Acquisition of Helicobacter pylori infection after outbreaks of gastroenteritis: prospective cohort survey in institutionalised young people

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Abstract
Our study took place in a French institution for neurologically handicapped children and adolescents. The young people had been institutionalised for several years and resided across five housing sections (A to E). We included all 112 residents in May 2001. H pylori infection present at the outset of the study was detected by using the non-invasive HpSA stool antigen test (Meridian; 91% sensitivity and 93% specificity).4 Stool samples were stored and transported at 4°C within 48 hours and then frozen. The residents were monitored for one year. Events and clinical data were recorded daily by nurses. Gastroenteritis was defined as a sudden outbreak of liquid stools in more than two residents concurrently. For each patient with H pylori infection, we defined one day of potentially infective diarrhoea or vomiting as that when at least one liquid stool or vomitus was emitted. Stool samples were collected every week for each resident who was free of infection at the study outset, and at the end of the study we compared the last sample with the first sample. When conversion was observed, we identified the oldest positive stool sample collected from that patient during follow up.