Two in a Bed, does Helicobacter Pylori Spread?

Introduction: Drumm et al. first described intra-familial clustering of Helicobacter pylori (HP) infection (1). Vertical transmission has been inferred, whilst spread among siblings close in age has been suggested. Intra-familial dynamics, which result in transmission, are still unknown. Our aim was to establish whether sharing a bed or bedroom with an infected family member is a risk factor for HP infection during childhood.

Methods: The HP status of 282 children and parents was established either by endoscopy and antral biopsy or ¹³Carbon urea breath testing. Past and present sleeping arrangements between family members were established. All variables were entered into a multivariate analysis.

Results: The strongest predictor of HP infection was sharing a bed with an infected sibling at the age of three years (odds ratio 19.6 [95%CI 2.08 to 185.80], p<0.01). A child was at an increased risk of being infected if his/her mother or father was positive (odds ratio 5.03 [95%CI 1.74 to 14.52], p<0.01 and 3.55 [95%CI 1.13 to 11.19], p=0.03 respectively). The presence of overcrowding was associated with an increased risk of infection (odds ratio 2.94 [95%CI 1.10 to 7.88], p=0.03).

Conclusions: This study is the first to examine the relationship between intra-familial bed sharing and paediatric HP infection with knowledge of the HP status of all family members. We have provided evidence in support of horizontal transmission of HP between siblings at an early age.

References: 1. Drumm B, Perez-Perez GI, Blaser MJ, Sherman PM. Intrafamilial clustering of Helicobacter pylori infection. N.Engl.J Med 1990;322(6):359–63.