Goodman K J, Correa P
School of Public Health, University of Texas-Houston Health Science Center 77225, USA.
Int J Epidemiol. 1995 Oct;24(5):875-87. doi: 10.1093/ije/24.5.875.
This paper critically reviews the reported data regarding the transmission of Helicobacter pylori. The mode of transmission remains poorly understood; no single transmission pathway has been clearly identified. Laboratory studies have experienced difficulty in isolating this organism from material other than gastric tissue. The problematic detection of this bacterium has presented obstacles to pinpointing portals of entry and exit and to implicating or ruling out environmental reservoirs. It is shown additionally that knowledge of H. pylori transmission is limited due to lack of solid epidemiological evidence from population-based analyses that adequately consider confounding. Reported observations in general support a person-to-person mode of transmission that occurs most frequently early in life; H. pylori is consistently linked to conditions associated with residential crowding in childhood. Laboratory studies have yielded evidence in favour of both faecal-oral and oral-oral pathways. However, a role for either waterborne or zoonotic transmission has not been ruled out. The failure of investigations to single out a mode of transmission for H. pylori signals the possibility of multiple transmission pathways.
本文对已报道的有关幽门螺杆菌传播的数据进行了批判性综述。传播模式仍知之甚少；尚未明确确定单一的传播途径。实验室研究在从胃组织以外的材料中分离出这种微生物时遇到了困难。这种细菌检测存在的问题为确定其进出途径以及确定或排除环境储存库带来了障碍。此外还表明，由于缺乏来自充分考虑混杂因素的基于人群分析的可靠流行病学证据，幽门螺杆菌传播的知识有限。所报道的观察结果总体上支持人际传播模式，这种传播最常发生在生命早期；幽门螺杆菌一直与儿童期居住拥挤相关的情况有关。实验室研究已得出支持粪口途径和口口途径的证据。然而，水传播或人畜共患病传播的作用尚未排除。未能确定幽门螺杆菌的单一传播模式表明可能存在多种传播途径。
