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Intrafamilial clustering of Helicobacter pylori infection
B Drumm1, G I Perez-Perez, M J Blaser
1Department of Pediatrics, Hospital for Sick Children, University of Toronto, Canada.
Insights
Helicobacter pylori (H. pylori) infection is common in children with gastritis. H. pylori-specific IgG antibodies indicate colonization, and intrafamilial spread suggests person-to-person transmission.
Area of Science:
- Gastroenterology
- Microbiology
- Pediatrics
Background:
- Helicobacter pylori (H. pylori) is linked to primary gastritis.
- Gastric antrum colonization by H. pylori is a key factor.
Purpose of the Study:
- Determine H. pylori colonization frequency in children with upper GI symptoms.
- Assess H. pylori IgG antibody levels in children and families.
- Investigate H. pylori infection patterns within families.
Main Methods:
- Gastric antrum biopsy analysis (silver staining, culture) in 93 children.
- Enzyme-linked immunosorbent assay (ELISA) for H. pylori IgG antibodies.
- Comparison of antibody levels in children, parents, and siblings.
Main Results:
- H. pylori identified in 24/27 children with unexplained gastritis.
- 96% of these children had H. pylori-specific IgG antibodies.
- Significant H. pylori antibody prevalence in parents (25/34) and siblings (18/22) of colonized children compared to controls.
Conclusions:
- H. pylori-specific IgG antibodies correlate with gastric antrum colonization.
- Intrafamilial clustering suggests person-to-person H. pylori transmission.
- H. pylori infection is prevalent in pediatric gastritis cases.
Abstract:
Colonization of the gastric antrum by Helicobacter pylori (formerly Campylobacter pylori) has been associated with primary gastritis. We determined the frequency of colonization by H. pylori in gastric-antrum biopsy specimens from 93 children undergoing gastroscopy for the evaluation of upper gastrointestinal symptoms. We also determined H. pylori IgG antibody levels by enzyme-linked immunosorbent assay in coded serum samples from these children, family members, and control subjects of comparable ages. Among 27 children with primary, or unexplained, gastritis, H. pylori was identified by silver staining in 24 biopsy specimens and by culture in 22; specific antibodies were present in 23 children (96 percent). Three children with unexplained gastritis had no evidence of H. pylori in the antrum, nor did any of 13 children with secondary gastritis or any of 53 children with normal antral histologic features; specific antibodies were present in only 1 of these 69 children. H. pylori antibody was detected in 25 of 34 parents of colonized children, but in only 8 of 33 parents of noncolonized children (P less than 0.001). Of 22 siblings of children colonized by H. pylori, 18 had specific antibodies, as compared with only 5 of 37 controls (P less than 0.001). We conclude that H. pylori-specific IgG antibodies are associated with bacterial colonization of the gastric antrum by this organism. The intrafamilial clustering of H. pylori infection suggests that there may be person-to-person spread of these bacteria.