Oderda G, Ponzetto A, Boero M, Bellis D, Forni M, Vaira D, Ansaldi N
Paediatric Gastroenterology Unit, University of Turin, Italy.
Ital J Gastroenterol Hepatol. 1997 Dec;29(6):509-14.
Familial clustering of Helicobacter pylori infection has been reported. We tested the hypothesis that simultaneously treating all Helicobacter pylori positive family contacts of infected symptomatic children results in lower treatment failure.
Relatives of 47 children (index) with Helicobacter pylori gastritis had endoscopy to assess prevalence of infection in first degree cohabiting relatives. Controls included 60 children with dyspepsia and Helicobacter pylori gastritis whose infected family contacts were not treated. Index children, siblings younger than 18 years of age and control children received a 2-week course of amoxicillin and tinidazole. Parents of index children and their siblings over 18 years of age received a 2-week course of Colloidal Bismuth Subcytrate and tinidazole. The eradication rate in index children and their relatives was compared to controls whose infected family contacts were not treated.
Helicobacter pylori was found in 67% of 31 siblings younger than 18, in 82% of 22 siblings older than 18 years, and in 87% of 92 parents. Endoscopy, repeated four to six weeks after the end of treatment, showed Helicobacter pylori eradication in 94% of children and siblings younger than 18, and in 70% of parents and siblings over 18 years in the family treatment group, compared with 75% of control children (p < .01).
The high prevalence of the infection in family members suggests that person-to-person spread of Helicobacter pylori takes place. Furthermore our results show that if (or when) required, simultaneous treatment given to the whole family results in lower treatment failure, since it may promote compliance to treatment.
已有报道称幽门螺杆菌感染存在家族聚集性。我们检验了这样一个假设，即同时治疗所有感染幽门螺杆菌的有症状儿童的家庭接触者会降低治疗失败率。
47名患有幽门螺杆菌胃炎的儿童（索引病例）的亲属接受了内镜检查，以评估一级同居亲属中的感染率。对照组包括60名患有消化不良和幽门螺杆菌胃炎且其感染的家庭接触者未接受治疗的儿童。索引病例儿童、18岁以下的兄弟姐妹以及对照儿童接受了为期2周的阿莫西林和替硝唑治疗。索引病例儿童的父母及其18岁以上的兄弟姐妹接受了为期2周的枸橼酸铋钾和替硝唑治疗。将索引病例儿童及其亲属的根除率与感染的家庭接触者未接受治疗的对照组进行比较。
在31名18岁以下的兄弟姐妹中，67%检测出幽门螺杆菌；在22名18岁以上的兄弟姐妹中，82%检测出幽门螺杆菌；在92名父母中，87%检测出幽门螺杆菌。治疗结束后四至六周重复进行内镜检查，结果显示，家庭治疗组中，94%的18岁以下儿童和兄弟姐妹以及70%的18岁以上父母和兄弟姐妹的幽门螺杆菌被根除，而对照儿童的这一比例为75%（p < 0.01）。
家庭成员中感染率较高表明幽门螺杆菌存在人传人现象。此外，我们的结果表明，如果（或当）有需要，对整个家庭同时进行治疗会降低治疗失败率，因为这可能会提高治疗的依从性。
