Fecal and oral shedding of Helicobacter pylori from healthy infected adults
Fecal and oral shedding of Helicobacter pylori from healthy infected adults
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DOI：
10.1001/jama.282.23.2240
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发表时间：
1999-12-15
影响因子：
120.7
通讯作者：
Haggerty, T
中科院分区：
文献类型：
--
作者：
Parsonnet, J;Shmuely, H;Haggerty, T
幽门螺杆菌通常感染人类;但是，在此情况下，目的确定幽门螺杆菌（H pylori）的主要宿主--人类是如何将其传播到环境中的设计对照临床实验研究从1998年2月至12月在北方加州的一家医院的临床研究单位进行患者16名无症状的H pylori感染者和10名未感染的成年人干预（磷酸钠）和催吐剂（吐根）给予所有感染的受试者和催吐剂给予1个未感染的subject.Main Outcome Measure确认幽门螺杆菌分离培养的粪便，空气，或唾液之前和之后的泻药和呕吐和呕吐期间的呕吐物。使用重复的基因外回文（REP）聚合酶链反应和物种的身份进行了指纹图谱的分离确认，通过测序的16 s核糖体RNA基因。结果所有呕吐物样本感染的受试者生长幽门螺杆菌，往往在高数量。16例受试者中有6例（37.5%）在呕吐期间采集的空气中生长出幽门螺杆菌。呕吐前和呕吐后的唾液中分别有3例（18.8%）和9例（56.3%）生长少量幽门螺杆菌。无正常粪便，101例诱导粪便中仅22例（21.8%）生长微生物，尽管14例受试者中有7例（50.0%）至少有1次阳性培养（2份粪便培养样本被真菌污染，未纳入）。受试者体内分离株的指纹彼此相同，但受试者之间存在差异。没有未感染受试者的样本产生Hpylori.Conclusions幽门螺杆菌可以培养均匀的呕吐物，偶尔，从唾液和泻药粪便。在胃肠道疾病发作期间，特别是呕吐期间，该微生物可能会传播。
Context Helicobacter pylori commonly infects humans; however, its mode of transmission remains unknown.Objective To determine how humans-the primary host for H pylori-shed the organism into the environment.Design Controlled clinical experimental study conducted from February through December 1998.Setting Clinical research unit of a hospital in northern California.Patients Sixteen asymptomatic H pylori-infected and 10 uninfected adults.Intervention A cathartic (sodium phosphate) and an emetic (ipecac) were given to all infected subjects and an emetic was given to 1 uninfected subject.Main Outcome Measure Confirmed H pylori isolates cultured from stool, air, or saliva before and after catharsis and emesis and from vomitus during emesis. Isolates were fingerprinted using repetitive extragenic palindromic (REP) polymerase chain reaction and species identity was confirmed by sequencing the 16s ribosomal RNA gene.Results All vomitus samples from infected subjects grew H pylori, often in high quantities. Air sampled during vomiting grew H pylori from 6 (37.5%) of the 16 subjects. Saliva before and after emesis grew low quantities of H pylori in 3 (18.8%) and 9 (56.3%) subjects, respectively. No normal stools and only 22 (21.8%) of 101 induced stools grew the organism, although 7 (50.0%) of 14 subjects had at least 1 positive culture (2 stool culture samples were contaminated by fungus and were not included). Fingerprints of isolates within subjects were identical to one another but differed among subjects. No samples from uninfected subjects yielded H pylori.Conclusions Helicobacter pylori can be cultivated uniformly from vomitus and, occasionally, from saliva and cathartic stools. The organism is potentially transmissible during episodes of gastrointestinal tract illness, particularly with vomiting.