艰难梭菌相关性疾病与幽门螺杆菌血清阳性率：一项病例对照研究。

Clostridium difficile-associated disease and Helicobacter pylori seroprevalence: A case-control study.

机构信息

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Department of Geriatric Rehabilitation, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel.

出版信息

Helicobacter. 2020 Feb;25(1):e12668. doi: 10.1111/hel.12668. Epub 2019 Nov 13.

DOI:10.1111/hel.12668

PMID:31721371

Abstract

BACKGROUND

Helicobacter pylori inhabits the stomach and causes persistent inflammation, with changes in gastric acidity. However, it is unclear whether the presence of H pylori plays a role in Clostridium difficile-associated disease (CDAD). The study's aim was to examine relationships of H pylori seroprevalence and serum pepsinogens (PGs), as markers of gastric inflammation, with CDAD.

MATERIALS AND METHODS

A case-control study was conducted among 49 CDAD cases and 54 controls (median age 82 years). Using enzyme-linked immunosorbent assays, sera were tested for H pylori IgG antibody, and PGI and PGII levels. Helicobacter pylori-positive samples were tested for IgG antibody to recombinant cytotoxin-associated gene A (CagA) virulent protein. Logistic regression models were fitted.

RESULTS

Cases and controls were comparable in age (P = .5) and sex distribution (females 62% vs 57%, P = .6). Helicobacter pylori IgG seroprevalence was 47%, of whom 23% were CagA seropositives. Among cases compared to controls, 43% vs 28% were H pylori seropositive but lacking CagA IgG antibody: adjusted odd ratio (OR) 3.43 (95% confidence intervals [CI] 1.29-9.10); 18% vs 4% were positive for CagA phenotype: adjusted OR 9.32 (95% CI 1.61-53.76). This association was not affected by PG levels.

CONCLUSIONS

Helicobacter pylori infection, especially with CagA virulent phenotype, might predispose to C difficile infection in elderly patients.

摘要

背景

幽门螺杆菌定植于胃部，引起持续性炎症，导致胃酸变化。然而，目前尚不清楚幽门螺杆菌的存在是否与艰难梭状芽孢杆菌相关疾病（CDAD）有关。本研究旨在研究幽门螺杆菌血清抗体阳性率和胃蛋白酶原（PG）作为胃炎症标志物与 CDAD 的关系。

材料与方法

对 49 例 CDAD 病例和 54 例对照者（中位年龄 82 岁）进行病例对照研究。采用酶联免疫吸附试验检测血清中幽门螺杆菌 IgG 抗体和 PG1、PG2 水平。对幽门螺杆菌阳性样本进行重组细胞毒素相关基因 A（CagA）毒力蛋白 IgG 抗体检测。拟合逻辑回归模型。

结果

病例组和对照组在年龄（P=0.5）和性别分布（女性占 62%，男性占 57%，P=0.6）方面无差异。幽门螺杆菌 IgG 血清抗体阳性率为 47%，其中 23%为 CagA 血清阳性。与对照组相比，病例组中 43%无 CagA IgG 抗体的幽门螺杆菌血清抗体阳性，调整后比值比（OR）为 3.43（95%可信区间 [CI]1.29-9.10）；18%为 CagA 表型阳性，调整后 OR 为 9.32（95% CI 1.61-53.76）。这种相关性不受 PG 水平的影响。