Total Family Unit Helicobacter Pylori Eradication and Paediatric Re-Infection

Introduction: Helicobacter pylori (HP) re-infection occurs more frequently in children than in adults, e.g. 5.4% vs. 0.36% per patient per year (1;2). We investigated whether eradication of HP from family members reduces the risk of childhood re-infection.

Methods: Fifty families, each with an HP infected paediatric index case (mean age 9.48 years, SD=3.01), were recruited. A ¹³Carbon urea breath test (UBT) was performed on family members in the same house as the index case. Each family unit was randomised into a 'treatment' (all infected family members treated) or a 'non-treatment' (index case only treated) group.

Results: At long term UBT (mean 62.2 months, SD 30.6) there were 3 re-infected children in the non-treatment group compared with 1 in the treatment group. The re-infection rate was 2.4% per patient per year in the non-treatment group and 0.7% per patient per year in the treatment group. Re-infection was 3.4 times more likely in the non-treatment group (p=0.313).

Conclusions: This study is the first to evaluate total family unit HP eradication on paediatric re-infection rates and reports the longest period of follow up in children. We have reported the lowest long-term paediatric HP re-infection rate in a group of children where all HP was eradicated from the family unit.

References: (1) Rowland M, Kumar D, Daly L et al. Low rates of Helicobacter pylori reinfection in children. Gastroenterology 1999;117(2):336–41.

(2) Borody TJ, Andrews P, Mancuso N et al. Helicobacter pylori reinfection rate, in patients with cured duodenal ulcer. Am J Gastroenterol 1994;89(4):529–32.