A survey on the current status of Helicobacter pylori infection in households in Hainan Province, China

Epidemiological status of family-based Helicobacter pylori infection in Yunnan Province, China

BACKGROUND

The status of family-based H. pylori infection in Yunnan Province is unknown. This study is the first family-based epidemiological survey of H. pylori in the province, aiming to provide new insights into the status of family-based H. pylori infections in Yunnan Province as well as in the country as a whole.

METHODS

Between 2021 and 2023, 1,176 families with 2,947 family members were tested for H. pylori in six cities in Yunnan Province with different geographic locations and economic status, to assess the status of H. pylori infection, and to clarify the related factors and modes of transmission by means of a questionnaire survey.

RESULTS

In Yunnan Province, the H. pylori infection rate was 31.46% (927/2947) in people and 54.59% (642/1176) in families.On the individual side, living outside of southern Yunnan (e.g., Central OR 1.41, 95% CI 1.10-1.81), having a family member living together for ≥ 1 year (OR 2.43, 95% CI 1.49-3.95), being ≥ 18 years old (e.g., 18-44 years old: OR 3.51, 95% CI 1.98-6.23), and gastrointestinal discomfort within the last 1 year (OR 1.25, 95% CI 1.04-1.50) were independent risk factors for H. pylori infection in the study population in Yunnan Province, whereas an education level of college/university and above (OR 0.62, 95% CI 0.48-0.79), and a gastroscopy within 5 years (OR 0.58, 95% CI 0.46-0.73) were independent protective factors for their H. pylori infection. In terms of family, living outside of southern Yunnan (e.g., Central OR 1.52, 95% CI 1.07-2.18), and having ≥ 3 people living together in the family (e.g., 3-4 people: OR 2.04, 95% CI 1.52-2.72) were independent risk factors for H. pylori infection in study families in Yunnan Province, whereas an annual household income of ≥ 100,000 ( OR 0.68, 95% CI 0.51-0.90), total household living area ≥ 60 m2 (OR 0.62, 95% CI 0.39-0.97), the use of separate meals for intra-household gatherings (OR 0.56, 95% CI 0.38-0.85), and the use of communal spoons and chopsticks (OR 0.38, 95% CI 0.28-0.52) were the independent protective factorse.

CONCLUSION

The risk factors of Family-Based H. pylori infection in Yunnan province were closely related to demographic characteristics, personal and family living habits. Close contact with infected family members may be the main cause of transmission. Family-based control of H. pylori infection should be regarded in clinical practice.

Occurrence of Helicobacter pylori in drinking water sources and antimicrobial resistance profile in the central region of Peru

Introduction

Contamination of drinking water by Helicobacter pylori can cause serious diseases, including cancer. The determinants of the infection rate are socioeconomic status, low standard of living and overcrowding. In addition, exposure to environmental sources contaminated with feces, such as water and vegetables, is another risk factor for infection. We analyzed the occurrence of H. pylori in drinking water sources and the antimicrobial resistance profile in central Peru.

Methods

Water samples were collected from taps in four provinces of the Junín region. Previously, biofilm sampling was performed from the internal surface of the taps. The samples were cultured on modified brain heart infusion blood agar at 37 °C under microaerophilic conditions for seven days. Antibiotic sensitivity of H. pylori was determined by the Kirby Bauer diffusion method.

Results

The results revealed that pH (9.25) and turbidity (5.15 NTU) exceeded the Peruvian environmental quality standards for drinking water. The amount of free chlorine residual in the H. pylori positive water samples ranged from 0.02 to 0.12 mg/L. H. pylori was present in 2/192 tap water samples (1.04 %) and in 3/192 tap biofilm samples (1.56 %). It was observed that 100 % of H. pylori isolates from water samples from the Chilca district showed resistance to nalidixic acid and 66.67 % to both amoxicillin and chloramphenicol. Resistance to nalidixic acid of H. pylori isolates obtained from biofilm samples from taps in the El Tambo district ranged from 66.67 % to 100 %.

Conclusion

The study findings reveal that water samples and tap biofilms in the Chilca, El Tambo and Huamancaca chico districts in the Junín region harbor H. pylori. They also reveal variability in the pattern of resistance to more than one antibiotic tested from one district to another.

Prevalence of Helicobacter pylori infection in China from 2014-2023: A systematic review and meta-analysis

BACKGROUND

Helicobacter pylori (H. pylori) stands as the predominant infectious agent linked to the onset of gastritis, peptic ulcer diseases, and gastric cancer (GC). Identified as the exclusive bacterial factor associated with the onset of GC, it is classified as a group 1 carcinogen by the World Health Organization. The elimination of H. pylori plays a crucial role in the primary prevention of GC. While the prevalence has declined in recent decades, H. pylori infection is still highly prevalent in China, accounting for a significant part of the disease burden of GC. Therefore, updated prevalence information for H. pylori infection, especially regional and demographic variations in China, is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H. pylori control.

AIM

To methodically evaluate the occurrence of H. pylori infection throughout China and establish a reference point for subsequent investigations.

METHODS

A systematic review and meta-analysis was conducted following established guidelines, as detailed in our methodology section.

RESULTS

Our review synthesized data from 152 studies, covering a sample of 763827 individuals, 314423 of whom were infected with H. pylori. We evaluated infection rates in mainland China and the combined prevalence of H. pylori was 42.8% (95%CI: 40.7-44.9). Subgroup analysis indicated the highest prevalence in Northwest China at 51.3% (95%CI: 45.6-56.9), and in Qinghai Province, the prevalence reached 60.2% (95%CI: 46.5-73.9). The urea breath test, which recorded the highest infection rate, showed a prevalence of 43.7% (95%CI: 41.4-46.0). No notable differences in infection rates were observed between genders. Notably, the prevalence among the elderly was significantly higher at 44.5% (95%CI: 41.9-47.1), compared to children, who showed a prevalence of 27.5% (95%CI: 19.58-34.7).

CONCLUSION

Between 2014 and 2023, the prevalence of H. pylori infection in China decreased to 42.8%, down from the previous decade. However, the infection rates vary considerably across different geographical areas, among various populations, and by detection methods employed.

The influence of Helicobacter pylori infection on acute coronary syndrome and lipid metabolism in the Chinese ethnicity

Background

Acute coronary syndrome (ACS) patients frequently present a relatively high prevalence of Helicobacter pylori (H. pylori) infection. H. pylori was previously hypothesized to induce ACS through the regulation of lipid levels. However, the risk of H. pylori-induced ACS varies significantly among different ethnic groups, and the associations between H. pylori and lipid parameters remain unclear. This study aimed to systematically assess the risk of ACS in Chinese populations with H. pylori infection while also evaluating the effects of H. pylori on lipid parameters.

Materials and methods

A hospital-based case-control study involving 280 participants was conducted. Immunoblotting was used for the detection and genotyping of H. pylori. The associations between H. pylori and ACS, as well as lipid parameters, were analyzed via the chi-square test and a multiple logistic regression model.

Results

H. pylori infection significantly increased the risk of ACS among all participants (adjusted odds ratio (OR) = 4.04, 95% confidence interval (CI): 1.76-9.25, P < 0.05), with no associations with virulence factors (cytotoxin-associated gene A (CagA) or vacuole toxin geneA (VacA)). Subgroup analysis revealed a significant increase in the risk of ACS among the elderly population aged 56-64 years with H. pylori infection. Additionally, a substantial association was observed between H. pylori and acute myocardial infarction (AMI). No significant differences were found in lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and the LDL/HDL ratio, between individuals positive and negative for H. pylori infection. Similar results were observed between the ACS group and the control group.

Conclusions

Our study has demonstrated for the first time that H. pylori does not significantly impact lipid metabolism but increases the risk of ACS fourfold in the Chinese population (OR = 4.04, 95% CI: 1.76-9.25). Furthermore, the virulence factors of H. pylori (CagA and VacA) may not be involved in the mechanisms by which they promote the development of ACS. This finding provides additional evidence for the association between H. pylori and ACS among different ethnic groups and refutes the biological mechanism by which H. pylori affects ACS through lipid metabolism regulation. Regular screening for H. pylori and eradication treatment in elderly individuals and those at high risk for ACS may be effective measures for reducing the incidence of ACS. Future research should include multicenter randomized controlled trials and explore host genetics and the effects of H. pylori on the gut microbiota as potential biological pathways linking H. pylori and ACS.

Association of Helicobacter pylori in Children With Self-Hand Hygiene, Maternal Hand Hygiene, Cooking, and Feeding Practices

Background and objective Helicobacter pylori infection is widely prevalent, but its route of transmission is not clear. Person-to-person transmission seems plausible, with hand hygiene being one of the many factors that play a role. The objective of this study was to study the effect of the children's and their mother's hand hygiene and feeding practices on the prevalence of H. pylori in children. Methodology This cross-sectional study involved 475 children and their mothers. A questionnaire was administered to mothers to gather information about maternal hygiene practices, specifically handwashing before food handling and after using the toilet. Additionally, both mothers and children underwent assessments for nail length (whether cut or uncut) and the presence or absence of dirt under their nails, if nails were uncut. The association of these parameters with H. pylori seropositivity in children was comprehensively examined. Furthermore, children were divided into two distinct groups: a younger age group (one month to two years and 11 months) and an older age group (three years to 15 years). For one specific parameter - the presence of dirt under mothers' nails (i.e., if nails were uncut) - the association was further analyzed separately within these age groups. The chi-square test was applied to all variables. P < 0.05 was considered significant Results The association of all variables with H. pylori seropositivity in children was tested. Association with H. pylori seropositivity was not present in mothers with uncut nails (P = 0.050315), mothers with uncut nails harboring dirt under their nails within the entire sample of 475 mothers (P = 0.39476), and mothers with uncut nails harboring dirt under their nails in the older age group (three years to 15 years) of children (P = 0.760071). Association with H. pylori seropositivity was present in mothers with dirt under their uncut nails belonging to the younger age group of children (one month to two years and 11 months (P = 0.014127) and mothers who did not wash their hands before food handling (P = 0.003032) and after using the toilet (P = 0.003082). In all 475 children, association with H. pylori seropositivity was significant with dirt under the uncut nails of children (P = 0.015194) and was not significant for children with merely grown nails but not harboring dirt under them (P = 0.355967).  Conclusions Mother-to-child transmission is one of the likely routes of transmission of H. pylori, and poor hand hygiene seems to play a major role in this process.