匹配病例对照研究，对80例病例和193例对照进行了研究，这些病例和对照是从在该医院接受结肠镜检查的患者中全面挑选出来的。统计分析采用了针对年龄、性别和居住地进行调整的逻辑回归模型。食用tFDP与结直肠癌无关（优势比（OR）为1.4；95%置信区间（CI）为0.7 - 2.7；p = 0.34）。与结直肠癌相关的风险因素包括40岁以上的年龄、食用加工肉类和饮酒。与对照组相比，结肠肿瘤和息肉患者的粪便中Sii携带率显著更高（8.4%对21.6%：OR：4.6；CI 1.3 - 15.9）。痔疮患者是一个意外的携带群体，其粪便中Sii携带率显著更高（30.4%，CI：17.7 - 45.8）。食用tFDP并非结直肠癌的风险因素，而Sii似乎与结直肠癌有关。然而，迫切需要在普通人群中也评估这一发现，调查SBSEC、Sii与结直肠癌之间的因果关系，以及比较人类和乳制品中Sii在系统发育、功能和基因组方面关于Sii在FDP生产中的持续应用的关系。
