Isolation of Helicobacter pylori from vomitus in children and its implication in gastro-oral transmission

OBJECTIVE: The route of transmission of Helicobacter pylori (H. pylori) is unclear. Castro-oral transmission via contaminated vomitus has been propose d as an important mode of transmitting H. pylori, especially in children. T his pilot study attempted to isolate H. pylori from the vomitus of children . METHODS: Children presenting for evaluation with gastroenteritis-associated vomiting were studied. Fresh vomitus samples were collected for detection of H. pylori by bacteriological culture and polymerase chain reaction (PCR) . A rapid, whole blood test was used to determine the H. pylori status of p atients. RESULTS: A total of 18 children with mean age of 6 yr were studied; four ha d a positive serology test. Among these four children, H. pylori was isolat ed from vomitus by culture in one child and by PCR in two. An 18-month-old girl with negative serology had H. pylori detected in vomitus by PCR. Six m onths later, she had seroconversion confirmed, suggesting that she had an a cute H. pylori infection on initial presentation. CONCLUSIONS: This is the first study reporting successful isolation of H. p ylori from naturally produced vomitus. The result implies that transmission of H. pylori infection by vomitus, especially in children, is possible. (C ) 1999 by Am. Cell. of Gastroenterology.