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Yang T, Li J, Zhang Y, Deng Z, Cui G, Yuan J, Sun J, Wu X, Hua D, Xiang S, Chen Z. Intracellular presence of Helicobacter pylori antigen and genes within gastric and vaginal Candida. PLoS One 2024; 19:e0298442. [PMID: 38329956 PMCID: PMC10852334 DOI: 10.1371/journal.pone.0298442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Helicobacter pylori infections are generally acquired during childhood and affect half of the global population, but its transmission route remains unclear. It is reported that H. pylori can be internalized into Candida, but more evidence is needed for the internalization of H. pylori in human gastrointestinal Candida and vaginal Candida. METHODS Candida was isolated from vaginal discharge and gastric mucosa biopsies. We PCR-amplified and sequenced H. pylori-specific genes from Candida genomic DNA. Using optical and immunofluorescence microscopy, we identified and observed bacteria-like bodies (BLBs) in Candida isolates and subcultures. Intracellular H. pylori antigen were detected by immunofluorescence using Fluorescein isothiocyanate (FITC)-labeled anti-H. pylori IgG antibodies. Urease activity in H. pylori internalized by Candida was detected by inoculating with urea-based Sabouraud dextrose agar, which changed the agar color from yellow to pink, indicating urease activity. RESULTS A total of 59 vaginal Candida and two gastric Candida strains were isolated from vaginal discharge and gastric mucosa. Twenty-three isolates were positive for H. pylori 16S rDNA, 12 were positive for cagA and 21 were positive for ureA. The BLBs could be observed in Candida cells, which were positive for H. pylori 16S rDNA, and were viable determined by the LIVE/DEAD BacLight Bacterial Viability kit. Fluorescein isothiocyanate (FITC)-conjugated antibodies could be reacted specifically with H. pylori antigen inside Candida cells by immunofluorescence. Finally, H. pylori-positive Candida remained positive for H. pylori 16S rDNA even after ten subcultures. Urease activity of H. pylori internalized by Candida was positive. CONCLUSION In the form of BLBs, H. pylori can internalize into gastric Candida and even vaginal Candida, which might have great significance in its transmission and pathogenicity.
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Affiliation(s)
- Tingxiu Yang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Department of Hospital Infection and Management, Guizhou Provincial People’s Hospital, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education/Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Scientific Research Center, School of Basic Medical Science, Guizhou Medical University Guiyang, Guiyang, China
| | - Jia Li
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Department of Clinical Laboratory, Jinyang Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yuanyuan Zhang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Department of Gastroenterology, People’s Hospital of Qiannan Prefecture, Guizhou, China
| | - Zhaohui Deng
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Guzhen Cui
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education/Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jun Yuan
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education/Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jianchao Sun
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Xiaojuan Wu
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Scientific Research Center, School of Basic Medical Science, Guizhou Medical University Guiyang, Guiyang, China
| | - Dengxiong Hua
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Song Xiang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Zhenghong Chen
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Science/Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education/Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Scientific Research Center, School of Basic Medical Science, Guizhou Medical University Guiyang, Guiyang, China
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Rosu OM, Gimiga N, Popescu R, Ioniuc I, Rusu CD, Clipa T, Florea DM, Pleșca DA, Nemtoi A, Tataranu E, Stefanescu G, Diaconescu S. Pattern of Primary Resistance of Helicobacter pylori to Clarithromycin among Pediatric Patients from North-Eastern Romania. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1752. [PMID: 38002843 PMCID: PMC10670121 DOI: 10.3390/children10111752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Helicobacter pylori antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with Helicobacter pylori by gastric biopsy. METHODS We studied 84 positive gastric samples for Helicobacter pylori. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. RESULTS Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6-17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. CONCLUSIONS One in 2.4 children infected with Helicobacter pylori had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.
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Affiliation(s)
- Oana-Maria Rosu
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Str., 540139 Targu Mures, Romania
| | - Nicoleta Gimiga
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Roxana Popescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Ileana Ioniuc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Carmen Daniela Rusu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Tatiana Clipa
- Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
| | - Diana-Maria Florea
- Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
| | - Doina-Anca Pleșca
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 21 Dionisie Lupu Str., 020021 Bucharest, Romania
| | - Alexandru Nemtoi
- Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
| | - Elena Tataranu
- Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
| | - Gabriela Stefanescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Smaranda Diaconescu
- Faculty of Medicine, “Titu Maiorescu” University of Medicine, 67A Gheorghe Petrascu Str., 031592 Bucharest, Romania
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Chen RX, Zhang DY, Zhang X, Chen S, Huang S, Chen C, Li D, Zeng F, Chen J, Mo C, Gao L, Zeng J, Xiong J, Chen Z, Bai F. A survey on Helicobacter pylori infection rate in Hainan Province and analysis of related risk factors. BMC Gastroenterol 2023; 23:338. [PMID: 37777740 PMCID: PMC10544117 DOI: 10.1186/s12876-023-02973-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/26/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE The aim of this study was to understand the prevalence and potential risk factors of Helicobacter pylori (H. pylori) infection in Hainan Province, China. METHODS We conducted this study in 21 health service stations in 5 cities of Hainan Province from August 2022 to April 2023. We selected the various participants based on a stratified whole-group sampling method. The 14C-UBT was used to analyze H. pylori infection in 3632 participants. We also analyzed the possible relationship between variables and H. pylori infection based on chi-square test and multifactorial logistic regression. The model was evaluated by performing a Hosmer-Lemeshow goodness-of-fit test and plotting receiver operating characteristic(ROC) curves. RESULTS In total, the results of 3632 eligible participants (age: 14 to 93 years) were included in the analysis. The total prevalence of H. pylori infection in Hainan Province was approximately 38.7%. The prevalence of H. pylori infection was found to increase with age, stabilized in the age group of 45 to 64 years, but peaked in the age group of 65 years and older. In multifactorial analysis, the prevalence of H. pylori infection was positively associated with middle-aged adults (45-64 years), older adults (≥ 65 years), drinking, farmers, natural labor, routinely share utensils, have habit of frequent betel nut consumption, upper gastrointestinal symptoms, and family history of gastric cancer. The factors negatively associated with prevalence included family size ≤ 3, washing hands often before meals, frequent exercise, regular meals, and frequent consumption of fruits and vegetables. In addition, the Hosmer-Lemeshow test showed a good fit (χ2 = 12.983, P = 0.112) and the area under ROC was 0.631 (95%CI: 0.613 ~ 0.649). CONCLUSION The prevalence of H. pylori infection in Hainan Province was observed to be moderate and closely related to age, local socioeconomic conditions, hygienic status and dietary habits.
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Affiliation(s)
- Run-Xiang Chen
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Da-Ya Zhang
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Xiaodong Zhang
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Shiju Chen
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Shimei Huang
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Chen Chen
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Da Li
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Fan Zeng
- Graduate School, Hainan Medical University, Haikou, 571199, China
| | - Jiajia Chen
- Department of Gastroenterology, Qionghai People's Hospital, Qionghai, 571400, China
| | - Cuiyi Mo
- Department of Gastroenterology, Qionghai People's Hospital, Qionghai, 571400, China
| | - Lei Gao
- Department of Gastroenterology, Sanya Central Hospital, Sanya, 572022, China
| | - Juntao Zeng
- Department of Gastroenterology, Sanya Central Hospital, Sanya, 572022, China
| | - Jianxin Xiong
- Department of Gastroenterology, Hainan Second People's Hospital, Wuzhishan, 572299, China
| | - Zhai Chen
- Department of Gastroenterology, Dongfang People's Hospital, Dongfang, 572699, China
| | - Feihu Bai
- Department of Gastroenterology, The Second Affiliated Hospital of Hainan Medical University, Yehai Avenue, #368, Longhua District, Haikou, 570216, Hainan Province, China.
- The Gastroenterology Clinical Medical Center of Hainan Province, Haikou, 570216, China.
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Yang T, Zhang Y, Zhang H, Wu X, Sun J, Hua D, Pan K, Liu Q, Cui G, Chen Z. Intracellular presence and genetic relationship of Helicobacter pylori within neonates' fecal yeasts and their mothers' vaginal yeasts. Yeast 2023; 40:401-413. [PMID: 37565669 DOI: 10.1002/yea.3891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/30/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023] Open
Abstract
Helicobacter pylori are transmissible from person to person and among family members. Mother-to-child transmission is the main intrafamilial route of H. pylori transmission. However, how it transmits from mother to child is still being determined. Vaginal yeast often transmits to neonates during delivery. Therefore, H. pylori hosted in yeast might follow the same transmission route. This study aimed to detect intracellular H. pylori in vaginal and fecal yeasts isolates and explore the role of yeast in H. pylori transmission. Yeast was isolated from the mothers' vaginal discharge and neonates' feces and identified by internal transcribed spacer (ITS) sequencing. H. pylori 16S rRNA and antigen were detected in yeast isolates by polymerase chain reaction and direct immunofluorescence assay. Genetic relationships of Candida strains isolated from seven mothers and their corresponding neonates were determined by random amplified polymorphic DNA (RAPD) fingerprinting and ITS alignment. The Candida isolates from four mother-neonate pairs had identical RAPD patterns and highly homologous ITS sequences. The current study showed H. pylori could be sheltered within yeast colonizing the vagina, and fecal yeast from neonates is genetically related to the vaginal yeast from their mothers. Thus, vaginal yeast presents a potential reservoir of H. pylori and plays a vital role in the transmission from mother to neonate.
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Affiliation(s)
- Tingxiu Yang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Department of Hospital Infection and Management, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yuanyuan Zhang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Department of Gastroenterology, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Hua Zhang
- Department of Obstetrics, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Xiaojuan Wu
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Jianchao Sun
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Dengxiong Hua
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Ke Pan
- Department of Gastroenterology, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Qi Liu
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Guzhen Cui
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhenghong Chen
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
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Hibaoui L, Massik A, Yahyaoui G, Mahmoud M, Hmass N, Chbani L, Lakhdar Idrissi M, Hida M. Moroccan Children With Helicobacter pylori Infection: Demographics, Clinical Features, and Histological Findings. Cureus 2023; 15:e40740. [PMID: 37485161 PMCID: PMC10361338 DOI: 10.7759/cureus.40740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Infesting nearly half of the world's population, Helicobacter pylori is thought to cause peptic ulcers and gastric adenocarcinoma. Several studies have examined the association between H. pylori and socioeconomic, clinical, and histological factors in pediatric populations. Similarly, this study aimed to describe the characteristics of H. pylori infection in Moroccan children. METHODS Patients aged 1-17 years who underwent upper gastrointestinal endoscopy over a period of two years from January 2019 to January 2021 were included in this study. Gastric biopsies from the antrum and corpus of the stomach were collected. Detection of H. pylori infection was confirmed by Giemsa stain. Demographic data and clinical and endoscopic characteristics were collected and histopathological findings with gastritis scoring were recorded according to the Sydney System. RESULTS In 213 children, 95 (45%) were found to be infected with H. pylori, and the infection rates increased as the children aged. While no significant relationship between the infection of H. pylori and all symptoms was founded, a significant association was found in nodular gastritis (p<0.05), and 98% of the infected children had chronic inflammation, which was active in 22% and atrophic in 47%. The atrophy and activity were absent or mild, and the inflammation was mild to moderate. CONCLUSION According to this study, nodular gastritis and nonspecific symptoms were related to H. pylori infection in Moroccan children. In addition, the association between this disease and gastric atrophy in our study needs the monitoring of the mucosa of Moroccan children with gastritis and identifying factors that may contribute to gastric cancer.
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Affiliation(s)
- Lahbib Hibaoui
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Abdelhamid Massik
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Ghita Yahyaoui
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Mustapha Mahmoud
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Naoual Hmass
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Surgical Pathology, Hassan II University Hospital, Fez, MAR
| | - Laila Chbani
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Surgical Pathology, Hassan II University Hospital, Fez, MAR
| | - Mounia Lakhdar Idrissi
- Laboratory of Epidemiology, Clinical Research and Community Medicine, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Paediatrics, Hassan II University Hospital, Fez, MAR
| | - Moustapha Hida
- Laboratory of Epidemiology, Clinical Research and Community Medicine, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Paediatrics, Hassan II University Hospital, Fez, MAR
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Zhou XZ, Lyu NH, Zhu HY, Cai QC, Kong XY, Xie P, Zhou LY, Ding SZ, Li ZS, Du YQ. Large-scale, national, family-based epidemiological study on Helicobacter pylori infection in China: the time to change practice for related disease prevention. Gut 2023; 72:855-869. [PMID: 36690433 PMCID: PMC10086479 DOI: 10.1136/gutjnl-2022-328965] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIMS Current practice on Helicobacter pylori infection mostly focuses on individual-based care in the community, but family-based H. pylori management has recently been suggested as a better strategy for infection control. However, the family-based H. pylori infection status, risk factors and transmission pattern remain to be elucidated. METHODS From September 2021 to December 2021, 10 735 families (31 098 individuals) were enrolled from 29 of 31 provinces in mainland China to examine family-based H. pylori infection, related factors and transmission pattern. All family members were required to answer questionnaires and test for H. pylori infection. RESULTS Among all participants, the average individual-based H. pylori infection rate was 40.66%, with 43.45% for adults and 20.55% for children and adolescents. Family-based infection rates ranged from 50.27% to 85.06% among the 29 provinces, with an average rate of 71.21%. In 28.87% (3099/10 735) of enrolled families, there were no infections; the remaining 71.13% (7636/10 735) of families had 1-7 infected members, and in 19.70% (1504/7636), all members were infected. Among 7961 enrolled couples, 33.21% had no infection, but in 22.99%, both were infected. Childhood infection was significantly associated with parental infection. Independent risk factors for household infection were infected family members (eg, five infected members: OR 2.72, 95% CI 1.86 to 4.00), living in highly infected areas (eg, northwest China: OR 1.83, 95% CI 1.57 to 2.13), and large families in a household (eg, family of three: OR 1.97, 95% CI 1.76 to 2.21). However, family members with higher education and income levels (OR 0.85, 95% CI 0.79 to 0.91), using serving spoons or chopsticks, more generations in a household (eg, three generations: OR 0.79, 95% CI 0.68 to 0.92), and who were younger (OR 0.57, 95% CI 0.46 to 0.70) had lower infection rates (p<0.05). CONCLUSION Familial H. pylori infection rate is high in general household in China. Exposure to infected family members is likely the major source of its spread. These results provide supporting evidence for the strategic changes from H. pylori individual-based treatment to family-based management, and the notion has important clinical and public health implications for infection control and related disease prevention.
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Affiliation(s)
- Xian-Zhu Zhou
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Nong-Hua Lyu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hui-Yun Zhu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Quan-Cai Cai
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xiang-Yu Kong
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Pei Xie
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Li-Ya Zhou
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and People's Hospital of Henan University, Zhengzhou, Henan, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yi-Qi Du
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China
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7
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Zhou M, Zeng Y, Xi Y, Luo S, Qi J, Zhao G, Sun Y, Guo Y, Cheng F. School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn (SHIP HOPE): protocol for a cluster-randomised controlled trial. BMJ Open 2022; 12:e064207. [PMID: 36600426 PMCID: PMC9772681 DOI: 10.1136/bmjopen-2022-064207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Helicobacter pylori infection rates are high in China and worldwide, and maintaining good hygiene is effective in preventing H. pylori infection. Childhood is a critical stage for developing good hygiene practices. Therefore, in this study, we aimed to explore whether a comprehensive hygiene intervention can prevent H. pylori infection in primary schools in China. METHODS AND ANALYSIS The School-based Hygiene Intervention to Prevent HelicObacter Pylori infection among childrEn study is a cluster-randomised controlled trial, which will include approximately 2400 children in grades 2-4 from 60 classes in 10 primary schools of Linqu County, Shandong Province. Schools will be randomly assigned (1:1) via a computer-generated list, to receive either comprehensive hygiene intervention (intervention) or the usual health education lessons (control), with stratification by area (urban or rural). The interventions will include the following: (1) Children's education: lessons and cartoon books designed to provide basic knowledge about hygiene, H. pylori, hand hygiene, diet and oral hygiene will be provided to children; (2) Caregiver's education: children will be empowered to share hygiene-related knowledge with their caregivers as homework; caregivers will be also invited to the school for hygiene lessons; (3) School hygiene promotion: suggestions will be provided for improving the hygienic environment. Children in control schools will receive usual health education lessons according to the arrangements of each school. The primary outcome is the prevalence and incidence of H. pylori infection among children at 1-year follow-up. The secondary outcomes are H. pylori and hygiene knowledge, family eating customs and hygiene practices among children and their caregivers, as well as school absences owing to diarrhoea. Additionally, growth in children is set as an exploratory outcome. General linear mixed models will be used to analyse differences between the intervention and control schools. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Institution Review Board of Tsinghua University (No: 20220020). Written informed consent will be obtained from each child and one of their caregivers. The findings of this study will be actively disseminated through scientific publications and conference presentations. TRIAL REGISTRATION NUMBER ChiCTR2200056191.
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Affiliation(s)
- Mengge Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, People's Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Yuhong Zeng
- Department of Epidemiology, College of Preventive Medicine, Army Medical University, Chongqing, People's Republic of China
| | - Yu'e Xi
- Vanke School of Public Health, Tsinghua University, Beijing, People's Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People's Republic of China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, People's Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People's Republic of China
| | - Jing Qi
- School of Management, Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Guanqi Zhao
- Center for Coronary Artery Disease, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Yamei Sun
- Department of Gastroenterology, Capital Medical University Affiliated Anzhen Hospital, Beijing, People's Republic of China
| | - Yang Guo
- Department of Dermatology, Institute of Dermatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People's Republic of China
| | - Feng Cheng
- Vanke School of Public Health, Tsinghua University, Beijing, People's Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People's Republic of China
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8
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Zong C. Salivary Dangers and their Resolution. ANTHROPOLOGY IN ACTION 2022. [DOI: 10.3167/aia.2022.290303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
In China, when people have a meal together, it is certainly possible for individuals to order a personal dish that is not for sharing with others. But it is far more common for food to be exchanged directly between hands, between hands-and-mouths and, as I will describe shortly, effectively between mouths. This describes the circumstance when consumers directly eat food from a shared dish, with the effect that they encounter each other's saliva. This mode of consumption is called gong can. On the face of it, it seems foolhardy to continue to eat together in such a way during a pandemic that travels between bodies through connecting droplets, like saliva, especially when other forms of eating together are available. Why is such a mode preferred during the COVID-19 pandemic? What makes it safe?
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9
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Gong Y, Luo Y, Chen Z, Sui Y, Zheng Y. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults. Open Med (Wars) 2022; 17:1742-1749. [PMID: 36407872 PMCID: PMC9635269 DOI: 10.1515/med-2022-0564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 03/15/2024] Open
Abstract
This research aimed to analyze lifestyle-related factors which influence Helicobacter pylori (Hp) infection and outcomes in Chinese adults. A single-center, retrospective study was performed from January 2012 to December 2020. Self-administered questionnaires were used to collect relevant lifestyle information, and the 13C-urea breath test was used to diagnose active Hp infection. A total of 18,211 subjects were enrolled in the study, of which 5,511 were females (30.26%). Subjects were studied longitudinally for up to five follow-up visits. At baseline, gastric Hp test was negative in 10,670 subjects (58.59%) and positive in 7,541 subjects (41.41%). Males exhibited a significantly higher Hp infection rate than females (38.56% vs 2.65%, respectively; χ 2 = 26.45, P < 0.001). Throughout the course of follow-up, Hp positive rates in the subjects decreased (χ trend 2 = 666.04, P < 0.001). Among the subjects with baseline negative results, 3-6% changed from negative to positive during follow-up. In contrast, among those with baseline positive results, >70% remained positive, and 21-26% changed from positive to negative. However, only 22-27% of Hp-infected subjects received pharmacotherapy. The results indicate the prevalence of Hp infection is high in the Chinese population. That additional effort is required to prevent and control Hp infection.
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Affiliation(s)
- Yan Gong
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yi Luo
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Zhilai Chen
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Ying Sui
- The 6th Health Department, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yansong Zheng
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28# Fuxing Road, Haidian District, Beijing 100853, China
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10
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Ma J, Yu M, Shao QQ, Yu XC, Zhang C, Zhao JB, Yuan L, Qi YB, Hu RB, Wei PR, Xiao W, Chen Q, Jia BL, Chen CL, Lu H, Ding SZ. Both family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are cost-effective for gastric cancer prevention. Helicobacter 2022; 27:e12911. [PMID: 35706404 DOI: 10.1111/hel.12911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection and its related diseases are substantial public health burden for highly infected areas. Recently, a novel family-based H. pylori infection control and management (FBCM) strategy is introduced for H. pylori infection prevention and control. However, its cost-effectiveness has not been evaluated. We conducted this health economic evaluation to investigate the cost-effectiveness of FBCM, screen-and-treat, and no-screen strategies in Chinese population. MATERIALS AND METHODS Cost-effectiveness analysis was performed using decision tree and Markov model. Parameters required for the model were from published literatures and public databases, including health state utility, screening characteristics, treatment effectiveness, and medical costs for the three strategies. Outcomes were cost, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER). Uncertainty analysis was performed to verify the robustness of this model. RESULTS To prevent gastric cancer in a cohort of 1 million asymptomatic Chinese families, FBCM and screen-and-treat strategies prevented 1010 and 1201 new gastric cancer cases, reduced 2809 and 3339 gastric cancer-related death, and saved 956,971 and 1,137,549 QALYs, respectively, when compared with no-screen strategy. Cost-effectiveness analysis showed that FBCM strategy cost $9.18/QALY, and screen-and-treat strategy cost $12.08/QALY for gastric cancer prevention when compared with no-screen strategy. One-way sensitivity analysis revealed that screening from younger age by both strategies are more cost-effective. When compared with FBCM strategy, screen-and-treat strategy saved 5.98% gastric cancer cases and 5.78% of gastric cancer deaths, but costed $9348 to reduce a gastric cancer case. Results are not sensitive to any variables, and probabilistic sensitivity analysis confirmed robustness of the results. CONCLUSIONS Both FBCM and screen-and-treat strategies are cost-effective for gastric cancer prevention compared with no-screen strategy. Since FBCM is more practical and convenient, it may be an efficient and excellent cost-effective strategy for gastric cancer prevention in H. pylori and gastric cancer prevalent areas.
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Affiliation(s)
- Jing Ma
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Miao Yu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Chen Zhang
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Jun-Bo Zhao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Lin Yuan
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ya-Bin Qi
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ruo-Bing Hu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Pei-Ru Wei
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Wei Xiao
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qi Chen
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bai-Ling Jia
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Chuan-Liang Chen
- Department of Medical Imaging, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Hong Lu
- Department of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, and Henan Provincial People's Hospital, Zhengzhou, Henan, China
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11
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Yu XC, Shao QQ, Ma J, Yu M, Zhang C, Lei L, Zhou Y, Chen WC, Zhang W, Fang XH, Zhu YZ, Wu G, Wang XM, Han SY, Sun PC, Ding SZ. Family-based Helicobacter pylori infection status and transmission pattern in central China, and its clinical implications for related disease prevention. World J Gastroenterol 2022; 28:3706-3719. [PMID: 36161052 PMCID: PMC9372799 DOI: 10.3748/wjg.v28.i28.3706] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/09/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has characteristics of family cluster infection; however, its family-based infection status, related factors, and transmission pattern in central China, a high-risk area for H. pylori infection and gastric cancer, have not been evaluated. We investigated family-based H. pylori infection in healthy households to understand its infection status, related factors, and patterns of transmission for related disease prevention.
AIM To investigate family-based H. pylori infection status, related factors, and patterns of transmission in healthy households for related disease prevention.
METHODS Blood samples and survey questionnaires were collected from 282 families including 772 individuals. The recruited families were from 10 selected communities in the greater Zhengzhou area with different living standards, and the family members’ general data, H. pylori infection status, related factors, and transmission pattern were analyzed. H. pylori infection was confirmed primarily by serum H. pylori antibody arrays; if patients previously underwent H. pylori eradication therapy, an additional 13C-urea breath test was performed to obtain their current infection status. Serum gastrin and pepsinogens (PGs) were also analyzed.
RESULTS Among the 772 individuals examined, H. pylori infection rate was 54.27%. These infected individuals were from 246 families, accounting for 87.23% of all 282 families examined, and 34.55% of these families were infected by the same strains. In 27.24% of infected families, all members were infected, and 68.66% of them were infected with type I strains. Among the 244 families that included both husband and wife, spouse co-infection rate was 34.84%, and in only 17.21% of these spouses, none were infected. The infection rate increased with duration of marriage, but annual household income, history of smoking, history of alcohol consumption, dining location, presence of gastrointestinal symptoms, and family history of gastric disease or GC did not affect infection rates; however, individuals who had a higher education level showed lower infection rates. The levels of gastrin-17, PGI, and PGII were significantly higher, and PGI/II ratio was significantly lower in H. pylori-infected groups than in H. pylori-negative groups.
CONCLUSION In our study sample from the general public of central China, H. pylori infection rate was 54.27%, but in 87.23% of healthy households, there was at least 1 H. pylori-infected person; in 27.24% of these infected families, all members were infected. Type I H. pylori was the dominant strain in this area. Individuals with a higher education level showed significantly lower infection rates; no other variables affected infection rates.
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Affiliation(s)
- Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Jing Ma
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Miao Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Chen Zhang
- Department of Gastroenterology and Hepatology, Henan University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Lei Lei
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yang Zhou
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wen-Chao Chen
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xin-Hui Fang
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yuan-Zeng Zhu
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Gang Wu
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xue-Mei Wang
- Department of Traditional Chinese Medicine, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Shuang-Yin Han
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Pei-Chun Sun
- Department of Gastrointestinal Surgery, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
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12
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Polivanova TV, Malaty H, Vshivkov VA. Epidemiology Helicobacter pylori infection in children in the Tyva Republic (Russia). Helicobacter 2022; 27:e12882. [PMID: 35285106 DOI: 10.1111/hel.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Tyva Republic is a small mountainous area at the geographical center of Asia in southern Siberia, with a high incidence of gastric cancer. AIM We examined the prevalence of H. pylori and associated risk factors among children in Tyva. METHODS Cross-sectional study was conducted among Tuvan children who had upper gastrointestinal symptoms and underwent upper gastroscopy with gastric biopsies. Informed consent was obtained from the parents and assent from the children. Demographic information, ethnicity, parents' education and employment status, and family size were collected. H. pylori infection was diagnosed by histologic examination. RESULTS There were 270 children between the ages 7 and 17 years (mean 13.4 ± 2.7); 64% girls; 147e Tuvan and 123 Caucasians. The overall prevalence of H. pylori was high and similar between boys and girls (55 vs. 57%, respectively, p = 0.42). The infection was highest in Tuvan children (67%. vs. 43%, respectively (OR = 2.4; 95%CI = 1.9.4-3), p = 0.05. H. pylori prevalence increased with age from 44% among 7 to 10 years and 64% among those 14 to 17 (OR = 3.0; 95%CI = 1.6-5.8), p = 0.0.005; the pattern was consistent among both ethnic groups. The prevalence of the infection among Caucasian children was inversely correlated with the level of mother's education (44%, vs. 61%) (i.e., for with and without a college education the OR = 2.3; 95%CI = 1.2-3.7), p = 0.02. Neither the total number of children nor adults living in the same household correlated with H. pylori prevalence. CONCLUSIONS Strategies to reduce the incidence of gastric cancer in Tyva will need to start in childhood.
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Affiliation(s)
- Tamara Vladimirovna Polivanova
- Scientific Research Institute for Medical Problems of the North, Federal Research Center «Krasnoyarsk Science Center» of the Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk, Russia
| | - Hoda Malaty
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Vitaliy Alekseevich Vshivkov
- Scientific Research Institute for Medical Problems of the North, Federal Research Center «Krasnoyarsk Science Center» of the Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk, Russia
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13
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Ding SZ, Du YQ, Lu H, Wang WH, Cheng H, Chen SY, Chen MH, Chen WC, Chen Y, Fang JY, Gao HJ, Guo MZ, Han Y, Hou XH, Hu FL, Jiang B, Jiang HX, Lan CH, Li JN, Li Y, Li YQ, Liu J, LI YM, Lyu B, Lu YY, Miao YL, Nie YZ, Qian JM, Sheng JQ, Tang CW, Wang F, Wang HH, Wang JB, Wang JT, Wang JP, Wang XH, Wu KC, Xia XZ, Xie WF, Xie Y, Xu JM, Yang CQ, Yang GB, Yuan Y, Zeng ZR, Zhang BY, Zhang GY, Zhang GX, Zhang JZ, Zhang ZY, Zheng PY, Zhu Y, Zuo XL, Zhou LY, Lyu NH, Yang YS, Li ZS. Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition). Gut 2022; 71:238-253. [PMID: 34836916 PMCID: PMC8762011 DOI: 10.1136/gutjnl-2021-325630] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/03/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Helicobacter pylori infection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-based H. pylori infection control and management to reduce the related disease burden. METHODS Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. RESULTS Experts discussed and modified the original 23 statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1) H. pylori infection and transmission among family members, (2) prevention and management of H. pylori infection in children and elderly people within households, and (3) strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases. CONCLUSION H. pylori is transmissible from person to person, and among family members. A family-based H. pylori prevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.
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Affiliation(s)
- Song-Ze Ding
- Department of Gastroenterology and Hepatology, People's Hospital, Zhengzhou University, Zhengzhou, Henan, China .,Department of Gastroenterology and Hepatology, People's Hospital, Henan University, Kaifeng, Henan, China
| | - Yi-Qi Du
- Gastroenterology Division, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Hong Lu
- GI Division, Renji Hospital, Shanghai Institution of Digestive Diseas, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Hong Wang
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Hong Cheng
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Shi-Yao Chen
- Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Min-Hu Chen
- Division of Gastroenterology and Hepatology, Sun Yat-Sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Wei-Chang Chen
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ye Chen
- Department of Gastroenterology and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jing-Yuan Fang
- Renji Hospital, Gastroenterology Division, Shanghai Jiao Tong University, Shanghai, China
| | - Heng-Jun Gao
- Department of Gastroenterology and Hepatology, School of Medicine, Tongji University, Shanghai, China
| | - Ming-Zhou Guo
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China
| | - Ying Han
- Department of Gastroenterology and Hepatology, The Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Hua Hou
- Department of Gastroenterology and Hepatology, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Fu-Lian Hu
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Bo Jiang
- Department of Gastroenterology and Hepatology, Changgeng Hospital, Tsinghua University, Beijing, China
| | - Hai-Xing Jiang
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Chun-Hui Lan
- Department of Gastroenterology and Hepatology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jing-Nan Li
- Department of Gastroenterology and Hepatology, Peking Union Medical College Hospital, Beijing, China
| | - Yan Li
- Department of Gastroenterology and Hepatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan-Qing Li
- Department of Gastroenterology and Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jie Liu
- Department of Gastroenterology and Hepatology, Huashan Hospital, Fudan University, Shanghai, China
| | - You-Ming LI
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bin Lyu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - You-Yong Lu
- Laboratory of Molecular Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital, Beijing, China
| | - Ying-Lei Miao
- Department of Gastroenterology and Hepatology, First Affilliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yong-Zhan Nie
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital, Air Force Medical University, Xian, Shaanxi, China
| | - Jia-Ming Qian
- Department of Gastroenterology and Hepatology, Peking Union Medical College Hospital, Beijing, China
| | - Jian-Qiu Sheng
- Department of Gastroenterology, The Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Cheng-Wei Tang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fen Wang
- Department of Gastroenterology and Hepatology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China,Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Changsha, Hunan, China
| | - Hua-Hong Wang
- Department of Gastroenterology and Hepatology, Peking University First Hospital, Beijing, China
| | - Jiang-Bin Wang
- Department of Gastroenterology and Hepatology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jing-Tong Wang
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China
| | - Jun-Ping Wang
- Department of Gastroenterology and Hepatology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xue-Hong Wang
- Department of Gastroenterology and Hepatology, Qinghai University Hospital, Qinghai University, Xining, Qinghai, China
| | - Kai-Chun Wu
- Department of Gastroenterology and Hepatology, Xijing Hospital, Air Force Medical University, Xian, Shaanxi, China
| | - Xing-Zhou Xia
- Department of Gastroenterology and Hepatology, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei-Fen Xie
- Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yong Xie
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jian-Ming Xu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chang-Qing Yang
- Division of Gastroenterology and Hepatology, Tongji Hospital, Tongji University, Shanghai, China
| | - Gui-Bin Yang
- Department of Gastroenterology and Hepatology, Aerospace Central Hospital, Beijing, China
| | - Yuan Yuan
- Key Laboratory of GI Cancer Etiology and Prevention in Liaoning Province, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhi-Rong Zeng
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Zhongshan University, Guangzhou, Guangdong, China
| | - Bing-Yong Zhang
- Department of Gastroenterology and Hepatology, People's Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Gui-Ying Zhang
- Department of Gastroenterology and Hepatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guo-Xin Zhang
- Department of Gastroenterology and Hepatology, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jian-Zhong Zhang
- Department of Communicable Disease Diagnostics(DCDD), National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen-Yu Zhang
- Department of Gastroenterology and Hepatology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peng-Yuan Zheng
- Department of Gastroenterology and Hepatology, The Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Yin Zhu
- Department of Gastroenterology, First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Li-Ya Zhou
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China
| | - Nong-Hua Lyu
- Department of Gastroenterology and Hepatology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yun-Sheng Yang
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China
| | - Zhao-Shen Li
- Department of Gastroenterology and Hepatology, Changhai Hospital, Naval Medical University, Shanghai, China
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14
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Dao LV, Dao HV, Nguyen HT, Vu VT, Tran ATN, Dat VQ, Hoang LB, Nguyen HTV, Nguyen TD. Helicobacter pylori infection and eradication outcomes among Vietnamese patients in the same households: Findings from a non-randomized study. PLoS One 2021; 16:e0260454. [PMID: 34818349 PMCID: PMC8612553 DOI: 10.1371/journal.pone.0260454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022] Open
Abstract
Objective Familial transmission can possibly influence the infection and treatment of Helicobacter pylori. This study aimed to describe the prevalence of H. pylori infection and outcomes of eradication treatment among Vietnamese patients who live in the same households. Methods We conducted a prospective cohort study of Vietnamese household members with upper gastrointestinal complaints. Participants received esophagogastroduodenoscopy and H. pylori testing. The H. pylori-positive patients were treated and asked to return for follow-up within 4 months. To explore factors associated with H. pylori infection at baseline, we performed multilevel logistic regression to account for the clustering effect of living in the same households. To explore factors associated with eradication failure, we used Poisson regression with robust variance estimation to estimate the risk ratio. Results The prevalence of H. pylori infection was 83.5% and highest among children <12 years old (92.2%) in 1,272 patients from 482 households. There were variations in H. pylori infection across households (intraclass correlation = 0.14, 95% confidence interval (CI) 0.05, 0.33). Children aged <12 years had higher odds of H. pylori infection (odds ratio = 3.41, 95%CI 2.11, 5.50). At follow-up, H. pylori was eradicated in 264 of 341 patients (77.4%). The risk of eradication failure was lower for the sequential regimen with tetracycline. Conclusion H. pylori infection was common among people living in the same households. Eradication success for H. pylori was higher for the tetracycline sequential regimen. More research should be focused on how family factors influence H. pylori infection and on eradication treatment.
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Affiliation(s)
- Long Van Dao
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
| | - Hang Viet Dao
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
- * E-mail:
| | - Hao Thi Nguyen
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | - Vung Thi Vu
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | | | - Vu Quoc Dat
- Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam
| | - Long Bao Hoang
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
| | - Hong Thi Van Nguyen
- Institute of Gastroenterology and Hepatology, Hanoi, Vietnam
- Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam
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Qiu E, Li Z, Han S. Methods for detection of Helicobacter pylori from stool sample: current options and developments. Braz J Microbiol 2021; 52:2057-2062. [PMID: 34392499 PMCID: PMC8578210 DOI: 10.1007/s42770-021-00589-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/03/2021] [Indexed: 01/19/2023] Open
Abstract
Accurate detection of Helicobacter pylori infection and determination of antibiotics have significant meaning in clinical practice. The detection methods can be categorized into two types, invasive and non-invasive, but nowadays we use the urease breath test most frequently which is non-invasive. However, many developing countries cannot meet the requirements for having specialized equipment and they lack trained personnel. Also, for the children, it is difficult to make them cooperate for the test. Methods that detect Helicobacter pylori from stool sample can be a promising alternative for detection used in children and mass screening. Stool antigen tests have several advantages such as rapidity, simplicity, and cheapness, though their results may be influenced by the heterogenicity of antigens, the nature of biochemical techniques, and the amount of antigen presented in the stool. PCR-based methods can specifically detect Helicobacter pylori infection and antibiotic resistance by targeting specific gene sequence, but they also are limited by the requirements of facilities and experts, the existence of inhibitory substance, and interference from the dead bacteria. Some novel methods also deserve our attention. Here we summarized the results of researches about methods using stool sample and we hope our work can help clinicians choose the appropriate test in clinical practice.
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Affiliation(s)
- Enming Qiu
- General Surgery Center, Department of Gastrointestinal Surgery, Zhujiang Hospital, Southern Medical University, Haizhu District, No.253. Gongye Middle Avenue, Guangzhou, Guangdong, 510280, China
| | - Zhou Li
- General Surgery Center, Department of Gastrointestinal Surgery, Zhujiang Hospital, Southern Medical University, Haizhu District, No.253. Gongye Middle Avenue, Guangzhou, Guangdong, 510280, China.
| | - Shuai Han
- General Surgery Center, Department of Gastrointestinal Surgery, Zhujiang Hospital, Southern Medical University, Haizhu District, No.253. Gongye Middle Avenue, Guangzhou, Guangdong, 510280, China.
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16
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Wang X, Shu X, Li Q, Li Y, Chen Z, Wang Y, Pu K, Zheng Y, Ye Y, Liu M, Ma L, Zhang Z, Wu Z, Zhang F, Guo Q, Ji R, Zhou Y. Prevalence and risk factors of Helicobacter pylori infection in Wuwei, a high-risk area for gastric cancer in northwest China: An all-ages population-based cross-sectional study. Helicobacter 2021; 26:e12810. [PMID: 33904635 DOI: 10.1111/hel.12810] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/02/2021] [Accepted: 03/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence and risk factors of Helicobacter pylori infection across all age groups in Wuwei City, a high-risk area for gastric cancer in Northwest China. METHODS We conducted this study from 2016 to 2017 in an urban and a rural community in Wuwei City. Stool antigen tests targeted individuals aged 0 to 3 years old, and 13 C-urea breath tests targeted individuals aged above 3 years. We selected participants based on hierarchical cluster sampling. We assessed the association between variables and H. pylori infection based on logistic regression models. RESULTS Ultimately, the results of 2,163 participants (age: 0 to 77 years old) were included (1,238 minors and 925 adults) in the analysis. The overall prevalence of H. pylori infection was 35.6%. It increased with age, reaching the peak in the 30 to 39 age group, and then began to decline. In multivariate analysis, age was positively associated with prevalence of H. pylori infection, and factors negatively associated with the prevalence were drinking running water, the frequency of yoghurt consumption, and an annual household income of Renminbi (¥) 30,000-100,000 or 100,000 above. In the subgroup analyses, however, the same variables associated differently in different age groups. Additionally, we interestingly noticed that boarding, eating at school cafeterias over six times per week, and frequently drinking untreated water were independent predictors of H. pylori infection in junior and senior high school students. CONCLUSION The prevalence of H. pylori infection is moderate and closely associated with the socioeconomic conditions of Wuwei City, as well as the sanitary situations and dietary habits of the participants in the city. Boarding, eating at school, and drinking untreated water are the main factors explaining the rising infection rate in junior-senior high school students.
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Affiliation(s)
- Xiaofeng Wang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xiaochuang Shu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Qiang Li
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | | | - Zhaofeng Chen
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ke Pu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yuwei Ye
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Min Liu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Lijun Ma
- Department of Medical Administration, The First Hospital of Lanzhou University, Lanzhou, China
| | | | - Zhengqi Wu
- Gansu Wuwei Tumour Hospital, Wuwei, China
| | - Fuhua Zhang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Second Provincial People's Hospital, Lanzhou, China
| | - Qinghong Guo
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yongning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
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Yang WJ, Hu HH, Yang Y, Li JH, Guo H. Unusual erythematous plaque with white scales, a case of acquired syphilis in a child and literature review. BMC Infect Dis 2021; 21:528. [PMID: 34090377 PMCID: PMC8178836 DOI: 10.1186/s12879-021-06114-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Syphilis in children is uncommon with the mode of infection for this rare condition likely being congenital or acquired. While most acquired cases of syphilis in children result from sexual abuse, children can also be infected with syphilis through kissing, breastfeeding, sharing of daily necessities or pre-chewed food. Here, we report a case of acquired secondary syphilis in a child due to consumption of pre-chewed-food and provide a review of the literature on the characteristics of acquired syphilis in preschool children. CASE PRESENTATION A 3-year-old girl presented with erythematous plaques and scales on her head, neck, and thighs as well as flat red papules with a moist, well circumscribed surface covered with a grayish-white film. The grandmother who cared for the girl was in the habit of pre-chewing food before giving it to the girl. The child and grandmother tested positive for RPR. The girl, who was not sexually abused, was diagnosed with acquired secondary syphilis, resulting from the transmission of pre-chewed food from her grandmother. CONCLUSIONS Our case report and literature review reveal that close contact among family members can result in the transmission of syphilis. We recommend that pre-chewing food should be discouraged by caregivers when caring for their children to avoid disease transmission.
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Affiliation(s)
- Wen-Jia Yang
- Department of Dermatology, The First Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, P. R. China
| | - Hong-Hao Hu
- Department of Dermatology, The First Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, P. R. China
| | - Yang Yang
- Department of Dermatology, The First Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, P. R. China
| | - Jiu-Hong Li
- Department of Dermatology, The First Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, P. R. China.
| | - Hao Guo
- Department of Dermatology, The First Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, P. R. China.
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Kharel S, Bist A, Shrestha S, Homagain S. Helicobacter pylori healthy South Asians. JGH Open 2020; 4:1037-1046. [PMID: 33319035 PMCID: PMC7731813 DOI: 10.1002/jgh3.12426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/19/2020] [Accepted: 09/26/2020] [Indexed: 11/09/2022]
Abstract
We aimed to estimate the pooled prevalence of Helicobacter pylori among asymptomatic South Asians based on available literature and highlight the importance of screening asymptomatic individuals and implementing preventive strategies for eradicating H. pylori. Electronic databases such as PubMed and Embase, a regional database of WHO South Asian Region, and gray literature sites were searched for relevant studies from 1983 to 5 May 2020. In addition, references of the included studies were thoroughly searched. The random-effect model was used to calculate the pooled prevalence with a 95% confidence interval (CI) along with subgroup analysis. Analysis of 19 studies showed a pooled prevalence of 56.5%, ranging from 10.3 to 91.7%. In subgroup analysis by country, the highest prevalence rate was reported from Bangladesh (86.3%, 95% CI: 0.806-0.921), whereas the lowest prevalence was from Sri Lanka (10.3%, 95% CI: 0.072-0.135). No differences were found between males and females. Prevalence among children and adolescents was 65.3% (95% CI: 0.529-0.777), greater than adults, 56.9% (95% CI: 0.353-0.785). The prevalence rate showed a decreasing trend upon comparison of studies conducted before and after 2000. Our analysis reveals the high prevalence of H. pylori infection among asymptomatic healthy populations in South Asia, particularly in children and adolescents. Public health awareness and sanitation interventions, pure drinking water, and respective strategies on a policy level to eradicate H. pylori and additional extensive multicentric cohort studies are necessary.
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Affiliation(s)
- Sanjeev Kharel
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Anil Bist
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Suraj Shrestha
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Sushan Homagain
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
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YU X, FENG D, WANG G, DONG Z, ZHOU Q, ZHANG Y. Correlation Analysis of Helicobacter pylori Infection and Digestive Tract Symptoms in Children and Related Factors of Infection. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1912-1920. [PMID: 33346225 PMCID: PMC7719659 DOI: 10.18502/ijph.v49i10.4694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To analyze the correlation between Helicobacter pylori infection and digestive tract symptoms in children and other related factors, and to explore the risk factors of H. pylori infection in children and the expression of inflammatory factors in H. pylori-positive and H. pylori-negative children. METHODS Overall, 234 children with H. pylori test in Xuzhou Children's Hospital, Xuzhou Medical University (Xuzhou, China) were enrolled. Among them, 73 children were H. pylori-positive and 161 were H. pylori-negative. The expression levels of cytokines interleukin-8 (IL-8), interleukin-18 (IL-18) and interferon-γ (IFN-γ) in H. pylori-positive and H. pylori-negative children were determined by ELISA. The correlation between H. pylori-positive and general data, digestive tract symptoms, other clinical symptoms, living habits, eating habits, family history and other related factors was statistically analyzed. Multivariate Logistic regression analysis was used to analyze the independent risk factors of H. pylori infection in children. RESULTS Family monthly income, inattentive eating, sharing toothbrushes and cups, gnawing fingers, eating fried food, drinking raw water, eating smoked and pickled food, father suffering from gastropathy and mother suffering from gastropathy were independent risk factors for H. pylori infection in children. The most common digestive tract symptoms of children with H. pylori infection were abdominal pain, accompanied by one or more clinical symptoms. The expression levels of IL-8, IL-18 and IFN-γ in H. pylori-positive children were significantly higher than those in H. pylori-negative children. CONCLUSION Prevention of H. pylori infection in children is helpful for healthy growth of children, and cytokines IL-8, IL-18, IFN-γ have the potential to be used as biomarkers for diagnosis of H. pylori-positive children.
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Affiliation(s)
- Xiaohong YU
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
| | - Dongjin FENG
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
| | - Guangmeng WANG
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
| | - Zhongmao DONG
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
| | - Qi ZHOU
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
| | - Yuan ZHANG
- Digestive System Department, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou 221000, P.R. China
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20
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Zhang Y, Dong Q, Tian L, Zhang S, Zuo N, Zhang S, Ding Z. Risk factors for recurrence of Helicobacter pylori infection after successful eradication in Chinese children: A prospective, nested case-control study. Helicobacter 2020; 25:e12749. [PMID: 32770644 DOI: 10.1111/hel.12749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/24/2020] [Accepted: 07/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Limited research has been published on the recurrence of Helicobacter pylori infection and risk factors in Chinese children. Our study aimed to identify risk factors for Helicobacter pylori infection recurrence after successful eradication in children. MATERIALS AND METHODS A prospective, nested case-control study was performed. A cohort of 230 children with successful eradication of Helicobacter pylori in Baoding (China) was selected from January 2018 to February 2019. A standardized questionnaire was used to obtain socioeconomic details. Eradication regimens and Helicobacter pylori antibiotic susceptibility testing results were also recorded. Interleukin-1β level, interferon-γ level, and genetic susceptibility (IFNGR1 and PTPRZ1 gene polymorphisms) were analyzed. All children were followed for 1 year. RESULTS Among 218 (94.8%) children who were successfully followed, 41 children (18.8%) had a Helicobacter pylori infection recurrence. The recurrence rate was higher in children ≤10 years old than >10 years old (22.8% vs 7.1%, P = .01). There was no significant difference between the recurrence group and the non-recurrence group in terms of types of therapy and antibiotic sensitivity (P > .05). Multivariable regression results indicated that residence in urban areas, higher household income, and having lunch at home were significantly protective against recurrence (OR 0.155, 0.408, and 0.351 respectively), whereas Helicobacter pylori infection in family members increased the risk of recurrence (OR 2.283). The levels of IL-1β and IFN-γ exhibited no significant difference between the recurrence group and the non-recurrence group. The allele frequency of G in the IFNGR1-56 site, A in the IFNGR1-600 site, and T in the IFNGR1-565 site was significantly higher in the recurrence group when compared to the non-recurrence group (P < .05). CONCLUSIONS The Helicobacter pylori infection recurrence rate is high in children in Baoding region and is closely correlated to socioeconomic factors. The IFNGR1 gene polymorphism may be an independent risk factor for Helicobacter pylori infection recurrence.
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Affiliation(s)
- Yuanda Zhang
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Qingwei Dong
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Lei Tian
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Shaohui Zhang
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Naying Zuo
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Sisi Zhang
- Department of Gastroenterology, Baoding Key Laboratory of Clinical Study on Respiratory and Digestive Diseases in Children, Baoding Children's Hospital, Baoding, China
| | - Zhaolu Ding
- Department of Pediatrics, Beijing United Family Hospital, Beijing, China
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21
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Gao T, Zhao M, Zhang C, Wang P, Zhou W, Tan S, Zhao L. Association of Helicobacter pylori Infection with Vitamin D Deficiency in Infants and Toddlers. Am J Trop Med Hyg 2020; 102:541-546. [PMID: 31933468 DOI: 10.4269/ajtmh.19-0523] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Helicobacter pylori (H. pylori), a gram-negative pathogen, has been shown to colonize multiple organs and cause various forms of extra-gastrointestinal diseases. The association of H. pylori infection with vitamin D status in apparently healthy children remained unclear; therefore, we investigated the relationship between vitamin D and H. pylori infection among apparently healthy infants and toddlers. In this large cross-sectional study, the examination data of children were collected from January 2013 to September 2017 in the Center for Children's Health Care. Among these children, 6,896 infants and toddlers were screened for our study. Helicobacter pylori infection and vitamin D status were the main indicators, and micronutrients (zinc, iron, copper, magnesium), and growth parameters (height, weight, and weight for age Z score [WAZ], height for age Z score [HAZ]) were also analyzed in this study. Among the 6,896 infants and toddlers, the detection rate of H. pylori seropositivity was 30.6%. The prevalence of vitamin D deficiency in H. pylori seropositive and seronegative groups was 20.7% and 12.1%, respectively (P < 0.001). The logistic regression analysis suggested children with H. pylori-positive antibody were 2.06 times more likely to be vitamin D deficient compared with children who had negative H. pylori antibody (odds ratio: 2.06; 95% CI: 1.77, 2.38) after controlling for confounding factors. These data suggested that there was a significant association between H. pylori seropositivity and vitamin D deficiency in children aged 6-36 months, which would make a contribution to the treatment and monitoring of vitamin D deficiency and H. pylori infection.
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Affiliation(s)
- Ting Gao
- Department of Neurology, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, China.,Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Mengwen Zhao
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Chen Zhang
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Peipei Wang
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Wenjuan Zhou
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Shan Tan
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Lingling Zhao
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
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Schacher K, Spotts H, Correia C, Walelign S, Tesfaye M, Desta K, Tsegaye A, Taye B. Individual and household correlates of Helicobacter pylori infection among Young Ethiopian children in Ziway, Central Ethiopia. BMC Infect Dis 2020; 20:310. [PMID: 32334539 PMCID: PMC7183626 DOI: 10.1186/s12879-020-05043-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/16/2020] [Indexed: 01/17/2023] Open
Abstract
Background Investigating distinct individual- and household-level risk factors for acquiring Helicobacter pylori (H. pylori) infection can inform disease prevention efforts and implicate possible routes of transmission. This study determined the magnitude of H. pylori infection among schoolchildren in Ziway, central Ethiopia and identified personal and household correlates of H. pylori infection in young Ethiopian children. Methods A total of 434 schoolchildren participated in this cross-sectional study. Infection status was assessed using antigen and antibody rapid tests. Demographic and lifestyle information was obtained from parents via an interviewer-led questionnaire. Univariate and multivariate logistic regressions were performed to assess the relationships between potential individual- and household-level risk factors and H. pylori infection. Results The prevalence of H. pylori infection was 65.7% (285/434). Of the personal variables assessed, the age group 10–14 years was found to be significantly associated with higher odds of H. pylori infection in univariate analysis (COR = 2.22, 95% CI: 1.06–4.66, p = 0.03) and remained positively correlated after adjusting for confounding factors. Of the household-level factors explored, having a traditional pit or no toilet was found to be significantly associated with 3.93-fold higher odds of H. pylori infection (AOR = 3.93, 95% CI: 1.51–10.3, p = 0.01), while the presence of smokers in the household was associated with 68% lower odds of infection (AOR = 0.32, 95% CI: 0.11–0.89, p = 0.03). Conclusion This study from a developing country provides additional evidence for older age as a personal risk factor for H. pylori infection and identifies correlations between socioeconomic and sanitation household factors and positive childhood infection status. The associations reported here support the hypothesized fecal-oralroute of transmission for H. pylori.
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Affiliation(s)
- Kayla Schacher
- Department of Biology, Colgate University, 214 Olin Hall, 13 Oak Dr., Hamilton, NY, 13346, USA
| | - Hannah Spotts
- Department of Biology, Colgate University, 214 Olin Hall, 13 Oak Dr., Hamilton, NY, 13346, USA
| | - Caroline Correia
- Department of Biology, Colgate University, 214 Olin Hall, 13 Oak Dr., Hamilton, NY, 13346, USA
| | - Sosina Walelign
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Mehret Tesfaye
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Kassu Desta
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | - Bineyam Taye
- Department of Biology, Colgate University, 214 Olin Hall, 13 Oak Dr., Hamilton, NY, 13346, USA.
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Fahim SM, Das S, Gazi MA, Alam MA, Hasan MM, Hossain MS, Mahfuz M, Rahman MM, Haque R, Sarker SA, Mazumder RN, Ahmed T. Helicobacter pylori infection is associated with fecal biomarkers of environmental enteric dysfunction but not with the nutritional status of children living in Bangladesh. PLoS Negl Trop Dis 2020; 14:e0008243. [PMID: 32324737 PMCID: PMC7200013 DOI: 10.1371/journal.pntd.0008243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 05/05/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background Because Helicobacter pylori (H. pylori) infection and Environmental Enteric Dysfunction (EED) follow a similar mode of transmission, there can be a complex interplay between H. pylori infection and EED, both of which can influence childhood growth. We sought to investigate the factors associated with H. pylori infection and identify its relationship with the fecal biomarkers of EED including Myeloperoxidase (MPO), Neopterin (NEO), Calprotectin, Reg1B and Alpha-1 antitrypsin (AAT), and nutritional status of the children. Methodology Data from an on-going community-based nutrition intervention study was used for this analysis. Total 319 children aged between 12–18 months were evaluated at enrolment and at the end of a 90-day nutrition intervention. Multivariable linear regression with generalized estimating equations was done to examine the association of H. pylori infection with stool biomarker of EED and nutritional status of the children. Principal findings One-fifth of the participants had H. pylori infection at both the time points, with 13.8% overall persistence. Children living in crowded households had higher odds of being infected by H. pylori (AOR = 2.02; 95% CI = 1.02, 4.10; p-value = 0.045). At enrolment, 60%, 99%, 69% and 85% of the stool samples were elevated compared to the reference values set for MPO, NEO, AAT and Calprotectin in the non-tropical western countries. The proportions reduced to 52%, 99%, 67%, and 77% for the same biomarkers after the nutrition intervention. Infection with H. pylori had significant positive association with fecal AAT concentrations (Coefficient = 0.26; 95% CI = 0.02, 0.49; p-value = 0.03) and inverse relationship with Reg1B concentrations measured in the stool samples (Coefficient = -0.32; 95% CI = -0.59, -0.05; p-value = 0.02). However, H. pylori infection was not associated with the indicators of childhood growth. Conclusions The study findings affirmed that the acquisition and persistence of H. pylori infection in the early years of life may exert an adverse impact on intestinal health, induce gut inflammation and result in increased intestinal permeability. Infection with H. pylori, a substantial public health burden in the tropical countries, follows the similar mode of transmission analogous to Environmental Enteric Dysfunction (EED). There can be a complex interplay between H. pylori infection and EED–both of which can influence childhood growth–but the definite role of H. pylori infection contributing to EED and subsequent growth failure is poorly understood. In this study, the authors present data from an ongoing community-based nutrition intervention study and investigated the factors associated with H. pylori infection and identify its relationship with fecal biomarkers of EED and indicators of the nutritional status of the children hailing from a resource-poor urban settlement. They demonstrated the acquisition and persistence of H. pylori infection during early childhood. The study results also corroborate that infection with H. pylori had significant positive association with fecal Alpha-1 antitrypsin concentrations and an inverse relationship with Reg1B concentrations measured in stool samples of the children. The findings revealed in this study may contribute to a better understanding of the role of H. pylori infection in contributing to EED as well as alteration of gut function in the early years of life.
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Affiliation(s)
- Shah Mohammad Fahim
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- * E-mail:
| | - Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Amran Gazi
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Mehedi Hasan
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Shabab Hossain
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - M Masudur Rahman
- Department of Gastroenterology, Sheikh Russel National Gastro Liver Institute & Hospital, Dhaka, Bangladesh
| | - Rashidul Haque
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shafiqul Alam Sarker
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ramendra Nath Mazumder
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Hu J, Wang X, Chua EG, He Y, Shu Q, Zeng L, Luo S, Marshall BJ, Liu A, Tay CY. Prevalence and risk factors of Helicobacter pylori infection among children in Kuichong Subdistrict of Shenzhen City, China. PeerJ 2020; 8:e8878. [PMID: 32280567 PMCID: PMC7134012 DOI: 10.7717/peerj.8878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/09/2020] [Indexed: 11/21/2022] Open
Abstract
Background Helicobacter pylori infection is a significant burden to the public health in China as it can lead to various gastric diseases including peptic ulcers and gastric cancer. Since most infections occurred during childhood, it is therefore necessary to understand the prevalence and risk determinants of this bacterial infection in children. Herewith, we conducted a cross-sectional study in the Kuichong Subdistrict of Shenzhen City to assess the prevalence and risk factors of H. pylori infection among children. Methods From September 2018 to October 2018, 1,355 children aged 6–12 years from four primary schools in the Kuichong Subdistrict of Shenzhen City were recruited. These children were screened for H. pylori infection using the 13C-urea breath test. In addition, parents were requested to fill out a standardized questionnaire. The chi-square test and multivariable logistic regression analysis were used to identify risk factors for H. pylori. Results Among 1,355 children recruited in this study, 226 (16.7%; 95% CI [14.7–18.7]) were positive of H. pylori infection. Multivariable logistic regression analysis identified six factors significantly associated with H. pylori infection children including parent(s) with tertiary education level (OR: 0.64; 95% CI [0.46–0.89]), testing bottle feed temperature using the mouth (OR: 1.79; 95% CI [1.19–2.68]), sharing of cutlery between the feeding person and young children during meals (OR: 1.84; 95% CI [1.22–2.78]), eating fruit after peeling (OR: 2.56; 95% CI [1.4–4.71]), frequent dining out (OR: 3.13; 95% CI [1.46–6.68]) and snacking (OR: 1.43; 95% CI [1.01–2.01]). Conclusions Overall, better educated parent(s) played a protective role against the acquisition of H. pylori infection in children. Testing bottle feed temperature using the mouth, cutlery sharing between the feeding person and young children, and snacking posed a lower but significant risk for H. pylori infection. Only eating peeled fruits and frequent dining out were associated with greater infection risks.
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Affiliation(s)
- Jingjing Hu
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiangyu Wang
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.,Shenzhen Kuichong People's Hospital, Shenzhen, China
| | - Eng Guan Chua
- The Marshall Centre for Infectious Diseases Research and Training, University of Western Australia, Perth, WA, Australia
| | - Yongsheng He
- Shenzhen Kuichong People's Hospital, Shenzhen, China
| | - Qing Shu
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Li Zeng
- The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Shiyang Luo
- Shenzhen Kuichong People's Hospital, Shenzhen, China
| | - Barry J Marshall
- Shenzhen Kuichong People's Hospital, Shenzhen, China.,The Marshall Centre for Infectious Diseases Research and Training, University of Western Australia, Perth, WA, Australia
| | - Aijun Liu
- Shenzhen Kuichong People's Hospital, Shenzhen, China
| | - Chin Yen Tay
- Shenzhen Kuichong People's Hospital, Shenzhen, China.,The Marshall Centre for Infectious Diseases Research and Training, University of Western Australia, Perth, WA, Australia
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Borges SS, Ramos AFPL, Moraes Filho AVD, Braga CADSB, Carneiro LC, Barbosa MS. [ARTICLE PARTIAL RETRACTION] PREVALENCE OF HELICOBACTER PYLORI INFECTION IN DYSPEPTIC PATIENTS AND ITS ASSOCIATION WITH CLINICAL RISK FACTORS FOR DEVELOPING GASTRIC ADENOCARCINOMA. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:66-70. [PMID: 31141074 DOI: 10.1590/s0004-2803.201900000-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/31/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND In Brazil, particularly in the underdeveloped localities, the prevalence of Helicobacter pylori (H. pylori) infections can range up to 90%. These rates are higher in older individuals and vary by country region. H. pylori infections are linked to the development of gastric pathologies, namely mild to moderate gastritis, gastroenteritis, peptic ulcer, intestinal metaplasia, and gastric cancer. In 1994, this organism was classified by the International Agency for Research on Cancer (IARC) as pertaining to the Group 1 carcinogen for gastric adenocarcinoma etiology. Gastric cancer represents a significant public health problem, being the fourth most common malignant tumor and the second largest cause of cancer-related deaths. OBJECTIVE To investigate the prevalence of H. pylori infection in dyspeptic patients and determine the link between clinical risk factors and gastric adenocarcinoma diagnosis. METHODS Polymerase chain reaction (PCR) analysis was employed for molecular diagnosis of gastric tissue biopsies collected from 113 dyspeptic patients at the University Hospital of Federal University of Goiás. Molecular analyses allowed the identification of H. pylori infections. Furthermore, histopathological examinations were performed to determine the clinical risks of developing gastric malignancies. RESULTS The test results identified 69 individuals older than 44 years, from 75 (66.4%) positive H. pylori infection samples. The prevalence of gastric adenocarcinoma in this study was 1.3%. Among the infected patients, six (8.2%) had high risk, and 67 (91.8%) had a low risk of developing gastric cancer (P<0.05). CONCLUSION This study shows a high prevalence of H. pylori infection and identifies its contribution to gastric inflammations, which in the long term are manifested in high-risk clinical factors for the development of gastric adenocarcinoma.
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Affiliation(s)
| | | | - Aroldo Vieira de Moraes Filho
- Universidade Federal de Goiás, Instituto de Ciências da Saúde, Programa de Pós-Doutorado em Ciências da Saúde, Goiânia, GO, Brasil
| | - Carla Afonso da Silva Bitencourt Braga
- Universidade Federal de Goiás, Faculdade de Farmácia, Goiânia, GO, Brasil.,Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brasil
| | - Lilian Carla Carneiro
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brasil
| | - Mônica Santiago Barbosa
- Universidade Federal de Goiás, Faculdade de Farmácia, Goiânia, GO, Brasil.,Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brasil
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Prevalence and Risk Factors of Helicobacter pylori Infection among Children Aged 1 to 15 Years at Holy Innocents Children's Hospital, Mbarara, South Western Uganda. J Trop Med 2019; 2019:9303072. [PMID: 30984271 PMCID: PMC6431523 DOI: 10.1155/2019/9303072] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/20/2019] [Indexed: 02/07/2023] Open
Abstract
Background Helicobacter pylori infection affects more than half of the world's population. The infection is generally acquired during childhood but can remain asymptomatic, with long-term clinical sequelae including gastritis, peptic ulcer disease, and stomach cancer. Methods The study was approved by Institutional Review Committee of Mbarara University of Science and Technology. After obtaining informed consent from parents/legal guardians, illegible children who presented with gastrointestinal complaints at Holy Innocents Children's Hospital were recruited; structured questionnaires were administered to the parents/guardians to collect information on sociodemographic data and risk factors of H. pylori infection. Four (4) millilitres of blood was collected from each child and tested for H. pylori blood Antibody test and stool specimens were used for H. pylori antigen test. Results The prevalence of H. pylori infection among the study participants was 24.3%. The infection rate increased with increase in age of the participants, from 16.2% among 1to 5 years old to 27.2% among 6 to 10 years. Infections were higher among school going children (68/74, p=0.003, OR 3.9; CI: 1.5 to 10.6) and children from crowded households (59/74, p<0.001, OR 2.6, and CI 1.3 to 5.0), unsafe source of drinking water at schools (46/74, p=0.003), and lack of sanitary facility at homes (57/74, p=0.001, and OR 1.6 CI 0.7 to 3.6). Conclusion The prevalence of H. pylori infection among children aged 1 to 15 years at Holy Innocents Children's Hospital was high and increases with age. School attendance, lack of sanitary facility, lack of safe drinking water, and overcrowding were the risk factors associated with H. pylori infection.
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Helicobacter pylori Infection in Children and Adolescents. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1149:107-120. [PMID: 31037557 DOI: 10.1007/5584_2019_361] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
About one-third of all children worldwide is infected with H. pylori and its prevalence is low in developed and high in developing countries. H. pylori is mainly acquired during childhood and transmission of the bacterium commonly proceeds from person to person, especially among family members. The most frequent transmission route is from the mother to children. Various gastrointestinal and extra-gastrointestinal diseases are reported to be associated with H. pylori in children and adolescents, but the strongest recommendation for testing and treating is introduced only with children and adolescents having peptic ulcer disease. Iron deficiency anemia and chronic immune thrombocytopenic purpura are also considered for testing and treating, but the effectiveness is somewhat controversial. Invasive diagnosis is recommended, whereas none of the available diagnostic tests have 100% accuracy for reliable diagnosis, and therefore at least two or more tests should be performed. Urea breath test is the most reliable among the non-invasive tests. Because the number of antibiotics-resistant H. pylori strains is increasing, it is desirable to conduct a drug susceptibility test before treatment and to select the corresponding regime. H. pylori has been proven to be a major cause of gastric cancer and 'screen-and-treat' strategies are recommended in communities at high risk of gastric cancer. However, the application to children and adolescents is controversial. An effective vaccine is desirable, but not yet available. Screen-and-treat for adolescents has started in a few areas in Japan, where conditions are well established. New prevention strategies for gastric cancer are awaited worldwide.
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Zhou Y, Ye Z, Huang J, Huang Y, Yan W, Zhang Y. High prevalence and low spontaneous eradication rate of Helicobacter pylori infection among schoolchildren aged 7-12 years. Acta Paediatr 2018; 107:1624-1628. [PMID: 29723912 DOI: 10.1111/apa.14387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 02/10/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022]
Abstract
AIM Helicobacter pylori infections mainly occur during childhood and may cause chronic diseases and persist for life unless they are treated. The aim of this study was to identify the prevalence and infection status of H. pylori infection among schoolchildren. METHODS We conducted a cross-sectional study of 867 children (52% male) aged 7-12 years in a primary school in the Minhang District of Shanghai, China, in 2014, and a one-year follow-up study of 352 subjects. The 13C-urea breath test was used to identify the H. pylori infection at baseline and one year later. A parental questionnaire provided information regarding the children's socioeconomic status and household environment. RESULTS The overall prevalence of the H. pylori infection was 24.1% (209/867), with a 95% confidence interval of 21.3% to 27.0%. The one-year follow-up study of 352 subjects found that 33.5% were positive for the infection at baseline and 66.5% were negative. We found that 27.1% of the positive cases recovered and 8.9% of the negative cases acquired the infection during the year. The spontaneous eradication rate was only 2.9% over the one-year period. CONCLUSION The prevalence of the H. pylori infection among Chinese schoolchildren aged 7-12 was high and spontaneous eradication was low.
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Affiliation(s)
- Ying Zhou
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Ziqing Ye
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Jie Huang
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Ying Huang
- Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Zhang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
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Wongphutorn P, Chomvarin C, Sripa B, Namwat W, Faksri K. Detection and genotyping of Helicobacter pylori in saliva versus stool samples from asymptomatic individuals in Northeastern Thailand reveals intra-host tissue-specific H. pylori subtypes. BMC Microbiol 2018; 18:10. [PMID: 29378521 PMCID: PMC5789744 DOI: 10.1186/s12866-018-1150-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 01/21/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Two-thirds of the world's population is thought to be infected by Helicobacter pylori. Although most people infected with H. pylori are asymptomatic, this pathogen is associated with several gastric pathologies including cancer. The risk factors for colonization are still unclear and the genetic diversity within individual hosts has never been clearly investigated. RESULT This study determined the prevalence of, and explored risk factors for, H. pylori infection directly from paired saliva (n = 110) and stool (n = 110) samples from asymptomatic persons in Northeast Thailand. Samples were subjected to indirect immunofluorescence assay (IFA), 16S rRNA-based real-time PCR and vacA-based semi-nested PCR. Partial vacA gene sequences of H. pylori were compared between saliva and stool samples. The overall prevalence of H. pylori infection in our asymptomatic study population was 64%. Age, gender, occupation and frequency of brushing teeth were not found to be associated with H. pylori colonization. The vacA gene was successfully sequenced from both saliva and stool samples of 12 individuals. For seven of these individuals, saliva and stool sequences fell into different clusters on a phylogenetic tree, indicating intra-host genetic variation of H. pylori. CONCLUSION This study reports a high prevalence of H. pylori infection in asymptomatic persons in this region of Thailand and demonstrates that genotypes (vacA gene sequences) of H. pylori may differ between the oral cavity and intestinal tract.
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Affiliation(s)
- Phattharaphon Wongphutorn
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Chariya Chomvarin
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Banchob Sripa
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wises Namwat
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Kiatichai Faksri
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, 40002, Thailand.
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Cameron D, Hock QS, Kadim M, Mohan N, Ryoo E, Sandhu B, Yamashiro Y, Jie C, Hoekstra H, Guarino A. Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region. World J Gastroenterol 2017; 23:7952-7964. [PMID: 29259371 PMCID: PMC5725290 DOI: 10.3748/wjg.v23.i45.7952] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 09/29/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023] Open
Abstract
Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745 (Sb) and Lactobacillus rhamnosus GG (LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of (with the indicated strains): antibiotic-associated diarrhea (LGG or Sb); Clostridium difficile-induced diarrhea (Sb); nosocomial diarrhea (LGG); infantile colic (L reuteri) and as adjunct treatment of Helicobacter pylori (Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.
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Affiliation(s)
- Donald Cameron
- Department of Gastroenterology and Clinical Nutrition, Royal Children’s Hospital, Melbourne 3052, Australia
| | - Quak Seng Hock
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Musal Kadim
- Child Health Department, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta 12220, Indonesia
| | - Neelam Mohan
- Department of Pediatric Gastroenterology, Hepatology And Liver Transplantation, Medanta The Medicity 122001, Gurugram Haryana, India
| | - Eell Ryoo
- Department of Pediatrics, Gachon University, Gil Gachon Children’s Hosptial, Incheon 21565, South Korea
| | - Bhupinder Sandhu
- Department of Paediatric Gastroenterology, Royal Hospital for Children, Bristol BS2 8BJ, United Kingdom
| | - Yuichiro Yamashiro
- Probiotics Research Laboratory, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Chen Jie
- The Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 610041, Zhejiang Province, China
| | - Hans Hoekstra
- Department of Pediatrics, Hieronymus Bosch Hospital, ’s-Hertogenbosch 5223GZ, The Netherlands
| | - Alfredo Guarino
- Unit of Pediatrics Infectious Diseases and Clinical Nutrition of the Department of Translational Medical Science-Section of Pediatrics, University of Naples Federico II, Naples 80131, Italy
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Wangda S, Richter JM, Kuenzang P, Wangchuk K, Choden T, Tenzin K, Malaty HM. Epidemiology of Helicobacter pylori infection in asymptomatic schoolchildren in Bhutan. Helicobacter 2017; 22. [PMID: 28940523 DOI: 10.1111/hel.12439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM Bhutan is a small mountainous country between Tibet and India with relatively homogenous population. According to the World Health Organization, gastric cancer is the most frequent cause of cancer death in Bhutan. This study examined the prevalence of Helicobacter pylori among children in Bhutan with emphasis on water source and living conditions. METHODS A cross-sectional sero-epidemiologic study was conducted among schoolchildren who attended public schools in Thimphu, Bhutan. Between 2015 and 2016, blood samples from schoolchildren were collected after obtaining an informed consent from the school management and the children's parents. Demographic information, parents' education, family size living in the same household, and aspects of household environment including type of latrines, boiling drinking water were collected. All serum samples were tested for H. pylori immunoglobulin G (IgG) by commercial ELISA kits. RESULTS There were 327 children between 4 and 19 years of age participated, 44% boys, mean age = 13.6 ± 3 years. The overall prevalence of H. pylori was 66% with no difference between boys and girls (66 vs 64%, respectively), P = .42. H. pylori prevalence was 75% among both 4-7 and 15-19 years and not statically different from that of the 8-10 or 11-14 age groups (59% and 63%, respectively), P = .1. H. pylori prevalence was inversely correlated with the level of mother's education (70% vs 55%) for those without and with a college education, respectively (OR = 2.3; 95%CI = 0.9-1.7), P = .08. The total number of people living in the same household did not correlate with H. pylori sero-prevalence, but households had less than 3 children had lower prevalence than those with 3 or more children (62% vs 71%, respectively OR = 1.7, 95% CI = [1.0-2.6], P = .05). CONCLUSIONS H. pylori infection is prevalent among all age group children in Bhutan. The results suggest that transmission of H. pylori is related to personal care practices that directly correlate with the mothers' education and crowded living condition with children. Our results are important to developing prevention strategies for gastric cancer in Bhutan.
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Affiliation(s)
- Sonam Wangda
- Health care and Diagnostic Division, Department of Medical Services, Ministry of Health, Thimphu, Bhutan
| | - James M Richter
- Harvard Medical School, Gastroenterology Associates Massachusetts General Hospital, Boston, MA, USA
| | | | - Kinley Wangchuk
- Sherbutse College, Kanglung, Royal University, Thimphu, Bhutan
| | - Tashi Choden
- Sherbutse College, Kanglung, Royal University, Thimphu, Bhutan
| | - Karma Tenzin
- Microbiology unit, Department of Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Hoda M Malaty
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Bacterial Infection and Associated Cancers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1018:181-191. [DOI: 10.1007/978-981-10-5765-6_11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Asgeirsdottir GA, Kjartansdottir I, Olafsdottir AS, Hreinsson JP, Hrafnkelsson H, Johannsson E, Björnsson ES. Helicobacter pylori infection in Icelandic children. Scand J Gastroenterol 2017; 52:686-690. [PMID: 28355955 DOI: 10.1080/00365521.2017.1304986] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The prevalence of Helicobacter pylori (HP) infection is decreasing in the western world. The seroprevalence among 25-50-year-old Icelandic adults was recently shown to be 30-40%. Information on the seroprevalence in Nordic children is limited. We aimed at ascertaining the infection prevalence among healthy Icelandic children. METHODS The infection status in stored frozen blood samples from two cross-sectional studies on the health of 7-9-year-old children (n = 125) and 16-18-year-old adolescents (n = 80) was determined by enzyme-linked immunosorbent assay (ELISA). Information on family demographics and GI symptoms was obtained by standardized questionnaires. RESULTS Overall, 3.4% (7/205) of the children were infected with H. pylori. The prevalence was 2.6% (5/190), missing data n = 3, among children with both parents born in a low prevalence country compared to 17% (2/12) among those with at least one parent born in a high prevalence area (p = .026). When at least one parent was born in a high prevalence country, the odds ratio for being H. pylori seropositive was 2.2 (95% CI, 1.02-54.67), when adjusted for the educational status of the mother. There was no significant association between H. pylori infection and gastrointestinal symptoms. CONCLUSION Prevalence of H. pylori infection in Iceland has become very low, suggesting a great reduction in transmission from older generations. There was an association between H. pylori infection and origin from high prevalence areas but not with gastrointestinal symptoms. The results mirror recent studies of children of Scandinavian ancestry.
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Affiliation(s)
- G A Asgeirsdottir
- a Section of Gastroenterology and Hepatology and Radiology , National University Hospital of Iceland , Reykjavík , Iceland
| | | | - A S Olafsdottir
- c School of Education, University of Iceland , Reykjavík , Iceland
| | - J P Hreinsson
- a Section of Gastroenterology and Hepatology and Radiology , National University Hospital of Iceland , Reykjavík , Iceland
| | | | - E Johannsson
- c School of Education, University of Iceland , Reykjavík , Iceland
| | - E S Björnsson
- a Section of Gastroenterology and Hepatology and Radiology , National University Hospital of Iceland , Reykjavík , Iceland.,b Faculty of Medicine
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Zabala Torrres B, Lucero Y, Lagomarcino AJ, Orellana-Manzano A, George S, Torres JP, O'Ryan M. Review: Prevalence and dynamics of Helicobacter pylori infection during childhood. Helicobacter 2017. [PMID: 28643393 DOI: 10.1111/hel.12399] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Long-term persistent Helicobacter pylori infection has been associated with ulceropeptic disease and gastric cancer. Although H. pylori is predominantly acquired early in life, a clear understanding of infection dynamics during childhood has been obfuscated by the diversity of populations evaluated, study designs, and methods used. AIM Update understanding of true prevalence of H. pylori infection during childhood, based on a critical analysis of the literature published in the past 5 years. METHODS Comprehensive review and meta-analysis of original studies published from 2011 to 2016. RESULTS A MEDLINE® /PubMed® search on May 1, 2016, using the terms pylori and children, and subsequent exclusion, based on abstract review using predefined criteria, resulted in 261 citations. An Embase® search with the same criteria added an additional 8 citations. In healthy children, meta-analysis estimated an overall seroprevalence rate of 33% (95% CI: 27%-38%). Seven healthy cohort studies using noninvasive direct detection methods showed infection prevalence estimates ranging from 20% to 50% in children ≤5 and 38% to 79% in children >5 years. The probability of infection persistence after a first positive sample ranged from 49% to 95%. Model estimates of cross-sectional direct detection studies in asymptomatic children indicated a prevalence of 37% (95% CI: 30%-44%). Seroprevalence, but not direct detection rates increased with age; both decreased with increasing income. The model estimate based on cross-sectional studies in symptomatic children was 39% (95% CI: 35%-43%). CONCLUSIONS The prevalence of H. pylori infection varied widely in the studies included here; nevertheless, model estimates by detection type were similar, suggesting that overall, one-third of children worldwide are or have been infected. The few cohort and longitudinal studies available show variability, but most studies, show infection rates over 30%. Rather surprisingly, overall infection prevalence in symptomatic children was only slightly higher, around 40%. Studies including only one positive stool sample should be interpreted with caution as spontaneous clearance can occur.
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Affiliation(s)
- Beatriz Zabala Torrres
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile.,Universidad de Aysén, Campus Rio Simpson, Coyhaique, Chile
| | - Yalda Lucero
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Anne J Lagomarcino
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Andrea Orellana-Manzano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida (FCV), Campus Gustavo Galindo Km. 30.5 Vía Perímetral, P. O. Box 09-01-5863, Guayaquil, Ecuador
| | - Sergio George
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Juan P Torres
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Miguel O'Ryan
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
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Hu Y, Zhu Y, Lu NH. Novel and Effective Therapeutic Regimens for Helicobacter pylori in an Era of Increasing Antibiotic Resistance. Front Cell Infect Microbiol 2017; 7:168. [PMID: 28529929 PMCID: PMC5418237 DOI: 10.3389/fcimb.2017.00168] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/18/2017] [Indexed: 01/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a common gastrointestinal bacterial strain closely associated with the incidence of chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer. A current research and clinical challenge is the increased rate of antibiotic resistance in H. pylori, which has led to a decreased H. pylori eradication rate. In this article, we review recent H. pylori infection and reinfection rates and H. pylori resistance to antibiotics, and we discuss the pertinent treatments. A PubMed literature search was performed using the following keywords: Helicobacter pylori, infection, reinfection, antibiotic resistance, bismuth, proton pump inhibitors, vonoprazan, susceptibility, quintuple therapy, dual therapy, and probiotic. The prevalence of H. pylori has remained high in some areas despite the decreasing trend of H. pylori prevalence observed over time. Additionally, the H. pylori reinfection rate has varied in different countries due to socioeconomic and hygienic conditions. Helicobacter pylori monoresistance to clarithromycin, metronidazole or levofloxacin was common in most countries. However, the prevalence of amoxicillin and tetracycline resistance has remained low. Because H. pylori infection and reinfection present serious challenges and because H. pylori resistance to clarithromycin, metronidazole or levofloxacin remains high in most countries, the selection of an efficient regimen to eradicate H. pylori is critical. Currently, bismuth-containing quadruple therapies still achieve high eradication rates. Moreover, susceptibility-based therapies are alternatives because they may avoid the use of unnecessary antibiotics. Novel regimens, e.g., vonoprazan-containing triple therapies, quintuple therapies, high-dose dual therapies, and standard triple therapies with probiotics, require further studies concerning their efficiency and safety for treating H. pylori.
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Affiliation(s)
- Yi Hu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityNanchang, China
| | - Yin Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityNanchang, China
| | - Nong-Hua Lu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityNanchang, China
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Hu Y, Zhu Y, Lu NH. Primary Antibiotic Resistance of Helicobacter pylori in China. Dig Dis Sci 2017; 62:1146-1154. [PMID: 28315035 DOI: 10.1007/s10620-017-4536-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/08/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Antibiotic resistance is the most important factor leading to the failure of eradication regimens; thus, it is important to obtain regional antibiotic resistance information. This review focuses on the prevalence of Helicobacter pylori primary resistance to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone in China. METHODS We searched the PubMed, EMBASE, the China National Knowledge Infrastructure, and Chinese Biomedical databases from the earliest date of each database to October 2016. The search terms included the following: H. pylori, antibiotic (including clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone) resistance with or without China or different regions of China. The data analysis was performed using MedCalc 15.2.2. Each article was weighted according to the number of isolated H. pylori strains. A pooled proportion analysis was performed. RESULTS Twenty-three studies (14 studies in English and 9 in Chinese) were included in this review. A total of 6274, 6418, 3921, 5468, 2802, and 275 H. pylori strains were included in this review to evaluate the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone, respectively. Overall, the primary resistance rates of clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone were 28.9, 63.8, 28.0, 3.1, 3.9, and 1.7%, respectively. CONCLUSIONS In China, the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, and levofloxacin was high and increased over time, whereas the resistance rates to amoxicillin, tetracycline, and furazolidone were low and stable over time.
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Affiliation(s)
- Yi Hu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 YongWaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
| | - Yin Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 YongWaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
| | - Nong-Hua Lu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 YongWaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
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Shu X, Ping M, Yin G, Jiang M. Investigation of Helicobacter pylori infection among symptomatic children in Hangzhou from 2007 to 2014: a retrospective study with 12,796 cases. PeerJ 2017; 5:e2937. [PMID: 28168109 PMCID: PMC5289104 DOI: 10.7717/peerj.2937] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/23/2016] [Indexed: 12/14/2022] Open
Abstract
Background and Aim The infection of Helicobacter pylori (H. pylori) is acquired in childhood and the prevalence vary greatly in different countries and regions. The study aimed to investigate the characteristics of H. pylori infection among children with gastrointestinal symptoms in Hangzhou, a representative city of eastern China. Methods A systematic surveillance of H. pylori infection according to the 13C-urea breath test was conducted from January 2007 to December 2014 in the Children’s hospital, Zhejiang University School of Medicine. The demographic information and main symptoms of every subject were recorded. Results A total of 12,796 subjects were recruited and 18.6% children evaluated as H. pylori positive. The annual positive rates decreased from 2007 to 2014 (χ2 = 20.461, p < 0.01). The positive rates were 14.8%, 20.2% and 25.8% in 3–6, 7–11 and 12–17 years age group respectively, which increased with age (χ2 = 116.002, p < 0.01). And it was significantly higher in boys than girls (χ2 = 15.090, p < 0.01). Multivariate logistic regression identified possible risk factors for H. pylori infection. Age, gender, gastrointestinal symptoms and history of H. pylori infected family member were all significantly associated with H. pylori infection (all p < 0.05). Conclusions H. pylori infection rates in children with gastrointestinal symptoms were lower than most of those reported in mainland China. Further studies are required to determine the prevalence in the general population. Comprehensively understanding of the characteristics and the possible risk factors of H. pylori infection will be helpful to its management strategies in children in China.
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Affiliation(s)
- Xiaoli Shu
- Gastrointestinal Laboratory, the Children's Hospital, Zhejiang University School of Medicine , Hangzhou , China
| | - Mingfang Ping
- Gastrointestinal Laboratory, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Current affiliation: Department of Pediatrics, Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Guofeng Yin
- Gastrointestinal Laboratory, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Current affiliation: Department of Pediatrics, Shaoxing Women & Children's Hospital, Shaoxing, China
| | - Mizu Jiang
- Gastrointestinal Laboratory, the Children's Hospital, Zhejiang University School of Medicine , Hangzhou , China
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Abstract
Helicobacter pylori infection in early childhood may differ in many aspects compared to infection in adulthood: the immune response in the gut, the type and prevalence of complications within and outside the stomach, and the impact on long-term health. In high prevalence countries, transient infections seem to be common in infants and toddlers, and the consequences of this phenomenon on the short- and long-term immune response are still unclear. Other controversial issues are related to the question of which H. pylori-infected children benefit from treatment and which is the best regimen to eradicate the infection in the presence of a worldwide increasing antibiotic resistance. The first large-scale randomized placebo-controlled vaccination trial in schoolchildren indicates that prevention of the infection may be possible.
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Affiliation(s)
- Andrea Sustmann
- Division of Gastroenterology and Hepatology, Dr. v. Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Masumi Okuda
- Department of General Medicine and Community Health Science, Sasayama Medical Center, Hyogo College of Medicine, Sasayama, Hyogo, Japan
| | - Sibylle Koletzko
- Division of Gastroenterology and Hepatology, Dr. v. Hauner Children's Hospital, Ludwig Maximilians University Munich, Munich, Germany
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Cai YL, Zhang KG. Clinical value of detection of anti- Helicobacter pylori antibody in urine. Shijie Huaren Xiaohua Zazhi 2016; 24:2513-2519. [DOI: 10.11569/wcjd.v24.i16.2513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a kind of gram-negative anaerobic bacterium that was first successfully isolated and cultivated from the specimens of the gastric mucosa by Warren and Marshall in 1983. It is one of the risk factors for gastric cancer and is closely related with chronic gastritis, peptic ulcer, gastric cancer and other diseases of the digestive system. There are a variety of detection technologies and diagnostic methods available for H. pylori infection, including direct detection of the bacterium, urease detection, antigen and antibody detection, polymerase chain reaction and so on. Generally, these methods can be divided into two major categories: invasive and non-invasive. However, no single test can be considered the gold standard for the diagnosis of H. pylori infection. In this paper, we will summarize a kind of completely non-invasive detection method - detection of H. pylori antibody in urine, review its use in the diagnosis of ongoing infection, and discuss its value in clinical applications.
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Chen Q, Lu H. Kyoto global consensus report on Helicobacter pylori gastritis and its impact on Chinese clinical practice. J Dig Dis 2016; 17:353-6. [PMID: 27164026 DOI: 10.1111/1751-2980.12358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Kyoto global consensus report on Helicobacter pylori (H. pylori) gastritis has had a great effect on the field of H. pylori studies worldwide. For the first time H. pylori gastritis was defined entirely as an infectious disease and H. pylori-associated dyspepsia as a new category of organic dyspepsia apart from functional dyspepsia, together with a proposed diagnostic algorithm. Accordingly, the report states that the eradication of H. pylori should be regarded as the first-line treatment for dyspepsia. Moreover, H. pylori eradication before the development of pre-neoplastic changes is recommended to reduce the risk of more serious complications of H. pylori gastritis. Despite the recommendations of this new global consensus, the task of transforming them into feasible and practical recommendations for individual countries will require them to become region-specific, which requires further discussion.
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Affiliation(s)
- Qi Chen
- Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
| | - Hong Lu
- Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China
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Laird-Fick HS, Saini S, Hillard JR. Gastric adenocarcinoma: the role of Helicobacter pylori in pathogenesis and prevention efforts. Postgrad Med J 2016; 92:471-7. [PMID: 27222587 DOI: 10.1136/postgradmedj-2016-133997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 04/24/2016] [Indexed: 12/20/2022]
Abstract
Gastric cancer is the third most common cause of cancer deaths in the world, prompting high-risk countries like South Korea and Japan to establish nationwide screening programmes. Helicobacter pylori is linked to the majority of gastric adenocarcinoma cases and to the vast majority of non-cardia gastric adenocarcinomas. Several studies have demonstrated the effectiveness of 'test-and-treat' programmes for H. pylori infection to prevent gastric cancer in high-risk populations. While this strategy has gained momentum, providers in low-risk developed countries may be unaware of the risk individual patients face, particularly those who have emigrated from high-risk regions and members of economically disadvantaged minority groups. Rapidly evolving science in recent years has made it difficult for clinicians to keep up with the current best practices. This article reviews the epidemiology of H. pylori and gastric cancer, screening and diagnostic tests and the current treatment regimens for clinicians.
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Affiliation(s)
- Heather S Laird-Fick
- Department of Medicine, Michigan State University, East Lansing, Michigan, USA Department of Medicine, EW Sparrow Hospital, Lansing, Michigan, USA
| | - Shivani Saini
- Department of Medicine, Michigan State University, East Lansing, Michigan, USA
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