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Published on: May 23, 2025
Detection rate of Helicobacter pylori stool antigen in newborn infants and small children
Arne Stray-Pedersen1, Peter Gaustad, Babill Stray-Pedersen
1Institute of Forensic Medicine, University of Oslo, Norway. arne.stray-pedersen@labmed.uio.no
Insights
Helicobacter pylori (H. pylori) antigen was found in over half of Norwegian neonates, suggesting transient colonization. Detection rates decreased significantly in older infants and children.
Area of Science:
- Microbiology
- Pediatrics
- Gastroenterology
Background:
- Helicobacter pylori infection is a significant global health concern.
- Understanding H. pylori transmission and colonization in early life is crucial for public health.
- Previous studies have focused less on neonatal H. pylori prevalence.
Purpose of the Study:
- To determine the prevalence of H. pylori antigen in stool samples from Norwegian neonates and young children.
- To explore potential associations between H. pylori antigen detection and factors like age and mode of delivery.
Main Methods:
- Stool samples were collected from 249 children aged 0 days to 3 years.
- H. pylori stool antigen test (HpSA) immunoassay was used for detection.
- Polymerase chain reaction (PCR) targeting the 16S rDNA Helicobacter gene was employed for verification.
Main Results:
- H. pylori antigen was detected in 52% of neonates, 15% of infants (7 days-1 month), and 5% of children (1 month-3 years).
- Neonatal H. pylori detection was significantly higher in those born via uncomplicated vaginal birth (59%) compared to Cesarean section (10%).
- PCR confirmed H. pylori or related species in 35% of HpSA-positive samples.
Conclusions:
- The high H. pylori antigen prevalence in neonates is unexpected and suggests transient neonatal colonization.
- Lower H. pylori antigen detection rates in older children align with existing data from Western countries.
- Further research is warranted to understand the implications of neonatal H. pylori colonization.
Aims:
To investigate the prevalence of H. pylori antigen in the stools of Norwegian neonates and small children.
Methods:
A total of 249 children aged 0 days-3 years were tested for the presence of H. pylori antigen in feces using the HpSA immunoassay. For verification purposes, a selection of samples were analyzed with PCR targeting the 16 S rDNA Helicobacter gene.
Results:
H. pylori antigen in stool was detected in 52% (36/69) of the neonates, in 15% (7/46) of infants aged 7 days-1 month, and in 5% (7/134) of children aged 1 month-3 years. In neonates, H. pylori antigen detection was significantly associated with mode of delivery: 59% (30/51) with uncomplicated vaginal births were HpSA positive compared to only 10% (1/10) of infants delivered by cesarean section (P=0.02). Positive PCR results were found in 35% (9/26) of HpSA positive samples. Sequencing of PCR products revealed 97-100% homology with gene sequences from both H. pylori and other Helicobacter species.
Conclusions:
The low H. pylori antigen detection rate in children >1 month of age is in accordance with previous prevalence studies from Western countries. The unexpected finding of a high H. pylori antigen detection rate in neonates suggests that transient colonization may occur in the neonatal period.
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