Helicobacter pylori reinfection with identical organisms: transmission by the patients' spouses.
Open Access
- 1 June 1995
- Vol. 36 (6) , 831-833
- https://doi.org/10.1136/gut.36.6.831
Abstract
Reinfection with Helicobacter pylori after eradication is responsible for the recurrence of duodenal ulcer disease. The mode of transmission has not yet been established. In this study, 18 patients with chronic duodenal ulcers in whom H pylori had been eradicated with amoxicillin and metronidazole were entered into a prospective follow up study. Control endoscopies were performed 4, 8, 14, 27, and 43 months after starting treatment and the results of direct tests were compared with the kinetics of H pylori specific IgG titres. After eradication there was a noticeable and consistent fall in anti-H pylori IgG, while reinfections were characterised by a significant increase in specific titres. Reinfection was detected in two patients after 14 and 43 months, respectively. The H pylori strains responsible for these reinfections, the corresponding pretreatment isolates, and the strains isolated from the spouses of these patients were examined by polymerase chain reaction based DNA fingerprinting. Analysis showed that reinfection had been caused by the same H pylori strain and identified the spouses of these patients as carriers of the identical strain. Considering the genomic diversity and the interpatient heterogeneity of H pylori these results suggest a person to person transmission of H pylori reinfection. By the end of the observation period reflux oesophagitis had developed in 10 of the 16 patients who had not been reinfected. This surprising finding may be explained by the changed eating habits of patients after healing of duodenal ulcer disease.Keywords
This publication has 11 references indexed in Scilit:
- Single and Multiple Strain Colonization in Patients with Helicobacter pylori Associated Gastritis: Detection by Macrorestriction DNA AnalysisThe Journal of Infectious Diseases, 1994
- Helicobacter pylori: comparison of DNA fingerprints provides evidence for intrafamilial infection.Gut, 1993
- Effect of Ranitidine and Amoxicillin plus Metronidazole on the Eradication of Helicobacter pylori and the Recurrence of Duodenal UlcerNew England Journal of Medicine, 1993
- Eighteen month follow up of Helicobacter pylori positive children treated with amoxycillin and tinidazole.Gut, 1992
- Helicobacter pylori reinfection 4 years post-eradicationThe Lancet, 1992
- Symptoms and risk factors of Helicobacter pylori infection in a cohort of epidemiologistsGastroenterology, 1992
- DNA diversity among clinical isolates ofHelicobacter pyloridetected by PCR-based RAPD fingerprintingNucleic Acids Research, 1992
- Duodenal Ulcer and Eradication ofHelicobacter pyloriin a Developing Country An 18-Month Follow-up StudyScandinavian Journal of Gastroenterology, 1992
- Intrafamilial Clustering ofHelicobacter pyloriInfectionNew England Journal of Medicine, 1990
- Recurrence of duodenal ulcer and Campylobacter pylori infection after eradicationThe Medical Journal of Australia, 1989