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. 2020 Feb;25(1):e12668.
doi: 10.1111/hel.12668. Epub 2019 Nov 13.

Clostridium difficile-associated disease and Helicobacter pylori seroprevalence: A case-control study

Khitam Muhsen  1 , Wasef Na'amnih  1   2 , Amos Adler  1   3 , Yehuda Carmeli  4   5 , Dani Cohen  1
Affiliations

Clostridium difficile-associated disease and Helicobacter pylori seroprevalence: A case-control study

Khitam Muhsen et al. Helicobacter. 2020 Feb.

Abstract

Background: Helicobacter pylori inhabits the stomach and causes persistent inflammation, with changes in gastric acidity. However, it is unclear whether the presence of H pylori plays a role in Clostridium difficile-associated disease (CDAD). The study's aim was to examine relationships of H pylori seroprevalence and serum pepsinogens (PGs), as markers of gastric inflammation, with CDAD.

Materials and methods: A case-control study was conducted among 49 CDAD cases and 54 controls (median age 82 years). Using enzyme-linked immunosorbent assays, sera were tested for H pylori IgG antibody, and PGI and PGII levels. Helicobacter pylori-positive samples were tested for IgG antibody to recombinant cytotoxin-associated gene A (CagA) virulent protein. Logistic regression models were fitted.

Results: Cases and controls were comparable in age (P = .5) and sex distribution (females 62% vs 57%, P = .6). Helicobacter pylori IgG seroprevalence was 47%, of whom 23% were CagA seropositives. Among cases compared to controls, 43% vs 28% were H pylori seropositive but lacking CagA IgG antibody: adjusted odd ratio (OR) 3.43 (95% confidence intervals [CI] 1.29-9.10); 18% vs 4% were positive for CagA phenotype: adjusted OR 9.32 (95% CI 1.61-53.76). This association was not affected by PG levels.

Conclusions: Helicobacter pylori infection, especially with CagA virulent phenotype, might predispose to C difficile infection in elderly patients.

Keywords: Clostridium difficile; Helicobacter pylori; case-control; cytotoxin-associated gene A; immunoglobulin G.

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References

REFERENCES

    1. McCollum DL, Rodriguez JM. Detection, treatment, and prevention of Clostridium difficile infection. Clin Gastroenterol Hepatol. 2012;10:581-592.
    1. Elliott B, Chang BJ, Golledge CL, Riley TV. Clostridium difficile-associated diarrhoea. Intern Med J. 2007;37:561-568.
    1. Gao T, He B, Pan Y, et al. Association of Clostridium difficile infection in hospital mortality: a systematic review and meta-analysis. Am J Infect Control. 2015;43:1316-1320.
    1. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372:825-834.
    1. Kuntz JL, Chrischilles EA, Pendergast JF, Herwaldt LA, Polgreen PM. Incidence of and risk factors for community-associated Clostridium difficile infection: a nested case-control study. BMC Infect Dis. 2011;11:194.

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