幽门螺杆菌感染途径的探讨  

Studies on the route of Helicobacter pylori infection

作　　者：田一玲[1] 蒋任举[1] 杨致邦[1] 

机构地区：[1]重庆医科大学病原生物学教研室,重庆400016

出　　处：《中国病原生物学杂志》2009年第4期266-267,295,共3页Journal of Pathogen Biology

摘　　要：目的检测幽门螺杆菌(Helicobacter pylori,Hp)感染慢性胃炎、消化性溃疡和胃癌患者的粪便是否存在活的Hp,以探讨Hp的传播途径。方法收集60例胃粘膜快速尿素酶试验强阳性患者的胃粘膜和新鲜粪便,进行Hp的分离培养和PCR检测。结果52份胃粘膜标本分离到Hp,阳性率86.7%;6份粪便标本分离到Hp,阳性率10.0%,其中4份来自慢性胃炎患者,2份来自消化性溃疡患者。粪便培养阳性的患者胃粘膜培养均阳性;PCR检测同一患者两种标本分离菌株的细胞毒素相关蛋白基因(CagA)和空泡毒素信号序列s1a基因(VacA s1a)一致,其中4株为CagA+和VacA s1a+,另2株VacA s1a+和尿素酶A亚单位(UreA)基因阳性。结论Hp感染者的粪便中有活的Hp存在,该菌可能通过粪-口途径传播。Objective To study the possibility of the fecal-oral route in the transmission of Helicobacter pylori, this study attempted to isolate H. pylori from stool specimens of patients infected with H. pylori with chronic gastritis, gastric and duodenal ulceration and gastric carcinoma. Methods Fresh fecal samples and gastric biopsy specimens were ob- tained from 60 patients with a strongly positive rapid urease in gastric biopsy specimens. The feces being processed by concentration and gastric biopsy specimens were respectively inoculated onto H. pylori selective growth media. The isolates of H. pylori were analyzed using polymerase chain reaction to confirm the genotypie identity. Results H. pylori strains were isolated from 52 gastric biopsy specimens, and the positive rate was 86.7%. H. pylori strains were isolated from 6 fecal samples, and the positive rate was 10.0 %. Among the 6 fecal samples, 4 were from the patients with chronic gastritis, and the other 2 were from patients with gastric and duodenal ulceration. Patients whose fecal samples were posi- tive for H. pylori also tested positive for H. pylori in their gastric biopsy specimens. The same cytotoxin-associated protein （CagA） gene and vacuolating cytotoxin signal sequence sla （VacA sla） gene were observed in the strains isolated from gastric biopsy specimens and from fecal samples in one patient, and 4 strains were CagA^＋ and VacA sla^＋ while the other 2 strains were VacA sla^＋ and UreA^＋. Conclusion H. pylori could be isolated from the feces of patients infected by H. pylori, and transmission via the fecal-oral route is feasible.

关 键 词：幽门螺杆菌 粪-口传播 粪便 分离培养 

分 类 号：R378.99[医药卫生—病原生物学]