caa a22 4500 445797282 CHVBK 20180317145129.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10620-010-1309-z doi (NATIONALLICENCE)springer-10.1007/s10620-010-1309-z Effect of Helicobacter pylori Infection on Symptoms of Gastroenteritis Due to Enteropathogenic Escherichia coli in Adults [Elektronische Daten] [Alicia Chang, Thomas Haggerty, Catherine de Martel, Cynthia Leung, Julie Parsonnet] Background: Helicobacter pylori can cause hypochlorhydria in some hosts and predispose to diarrheal infections. Aims: We tested the hypothesis that chronic H.pylori infection increases the risk of diarrheal illness due to an acid-sensitive organism: enteropathogenic Escherichia coli (EPEC). Methods: After testing healthy adult volunteers for H.pylori, 19 infected and 26 uninfected subjects had gastric pH probes placed and were given 5-10×109 EPEC organisms; six had previously received a proton pump inhibitor. We measured diarrhea and created a composite gastroenteritis severity score based on symptoms in the 48h following exposure. Outcomes were compared using logistic regression and analysis of covariance. Results: More H.pylori-infected (36.8%) than H.pylori-uninfected subjects (7.7%) were hypochlorhydric (P=0.02). Six (31.6%) H.pylori-infected and five H.pylori-uninfected subjects (19.2%) developed diarrhea (P=0.34). Hypochlorhydria was a strong risk factor for diarrhea [odds ratio (OR) 6.25, confidence interval (CI): 1.29-30.35]. After adjusting for hypochlorhydria and EPEC dose, H.pylori was not associated with diarrhea (OR 0.89, CI: 0.17-4.58). Among those with symptoms, H.pylori-infected subjects had lower gastroenteritis severity score than did H.pylori-uninfected subjects (2.6, CI: 1.9-3.4 versus 1.5, CI: 1.1-1.9, P=0.01), particularly if they were also hypochlorhydric (3.8, CI: 2.3-5.3 versus 1.9, CI: 1.3-2.5, P=0.02). Conclusions: In adults, H.pylori infection was associated with hypochlorhydria but had no detectable effect on occurrence of diarrhea. Among symptomatic subjects, H.pylori infection decreased severity of gastroenteritis. Springer Science+Business Media, LLC, 2010 Helicobacter pylori nationallicence Hypochlorhydria nationallicence Gastroenteritis nationallicence Enteropathogenic Escherichia coli nationallicence Diarrhea nationallicence Interaction nationallicence Chang Alicia Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut Haggerty Thomas Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut de Martel Catherine Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut Leung Cynthia Division of Epidemiology, Department of Health Research and Policy, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut Parsonnet Julie Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 457-464 0163-2116 56:2<457 2011 56 10620 https://doi.org/10.1007/s10620-010-1309-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1309-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chang Alicia Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Haggerty Thomas Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- de Martel Catherine Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Leung Cynthia Division of Epidemiology, Department of Health Research and Policy, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Parsonnet Julie Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, 300 Pasteur Drive, Grant Bldg S-131, 94305, Stanford, CA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 457-464 0163-2116 56:2<457 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer