Oral H. pylori Prevalence in Intellectually/Developmentally Disabled Adults

智力/发育障碍成人中口腔幽门螺杆菌的患病率

• 批准号: 7645788
• 负责人: CATHERINE J BINKLEY
• 金额: $ 18.5万
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7645788
• 关键词: Accounting; Address; Adult; Aftercare; Antibiotic Therapy; Antibiotics; Bacteria; Biological Assay; Breath Tests; Caregivers; Caring; Cessation of life; Clinical Research; Clinical Trials; Data; Dental Clinics; Dental Hygiene; Dental Plaque; Dental Plaque Index; Dental caries; Development; Disabled Persons; Disadvantaged; Disease; Duodenal Ulcer; Environment; Epidemiologic Studies; Etiology; Exploratory/Developmental Grant; Foundations; Frequencies; Future; Gastric Adenocarcinoma; Gastroesophageal reflux disease; General Population; Genotype; Goals; Habits; Health Policy; Health Status; Healthcare; Healthy People 2010; Helicobacter Infections; Helicobacter pylori; Incidence; Individual; Infection; Intervention; Intestinal Diseases; Knowledge; Malignant Neoplasms; Morbidity - disease rate; Nested PCR; Oral; Oral Examination; Oral Hygiene Index; Oral cavity; Oral health; Patients; Pattern; Periodontal Diseases; Play; Polymerase Chain Reaction; Population; Prevalence; Preventive; Protocols documentation; Pylorus; Quality of life; Recurrence; Reporting; Research; Resistance; Risk; Risk Factors; Role; Route; Sampling; Site; Stomach; Stomach Diseases; Surgeon; Testing; Tooth structure; United States; Urea; Vulnerable Populations; developmentally disabled; experience; genetic strain; health disparity; improved; malignant stomach neoplasm; medically necessary care; mortality; oral care; oral infection; oral status

DESCRIPTION (provided by applicant): Helicobacter pylori (H. pylori) bacteria play a significant role in the etiology of gastric and duodenal ulcers, gastro-esophageal reflux disease and gastric adenocarcinoma. Intellectually disabled/developmentally disabled (ID/DD) adults are reported to have H. pylori infection at approximately twice the rate of the general population and experience recurrence at a seven-fold higher rate, contributing to increased mortality due to gastric cancer. The oral cavity may serve as a reservoir for H. pylori and subsequently contribute to the recurrence of gastric infection. Numerous studies have identified H. pylori in dental plaque, an environment that is relatively resistant to systemic antibiotics. Systemic antibiotics are used to treat H. pylori infections but do not appear to eradicate H. pylori in the mouth. The oral status of ID/DD adults is reported to be poor due to inadequate oral hygiene, leading to increased plaque, caries and periodontal disease. Furthermore, poor oral status (periodontal disease) has been associated with H. pylori seropositivity. While ID/DD adults have elevated rates of H. pylori gastric infections, nothing is known about the prevalence of H. pylori in their oral cavities. The proposed exploratory research will address the following questions in this disadvantaged population: 1) What is the prevalence of H. pylori in the dental plaque in ID/DD adults? 2) Is poor oral status associated with H. pylori gastric infection? and 3) Does H. pylori persist in the dental plaque of ID/DD adults after systemic antibiotic treatment, and if so, is it associated with recurrence of gastric infection? This epidemiological study of 112 institutionalized ID/DD and 112 control subjects will involve oral examinations, indices, dental plaque sampling, and C13 Urea Breath Tests at baseline to determine prevalence. Nested Polymerase Chain Reaction (PCR) analyses will be used to detect H. pylori in the dental plaque. For those ID/DD subjects who have a positive gastric H. pylori test at baseline, repeated oral sampling and gastric tests will be performed over 1 year to determine persistence. If poor oral health status and oral H. pylori prevalence are correlated with gastric H. pylori infections, a future pilot clinical trial will be conducted to investigate the concordance between genetic strains of H. pylori in the mouth and stomach, the effect of various interventions on oral health, oral H. pylori prevalence, and H. pylori gastric infections in ID/DD adults. The proposed research responds to the Surgeon General's National Call to Action to conduct studies to elucidate underlying mechanisms and determine any causal associations between oral infections and systemic conditions. The proposed research also addresses the need to reduce health disparities, improve quality of life, and reduce morbidity and mortality in vulnerable populations. Project Narrative: Helicobacter pylori infections are a significant cause of morbidity in institutionalized intellectually and developmentally disabled (ID/DD) persons in the United States. There is reason to investigate whether there is an association between oral health and H. pylori infection and recurrence of H. pylori infection in ID/DD individuals. The proposed study would provide pilot data for a clinical trial and add to the knowledge concerning oral status and H. pylori infection. Our results may demonstrate that professional oral care is medically necessary for the reduction of morbidity and mortality caused by H. pylori infection in ID/DD persons. This research is consistent with the Healthy People 2010 overarching goal of eliminating health disparities. It is also consistent with the Surgeon General's National Call to Action to determine oral health care needs, refine protocols of care for special needs patients, and to conduct studies to determine associations between oral infections and systemic conditions.

描述（由申请人提供）：幽门螺杆菌（H. pylori）细菌在胃和十二指肠溃疡、胃食管反流病和胃腺癌的病因学中起重要作用。据报道，智力残疾/发育残疾（ID/DD）成人患有H。幽门螺杆菌感染率约为一般人群的两倍，复发率高出7倍，导致胃癌死亡率增加。口腔可作为H的储存库。幽门螺杆菌，并随后有助于复发的胃感染。许多研究已经确定了H。幽门螺杆菌在牙菌斑，一个环境，是相对耐全身抗生素。全身抗生素用于治疗H。pylori感染，但似乎不能根除H.口腔中的幽门螺杆菌据报道，ID/DD成人的口腔状况很差，因为口腔卫生不佳，导致牙菌斑、龋齿和牙周病增加。此外，不良的口腔状况（牙周病）与H。幽门螺杆菌血清阳性。而ID/DD成人的H. pylori胃感染，对H.幽门螺旋杆菌的感染。本研究拟探讨以下问题：1）H。在ID/DD成人牙菌斑中的幽门螺杆菌？2)口腔状况差与H。幽门螺杆菌胃感染？（3）H.幽门螺杆菌在全身抗生素治疗后仍存在于ID/DD成人的牙菌斑中，如果是这样，它是否与胃感染复发有关？本流行病学研究纳入112名住院ID/DD受试者和112名对照受试者，包括口腔检查、指数、牙菌斑采样和基线C13尿素呼气试验，以确定患病率。巢式聚合酶链反应（PCR）分析将用于检测H。牙菌斑中的幽门螺杆菌。对于胃H阳性的ID/DD受试者。将在1年内进行基线幽门螺杆菌试验、重复口腔采样和胃部试验，以确定持续性。如果口腔健康状况不佳，口腔H。pylori感染率与胃H. pylori感染，未来的试点临床试验将进行调查之间的一致性遗传菌株的H。幽门螺杆菌在口腔和胃中的作用，各种干预措施对口腔健康的影响，口腔H。pylori感染率和H. ID/DD成人中的幽门螺杆菌胃感染。拟议的研究响应了卫生部长的国家行动呼吁，进行研究，以阐明潜在的机制，并确定口腔感染和全身性疾病之间的任何因果关系。拟议的研究还涉及减少健康差距、提高生活质量和降低弱势群体发病率和死亡率的需要。项目叙述：在美国，幽门螺杆菌感染是制度化智力和发育残疾（ID/DD）患者发病的重要原因。有理由调查口腔健康与H。pylori感染与H. ID/DD个体中的pylori感染。这项研究将为临床试验提供初步数据，并增加有关口腔状况和H。幽门感染我们的研究结果可能表明，专业的口腔护理是必要的医疗减少的发病率和死亡率由H。ID/DD患者的幽门螺杆菌感染。这项研究符合2010年健康人消除健康差距的总体目标。它也符合卫生部长的国家行动呼吁，以确定口腔保健需求，完善特殊需要患者的护理协议，并进行研究，以确定口腔感染和全身性疾病之间的关联。