[Helicobacter pylori infections: familial clustering and transmission].

Background: The importance of Helicobacter pylori for the development of gastritis and gastro-duodenal ulceration is generally accepted. The objective of the presented work was to find out whether its transmission is involved in families of children examined on account of upper dyspeptic syndrome. Aggregation and transmission of Helicobacter pylori infection were not described so far in the Czech Republic.

Methods And Results: The authors examined IgG antibodies (ELISA) against Helicobacter pylori in 411 subjects incl. 102 children with non-ulcerative or ulcerative dyspepsia and in 115 children of similar age but without gastrointestinal complaints and in 194 family members of children with dyspepsia. The specificity of the ELISA test is 97.1% and the sensitivity 92.1% (discrimination analysis). Children with dyspepsia had more frequently a positive finding of IgG antibodies against H. pylori (p = 0.0001), as compared with the control group of children of the same age but without dyspepsia. A statistically significant source of infection with H. pylori for dyspeptic children was the mother (p = 0.0006) and both parents (p = 0.0069), who were also a source of infection for other family members (p = 0.0003 and 0.0084). The most frequent positive IgG finding was in fathers (76.7%), but the father was not a statistically significant source of infection for the examined children (p = 0.6120) nor for other members of the family (p = 0.2330). IgG positive mothers had 85.2% positive husbands, IgG negative mothers had 68.4% positive husbands (p = 0.1601). The frequency of IgG antibodies in the mother and father (in couples) was thus statistically independent. However, there was a significant correlation (p = 0.01) of (P/N) IgG antibodies in couples--i.e. father and mother of the examined children. Siblings of IgG positive children had a significantly higher mean value of antibodies (p = 0.05) and were older.

Conclusions: The presented facts provide evidence that in the investigated group the Helicobacter pylori infection is more frequent in children with the upper dyspeptic syndrome than in children of similar age without gastrointestinal complaints. In families of children with dyspepsia the infection aggregates and is transmitted. The mother and both parents are involved in the transmission to children. Nevertheless it is probable that there is also mutual transmission in children and from adults to children outside the family and in another environment.