History of breastfeeding and Helicobacter pylori infection in children: results of a community-based study from northeastern Brazil

The aim of this study was to evaluate the role of breastfeeding and the infection status of the mother in the acquisition of Helicobacter pylori infection in a poor urban community in northeastern Brazil. Helicobacter pylori status was evaluated by 13C-urea breath test in individuals under the age of 14 years and by ELISA in the mothers. The prevalence of H. pylori infection was 55.8% (197/353) in the children and it increased with age (P<0.0001). Of the children in whom breastfeeding status was known, 93.2% (316/339) were breastfed. The H. pylori prevalence did not differ between breastfed and never breastfed children (55% vs. 52%) even when children were breastfed for >6 months. The prevalence of infection was much higher in children whose mothers were H. pylori infected than in children whose mothers were not infected, resulting in a crude odds ratio (OR) of 3.11 (95% CI 1.57-6.19) and 2.40 after adjustment for potential confounders (95% CI 1.12-5.15). This study suggests that breastfeeding does not protect against acquisition of H. pylori in northeastern Brazil; conversely, an infected mother may have an important role in transmission of the disease to the child.     

Helicobacter pylori infection and colorectal cancer risk: evidence from a large population-based case-control study in Germany

Evidence concerning the role of Helicobacter pylori infection in the development of colorectal cancer remains controversial. The authors assessed the association of H. pylori seroprevalence with risk of colorectal cancer in a large population-based case-control study from Germany in 2003-2007. Serum antibodies to H. pylori in general and the cytotoxin-associated gene A protein (CagA) were measured in 1,712 incident colorectal cancer cases and 1,669 controls. The association between H. pylori seroprevalence and colorectal cancer risk was estimated by logistic regression, with adjustment for potential confounders and stratification by age group, sex, anatomic subsites, and cancer stage. Overall, H. pylori seroprevalence was higher in cases (46.1%) than in controls (40.1%), resulting in an age- and sex-adjusted odds ratio of 1.30 (95% confidence interval (CI): 1.14, 1.50). Adjustment for established colorectal cancer risk factors decreased the odds ratio to 1.26 (95% CI: 1.09, 1.47), with a further reduction to 1.18 (95% CI: 1.01, 1.38) after additional adjustment for previous colorectal endoscopy. Stratified analyses showed risk elevation to be essentially confined to left-sided colorectal cancer, with an odds ratio of 1.22 (95% CI: 1.02, 1.45), suggesting that H. pylori infection may be associated with a small yet relevant risk increase in the left colorectum.     

母乳喂养与婴儿幽门螺杆菌感染的前瞻性研究

目的研究母乳喂养与婴儿幽门螺杆菌（H.pylori）感染的相关性和H.pylori阳性母亲婴儿H.pylori的感染率。方法通过对2005年1月-2005年12月出生的中山市城镇婴儿的父母提供标准化问卷调查，随机选择经济生活条件好和依从性好的家庭进入研究。婴儿分为母亲H.pylori阳性组（50例）和母亲H.pylori阴性组（100例），又各自分为母乳喂养组和非母乳喂养组。用ELISA方法检测母亲分娩前及婴儿出生后1-2 d、6月、12月粪便幽门螺杆菌抗原（HpSA）。结果母亲H.pylori阳性组婴儿HP感染率均高于母亲H.pylori阴性组（P〈0.05）；无论母亲是否H.pylori阳性，母乳喂养组和非母乳喂养组婴儿H.pylori感染率差异均无统计学意义（P〉0.05）。结论婴儿H.pylori感染与H.pylori阳性母亲有关，可能通过密切接触传播，与母乳喂养无关。     

Helicobacter pylori colonization and diarrhoeal illness: results of a population-based cross-sectional study in adults

It has been suggested that Helicobacter pylori colonization may protect against diarrhoeagenic gastrointestinal infections. The aim of this analysis was to investigate the association between H. pylori infection and the frequency of diarrhoeal episodes among adults. Helicobacter pylori infection status was determined by ¹³C-urea breath test. Overall, 784 adults (mean age: 48.7 ± 17.7; range 18–85 years) who participated in two epidemiological studies were included in the analysis. Overall H. pylori prevalence was 25.5%. Episodes of diarrhoea within prior 3 months were less often reported for H. pylori infected subjects compared with H. pylori negative subjects (40.2 vs. 51.6%, p = 0.016). Compared to H. pylori negative subjects the odds ratio (OR) for the occurrence of diarrhoea within the prior 3 months was 0.63 (95% CI: 0.45–0.87) for H. pylori infected subjects. After adjustment for covariates the OR was 0.67 (95% CI: 0.47–0.95). These results support the hypothesis that colonization with H. pylori may protect from gastrointestinal infections that cause diarrhoea.     

Children Helicobacter pylori infection: antibiogram results

Helicobacter pylori infection is frequent in children. The eradication rate is variable, it is influenced by resistance of the bacteria to the antibiotics used. The aim of this study was to determine the resistance rate of the most commonly used antibiotics among helicobacter pylori (Hp) strains isolated in infected children. PATIENTS AND METHODS: 60 children (26 males, 34 females), with mean age of 8 years 8 months (3 years and 2 month (2.5-13.5 years) underwent an oesogastroscopy. Forty six of them had helicobacter infection assessed by the presence of Hp on the gastric biopsy and or positivity of urease test. The infected children were treated with three medication; Omeprazole. Clarythromycin, and Amoxicillin. The eradication of Hp was confirmed in 13 patients by the absence of Hp on the gastric biopsy and/or negativation of the urease test; RESULTS: Culture was positive in 13 infected children susceptibility to anti microbial drugs was done in ten children. Nine children had primary metronidazole resistance, three had both clarythromycin and Metronidazole resistance, three had Clarythromycin primary resistance. No case of Amoxicillin primary resistance was detected. Children eradication was achieved in four children among 13 children. This study shows the difficulty of Hp culture. It confirms the absence of Hp resistance to Amoxicilline. the high level of Hp resistance to Metronidazole and the mild level of Clarythromycin resistance. The authors stress the importance of Antibiotic susceptibility assay in helicobacter pylori infections.     

Aggregation of lung cancer in families: results from a population-based case-control study in Germany

The authors investigated familial aggregation of lung cancer by means of a population-based case-control study, conducted in Germany between 1988 and 1993. They compared lung cancer prevalence in first degree relatives of 945 patients and 983 controls, accounting for various potential risk factors using logistic regression and generalized estimating equations. Some 83% of the study participants were male, and about 14% were below age 51 (young age group). Overall, lung cancer in parents or siblings was associated with a 1.67-fold (95% confidence interval (CI): 1.11, 2.52) increase in lung cancer risk. For the young participants, this risk was 4.75 (95% CI: 1.20, 18.77). Having multiple affected relatives (two or more) was related to a threefold risk elevation (odds ratio (OR) = 2.99, 95% CI: 0.32, 27.55). Paternal (OR = 1.64, 95% CI: 0.91, 2.96) but not maternal (OR = 0.91, 95% CI: 0.32, 2.61) lung cancer was associated with an increased risk of the disease. Lung cancer risk from smoking was particularly pronounced in the parents of cases (OR = 12.20, 95% CI: 3.34, 44.62 vs. OR = 7.93, 95% CI: 2.43, 25.91 in parents of controls). No risk elevation was detected for other smoking-related and other cancers in general. Results confirm previous findings and support the etiologic role of a genetic predisposition to lung cancer.     

2369例高校职工幽门螺杆菌感染检测结果分析

目的 观察高校教职工人群胃幽门螺杆菌(HP)感染情况,加强对其感染的防控工作。方法 空腹采集教职工体检人群静脉血,检测胃幽门螺杆菌抗体滴度,观察其感染情况。结果 人群HP总阳性率为43.31%。其中:男性阳性率为45.82%,女性阳性率为40.53%,差异有统计学意义(P<0.05)。按年龄段分组比较其感染情况,各年龄组阳性率男性普遍高于女性,但只有41～50岁组男性与女性比较差异有统计学意义(P<0.05)。41～50岁年龄组和51～60岁年龄组阳性率高于其他年龄组,差异有统计学意义(P<0.05)。结论 胃幽门螺杆菌感染率较高,且男性感染率高于女性。应加强对该疾病的预防保健工作,提高人群防病治病的健康意识。     

Seroepidemiology of Helicobacter pylori infection in a population of Egyptian children

BACKGROUND: To describe the seroepidemiology of Helicobacter pylori infection in a population of Egyptian children under 3 years. METHODS: A cohort of children under 36 months, residing in Abu Homos, Egypt, were visited at home twice weekly. Information regarding the child's breastfeeding status was obtained, and periodic anthropometric and household hygiene surveys were performed. In June 1997, a serosurvey was conducted on 187 study participants over 6 months old. The serosurvey was repeated in October 1997. All sera were tested for IgG antibodies to H. pylori. RESULTS: The June prevalence of H. pylori infection was 10%, and the incidence from June to October was 15%. Between June and October, 8 (42%) of 19 children that were positive for H. pylori infection seroreverted to negative. All seroreversions occurred in children 6-17 months. Other than age, no sociodemographic or environmental factor was significantly associated with incident H. pylori infection. There was no significant differences in the weight-for-age, weight-for-height, and height-for-age z-scores between children with and without prevalent H. pylori infection. CONCLUSIONS: Infection with H. pylori is common in Egyptian children under 3 years old and is not associated with malnutrition. No predictors for H. pylori infection were found. Our preliminary evidence for transient H. pylori infections in young children needs to be confirmed in a prospective cohort study, and predictors for persistent infection should be sought, since only these may be relevant to the known sequellae of infection.     

Diagnostic methods for Helicobacter pylori infection in children

A Helicobacter pylori infection is usually acquired during early childhood. Poor socioeconomic circumstances form an important risk factor for this. An untreated infection may lead to peptic ulceration and, particularly in adults, to gastric cancer and mucosa associated lymphoid tissue (MALT) lymphoma. The gold standard for the diagnosis of H. pylori infection is gastroscopy with histology and culture of biopsy specimens. Non-invasive tests are serology, 13C-urea breath test and stool antigen test. The sensitivity and specificity of serology tests are low in children, but for both the 13C-urea breath test and the stool antigen test the sensitivity and specificity are high. A 'test and treat' approach is advised with due consideration for possible symptoms and the risk for peptic ulcers and gastric cancer at a more advanced age. The treatment results must be evaluated. If necessary, young children can be treated at a later age.     

Helicobacter pylori infection in children: prevalence, diagnosis and treatment outcome

The clinical significance of Helicobacter pylori infection in children remains largely unknown. The rate of acquisition at different ages has not been ascertained using reliable tests on gastric biopsies. We determined prospectively the prevalence of H. pylori infection in children and its association with gastroduodenal disease. We evaluated 240 children undergoing upper gastrointestinal endoscopy for H. pylori infection by rapid urease test, culture, ureA PCR and histopathology. Group I constituted 58 children with upper abdominal pain (UAP) and group II (controls) of 182 children without UAP who underwent diagnostic or therapeutic endoscopy for other reasons. Helicobacter pylori-positive children with UAP received anti-H. pylori therapy. Helicobacter pylori infection was significantly higher in children with UAP than controls (53.4% vs. 28%; P<0.001) and overall prevalence increased with age. On follow-up endoscopy, H. pylori had been eradicated from 82% of children with UAP; it was eradicated from the remaining 18% after a second regimen. Treated H. pylori-positive children with UAP remained symptom-free for a median of 25 months. Control children remained chronically H. pylori infected. Chronic inflammation was present in all infected children, and active inflammation in 48.8%. The study shows H. pylori infection increases with age and is strongly linked to UAP in children.     

沈阳市学龄前儿童幽门螺杆菌感染的流行病学调查

目的 了解沈阳市学龄前儿童Hp感染状况, 分析其相关影响因素。方法 采用整群抽样方法抽取8所幼儿园的1 150名儿童作为调查对象, 做血清学Hp-IgG抗体检测和家长问卷调查。结果 沈阳市学龄前儿童Hp感染率为13.13%, 随年龄增加而呈上升趋势。有胃肠道症状儿童Hp感染率(24.90%)明显高于无症状儿童(10.01%)。专用餐具和高经济收入是学龄前儿童Hp感染的保护性因素, 而年龄、低经济收入、啃手指/玩具、不常洗手和家族胃病史为危险因素。结论 本地区学龄前儿童Hp感染率低于全国平均水平, 但仍属易感人群。教育儿童从小养成良好卫生习惯对降低儿童Hp感染起重要作用。     

Alcohol consumption and Helicobacter pylori infection: results from the German National Health and Nutrition Survey

Alcohol has strong antimicrobial activity and stimulates gastric acid secretion. Alcohol consumption may therefore compromise the living conditions of Helicobacter pylori in the stomach. We assessed the relation of alcohol consumption with H. pylori infection among 1,785 participants ages 18-88 in the German National Health and Nutrition Survey. Detailed information on dietary and lifestyle habits was obtained in personal interviews using a standardized food frequency questionnaire. Serum samples were analyzed for H. pylori immunoglobulin G antibodies by enzyme-linked immunosorbent assay. Overall prevalence of H. pylori infection was 39.2%. There was a clear inverse dose-response-relation between reported alcohol consumption and H. pylori infection. The relation persisted after control for potential confounding factors. The adjusted prevalence ratios (95% confidence intervals) for H. pylori infection among persons who consumed up to 10, 10 to 20, and more than 20 gm of alcohol per day compared with non-drinkers were 0.93 (0.77-1.13), 0.82 (0.65-1.04), and 0.71 (0.55-0.92). The inverse relation between alcohol consumption and H. pylori infection was even stronger when individuals with an indication of a recent change of alcohol consumption were excluded from the analysis. These findings support the hypothesis that moderate alcohol consumption may facilitate spontaneous elimination of H. pylori infection among adults.     

Concordance of Helicobacter pylori infection among children in extended-family homes

Helicobacter pylori is transmitted within households and high concordance is observed among siblings. To better understand the contributions of close interpersonal contact and family relatedness to transmission, we compared concordance of H. pylori infection among 241 sibling and non-sibling children aged 2-18 years in 68, predominantly low-income, Hispanic households with at least two nuclear families. Prevalence of H. pylori infection was 24%. Compared to children with no infected siblings or non-siblings and adjusting for age, odds of H. pylori infection were 1.2 (95% CI 0.52-2.9), 3.2 (95% CI 1.14-9.1), and 9.4 (95% CI 3.1-28.5) for children residing with at least one infected non-sibling, one infected sibling, and with at least one infected sibling and non-sibling, respectively. The study further implicates intersibling transmission as a pathway for H. pylori infection in childhood. In addition, living with a non-sibling in extended-family homes may contribute to infection risk but only in households with prevalent H. pylori infection within all family groups.     

甘肃省天祝县幽门螺杆菌感染状况分析

目的调查甘肃省天祝县居民幽门螺杆菌(Hp)感染状况及其流行相关因素。方法采用血清幽门螺杆菌IgG抗体金标免疫斑点渗滤法和¹⁴C-UBT检测天祝县1 495名常住居民幽门螺杆菌感染状况。结果天祝县幽门螺杆菌感染率74.0%,藏族、汉族及不同性别比较,其感染率差异均无统计学意义(P>0.05);山区感染率显著高于城区(P<0.01);随着年龄增长,幽门螺杆菌感染率逐渐升高,到30岁左右达到最高值;干部感染率显著低于农民、工人和医护人员(P<0.05);幽门螺杆菌感染有家庭聚集现象;幽门螺杆菌感染与饮水源显著相关,饮用自来水者感染率显著低于饮用井水和池塘/沟渠/河水者(P<0.01)。幽门螺杆菌感染与年人均收入、碗筷刷洗情况、便后洗手、上消化道症状显著相关(P<0.05)。结论天祝县居民幽门螺杆菌感染率较高,其感染率与经济状况、生活卫生习惯、饮用水源和上消化道症状等影响因素显著相关。     

Effects of a new Helicobacter pylori infection on height and weight in Colombian children

PURPOSE: The aim of the study is to investigate whether a new infection caused by Helicobacter pylori in preschool children transiently or permanently affects height and weight. METHODS: A cohort of 347 children from three day care centers was followed up for a median of 494 days. Breath tests and anthropometric measurements were performed every 2 to 4 months. The lag effect of a new infection on linear growth during a period of 8 months was analyzed by using mixed-effects models. RESULTS: One hundred five children (30.3%) became infected during the follow-up period and accumulated 92 person-years of follow-up. A significant decrease in growth velocity was observed during the first 4 months after infection. There was no height catch-up in infected children, and after 8 months, an infected child had a cumulative difference of 0.24 cm (growth velocity; 95% confidence interval, 0.22-0.26) compared with an uninfected child. Newly infected children experienced a small decrease in weight at the first visit compared with uninfected children, which became nonsignificant after the second visit without catch-up. CONCLUSIONS: This study shows a significant and nontransient effect of infection caused by H. pylori on height and weight. Potential interventions that target infected preschool children are likely to prevent growth retardation.