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Sakaguchi, Takuki, Takaaki Sugihara, Ken Ohnita, Daisuke Fukuda, Tetsuro Honda, Ryohei Ogihara, Hiroki Kurumi, Kazuo Yashima, and Hajime Isomoto. "Pyloric Incompetence Associated with Helicobactor pylori Infection and Correlated to the Severity of Atrophic Gastritis." Diagnostics 12, no. 3 (February 23, 2022): 572. http://dx.doi.org/10.3390/diagnostics12030572.
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Duodenogastric reflux (DGR) causes bile reflux gastritis (BRG) and may develop into gastric cancer. DGR is classified as primary in non-operated stomachs or secondary to surgical intervention. Primary DGR and Helicobacter pylori (H. pylori) infection are reportedly related. However, the mechanism is not fully understood. This study aimed to elucidate the relationship between H. pylori infection and pyloric incompetence in a non-operated stomach. A total of 502 non-operated participants who underwent an upper intestinal endoscopy were prospectively enrolled. Endoscopic findings (EAC, endoscopic atrophy classification; nodular gastritis; xanthoma; fundic gland polyp; and incompetence of pylorus), sex, age, gastrin, pepsinogen (PG) I and PG II levels were evaluated. PG I/PG II ratio, anti-H. pylori-Ab positivity, and atrophic gastritis status were significantly different between the normal and incompetent pylori (p = 0.043, <0.001, and 0.001, respectively). Open-type atrophic gastritis was significantly higher in the incompetent pylori. Incompetence of the pylorus and EAC were moderately correlated (Cramer’s V = 0.25). Multivariate analysis revealed that the presence of anti-H. pylori-Ab was the only independent factor associated with the incompetence of the pylorus, with an adjusted odds ratio of 2.70 (95% CI: 1.47–4.94, p = 0.001). In conclusion, pyloric incompetence was associated with H. pylori infection and moderately correlated to the severity of atrophic gastritis in non-operated stomachs.
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. "NSAID, gebruikNSAID-gebruik en H. pylori, tetracycline H. pylori, naproxen H. pylori, metronidazol H. pylori, bismutoxideH. Pylori-eradicatie." Medisch-Farmaceutische Mededelingen 38, no. 4 (April 2000): 72. http://dx.doi.org/10.1007/bf03057514.
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Garcés-Duran, R., S. Kindt, K. Kotilea, S. François, G. Rasschaert, A. Smet, B. Hauser, et al. "Belgian consensus for Helicobacter pylori management 2023." Acta Gastro Enterologica Belgica 86, no. 1 (March 2023): 74–91. http://dx.doi.org/10.51821/86.1.11327.
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Helicobacter pylori (H. pylori) infection causes chronic gastritis, peptic ulcers and gastric cancer. Although H. pylori prevalence is decreasing worldwide, regional variations exist in Europe, with the lowest infection prevalence in Northern Europe, and the highest in Eastern and Southern Europe (1). Changes in the treatment recommendations and the increasing available evidence have justified the implementation of new recommendations since last Belgian consensus in 1998 (2). Several non-H. pylori Helicobacter species (NH.PYLORI-H), colonizing the stomach of domestic animals, also have the ability to cause gastric disease in humans, although to a lesser extent. These zoonotic NH. PYLORIH are not the subject of the current recommendations.
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Hayashi, Shunji, Toshiro Sugiyama, Ken-Ichi Amano, Hiroshi Isogai, Emiko Isogai, Miki Aihara, Mikio Kikuchi, et al. "Effect of Rebamipide, a Novel Antiulcer Agent, onHelicobacter pylori Adhesion to Gastric Epithelial Cells." Antimicrobial Agents and Chemotherapy 42, no. 8 (August 1, 1998): 1895–99. http://dx.doi.org/10.1128/aac.42.8.1895.
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ABSTRACT Helicobacter pylori is a major etiological agent in gastroduodenal disorders. The adhesion of H. pylori to human gastric epithelial cells is the initial step of H. pylori infection. Inhibition of H. pylori adhesion is thus a therapeutic target in the prevention of H. pyloriinfection. Experiments were performed to evaluate the effect of rebamipide, a novel antiulcer agent, on H. pylori adhesion to gastric epithelial cells. MKN-28 and MKN-45 cells, derived from human gastric carcinomas, were used as target cells. Ten H. pylori strains isolated from patients with chronic gastritis and gastric ulcer were used in the study. We evaluated the effect of rebamipide on H. pylori adhesion to MKN-28 and MKN-45 cells quantitatively using our previously established enzyme-linked immunosorbent assay. The adhesion of H. pylori to MKN-28 and MKN-45 cells was significantly inhibited by pretreatment of these cells with 100 μg of rebamipide per ml. However, the adhesion was not affected by the pretreatment of H. pylori with rebamipide. On the other hand, the viabilities of H. pylori, MKN-28 cells, and MKN-45 cells were not affected by rebamipide. Our studies suggest that rebamipide inhibits the adhesion of H. pylorito gastric epithelial cells.
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Öztekin, Merve, Birsen Yılmaz, Duygu Ağagündüz, and Raffaele Capasso. "Overview of Helicobacter pylori Infection: Clinical Features, Treatment, and Nutritional Aspects." Diseases 9, no. 4 (September 23, 2021): 66. http://dx.doi.org/10.3390/diseases9040066.
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Helicobacter pylori (H. pylori) is a 0.5–1 µm wide, 2–4 µm long, short helical, S-shaped Gram-negative microorganism. It is mostly found in the pyloric region of the stomach and causes chronic gastric infection. It is estimated that these bacteria infect more than half of the world’s population. The mode of transmission and infection of H. pylori is still not known exactly, but the faecal–oral and oral–oral routes via water or food consumption are thought to be a very common cause. In the last three decades, research interest has increased regarding the pathogenicity, microbial activity, genetic predisposition, and clinical treatments to understand the severity of gastric atrophy and gastric cancer caused by H. pylori. Studies have suggested a relationship between H. pylori infection and malabsorption of essential micronutrients, and noted that H. pylori infection may affect the prevalence of malnutrition in some risk groups. On the other hand, dietary factors may play a considerably important role in H. pylori infection, and it has been reported that an adequate and balanced diet, especially high fruit and vegetable consumption and low processed salty food consumption, has a protective effect against the outcomes of H. pylori infection. The present review provides an overview of all aspects of H. pylori infection, such as clinical features, treatment, and nutrition.
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Blasiak, Janusz, Jan Chojnacki, and Cezary Chojnacki. "Inflammation, oxidative stress, DNA damage response and epigenetic modifications interact behind the beneficial actions of melatonin on H. pylori-mediated gastric disorders." Melatonin Research 6, no. 2 (June 30, 2023): 135–47. http://dx.doi.org/10.32794/mr112500145.
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Helicobacter pylori (H. pylori) infection is associated with several disorders of the gastrointestinal tract, including gastric cancer. Studies of ours and others suggest that H. pylori infection may affect melatonin synthesis in the gastric epithelial cells. On the other hand, melatonin ameliorates gastric disorders as shown in clinical trials and experimental studies. Moreover, melatonin not only suppresses the DNA-damaging reaction of diet-related mutagens that can initiate carcinogenesis in gastric mucosa, but also the oxidative DNA damage evoked by reactive oxygen and nitrogen species produced during H. pylori-related gastric inflammation. H. pylori infection is associated with several functional and organic gastric disorders, including gastritis, peptic ulcer disease and gastric cancer, but the precise mechanism behind this association is not known and many pathways can be involved. Some of beneficial effects of melatonin in the gastrointestinal tract are underlined by mechanisms that likely play a role in detrimental effects of H. pylori in the stomach. Therefore, melatonin may modulate these mechanisms resulting in ameliorating H. pylori-related symptoms. In this narrative review the role of inflammation, oxidative stress, DNA damage response and epigenetic modifications in H. pylori-associated gastric disorders will be discussed with an emphasis on gastric cancer. We also suggest that melatonin may have potential to inhibit H. pylori-mediated pathologies through its interaction with essential pathways as described herein. Overlapping mechanisms of H. pylori-associated pathogenesis and beneficial effects of melatonin justify further studies on the action of melatonin on gastric disorders associated with H. pylori infection, including clinical trials.
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Asonuma, Sho, Akira Imatani, Naoki Asano, Tomoyuki Oikawa, Hidetomo Konishi, Katsunori Iijima, Tomoyuki Koike, Shuichi Ohara, and Tooru Shimosegawa. "Helicobacter pylori induces gastric mucosal intestinal metaplasia through the inhibition of interleukin-4-mediated HMG box protein Sox2 expression." American Journal of Physiology-Gastrointestinal and Liver Physiology 297, no. 2 (August 2009): G312—G322. http://dx.doi.org/10.1152/ajpgi.00518.2007.
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Helicobacter pylori is a major cause of the transdifferentiation into intestinal metaplasia that may develop gastric cancer. However, the molecular pathogenesis of this transdifferentiation is poorly understood. A SRY-related HMG box protein Sox2 is an essential transcription factor of organ development in brain, lung, and stomach. Our aim of this study was to investigate the mechanism responsible for regulation of Sox2 in host Th1-dominant response to H. pylori. Sox2 protein was immunohistochemically expressed in both human oxyntic and pyloric glands with H. pylori infection, but not in intestinal metaplasia. Western immunoblotting of gastric epithelial cell lines showed that IL-4, a Th2-related cytokine, dose dependently enhanced Sox2 expression among H. pylori infection-mediated cytokines. Small changes of Sox2 expression were observed after each treatment with IFN-γ, IL-1β, or TNF-α. IL-4-mediated Sox2 induction was suppressed by the inhibition of STAT6 activation with STAT6 RNA interference, and electrophoretic mobility shift assay indicated that activation of the Sox2 promoter by IL-4 occurred through the action of STAT6. Furthermore, H. pylori and IFN-γ inhibited the phosphorylation of STAT6, resulting in the suppression of IL-4-mediated Sox2 expression. Immunohistochemical analyses showed significantly the suppressed STAT6 activity in H. pylori-infected human gastric mucosa. Additionally, downregulation of Sox2 by knockdown experiments led to intestinal phenotype with expressions of Cdx2 and MUC2. These results suggest that H. pylori and IFN-γ interfere with the differentiation into oxyntic and pyloric glands by the downregulation of Sox2 on IL-4/STAT6 signaling, which may contribute to the transdifferentiation into intestinal metaplasia.
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Rao, Prashant, Sarika Mayekar, Vishwajit Pawar, and Mohan Achyut Joshi. "Endoscopic assessment and Helicobacter pylori status evaluation in operated cases of peptic ulcer perforation." International Surgery Journal 7, no. 2 (January 27, 2020): 535. http://dx.doi.org/10.18203/2349-2902.isj20200310.
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Background: Helicobacter pylori’s role in delaying ulcer healing after surgical repair for peptic ulcer perforation causing ulcer persistence hasn’t been definitively established as it has been for uncomplicated ulcers.Methods: Authors performed an endoscopy and H. pylori status evaluation in 30 patients at an average of 6.2 weeks after simple omental patch closure for perforated peptic ulcer.Results: A positive H. pylori status was found in 12 patients (40%) of which 9 had active ulcers. None in the negative group had an active ulcer. H. pylori infection was the only factor found to be responsible for ulcer persistence after surgery.Conclusions: A reasonable approach would thus be to perform an endoscopy 6 weeks after surgery to assess ulcer healing and H. pylori status. H. pylori eradication therapy should then be selectively initialled for patients with an active ulcer or positive H. pylori status.
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Elshenawi, Yasmine, Shuai Hu, and Skander Hathroubi. "Biofilm of Helicobacter pylori: Life Cycle, Features, and Treatment Options." Antibiotics 12, no. 8 (July 31, 2023): 1260. http://dx.doi.org/10.3390/antibiotics12081260.
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Helicobacter pylori is a gastric pathogen that infects nearly half of the global population and is recognized as a group 1 carcinogen by the Word Health Organization. The global rise in antibiotic resistance has increased clinical challenges in treating H. pylori infections. Biofilm growth has been proposed to contribute to H. pylori’s chronic colonization of the host stomach, treatment failures, and the eventual development of gastric diseases. Several components of H. pylori have been identified to promote biofilm growth, and several of these may also facilitate antibiotic tolerance, including the extracellular matrix, outer membrane proteins, shifted morphology, modulated metabolism, efflux pumps, and virulence factors. Recent developments in therapeutic approaches targeting H. pylori biofilm have shown that synthetic compounds, such as small molecule drugs and plant-derived compounds, are effective at eradicating H. pylori biofilms. These combined topics highlight the necessity for biofilm-based research in H. pylori, to improve current H. pylori-targeted therapeutic approaches and alleviate relative public health burden. In this review we discuss recent discoveries that have decoded the life cycle of H. pylori biofilms and current biofilm-targeted treatment strategies.
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Samra, Zahoor Qadir, Umber Javaid, Sadia Ghafoor, Aleeza Batool, Nadia Dar, and Muhammad Amin Athar. "PCR assay targeting virulence genes of Helicobacter pylori isolated from drinking water and clinical samples in Lahore metropolitan, Pakistan." Journal of Water and Health 9, no. 1 (February 3, 2011): 208–16. http://dx.doi.org/10.2166/wh.2010.169.
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Helicobacter pylorus is considered for chronic gastritis, gastric ulcers and adenocarcinoma and its high infection rate is observed in overcrowded and lower socioeconomic groups in developing countries. This study was designed to identify the role of drinking water in the transmission and prevalence of H. pylori (HP). Selective HP medium was developed for enrichment and presumptive identification of H. pylori by urease, catalase and species specific 16S rRNA tests. The virulence genes (vacA ‘s’ and ‘m’ regions and cagA) of H. pylori in 90 out of 225 H. pylori positive drinking water samples were present (40%). Ten out of 18 biopsies (55.55%) and 15 out of 50 vomiting fluids of gastric disease patients (30%) were also positive for virulence genes. Anti-H. pylori antibodies were also detected in 31 out of 50 patients’ sera. The presence of virulence genes was also directly confirmed by hybridization studies using non-radioactive DNA probes of 16S rRNA, vacA and cagA genes. The presence of H. pylori in water is due to poor sanitary conditions, improper waste disposal and lack of public health education. PCR-based analysis and colony hybridization can be used for detection of H. pylori in clinical and environmental samples.
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Sayadishahraki, Masoud, Mahsa Khodadoostan, Hossein Bahrami Samani, Flora Mazaheri, and Somayeh Haghighat. "Body Mass Index and the Success of Helicobacter-pylori Eradication Therapy." Annals of Bariatric Surgery 10, no. 1 (June 30, 2021): 21–26. http://dx.doi.org/10.32598/abs.10.1.1.
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Objective: Helicobacter pylorus (H. pylori) is a gram-negative spiral bacterium related to varieties of gastric and extra-gastric complications. The effects of H. pylori infection on cardiometabolic conditions such as dyslipidemia, diabetes, and metabolic syndrome have to need to be investigated. The present paper aims to assess the effects of body mass index on the success of helicobacter-pylori eradication therapy for the first time. Patients and Methods: This study included 198 patients with H. pylori infection. Patients underwent H. pylori eradication using clarithromycin (500 mg, twice daily, pantoprazole (40 mg, twice daily), amoxicillin (500 mg, three times daily), and bismuth substrate (120 mg, twice daily) for 14 days. After that, the success of eradication was assessed through stool antigen within a month following the treatment. The association of eradication success with age, gender, and BMI were evaluated. Results: H. pylori infection was eradicated in 76.3% (P-value<0.001) of the patients following the eradicative treatment. The rate of response to the anti-H. Pylori remedy was affected by age (P-value=0.29). But it wasn’t affected by gender (P-value=0.81), and BMI (P-value=0.60). Conclusion: Based on the findings of this study, the patientschr('39') response to the H. Pylori eradication was not affected by age, gender, and BMI.
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Tempera, Patrick Joseph, Mark Michael, Omar Tageldin, and Stephen Hasak. "Gastric Cancer Due to Chronic H. pylori Infection: What We Know and Where We Are Going." Diseases 10, no. 3 (August 25, 2022): 57. http://dx.doi.org/10.3390/diseases10030057.
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Helicobacter pylori is an established cause of many gastrointestinal pathologies including peptic ulcer disease, gastritis, and gastric cancer. It is an entity that affects the global population, and its true nature has only been known since the 1980s. Although there is much known about H. pylori including its pathophysiology, detection, and eradication, resistance to current therapy models is common. This is problematic because untreated or inadequately treated H. pylori increases morbidity and mortality related to gastric cancer and peptic ulcer disease among others. In order to improve the treatment and reduce resistance, there is significant ongoing research identifying new detection and eradication methods for H. pylori. This review aims to highlight what has already been established regarding H. pylori’s epidemiology, pathophysiology, detection, and treatment as well as the most current and novel research involving detection and treatment of H. pylori.
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Hassan, Md Ali, MA Ahad, MH Rahman, MSH Bhuiyan, and MAH Khan. "Association between cytotoxin producing H. pylori and gastric carcinoma." Bangladesh Medical Journal Khulna 49, no. 1-2 (March 7, 2017): 13–17. http://dx.doi.org/10.3329/bmjk.v49i1-2.31819.
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Background: Enormous studies have been conducted worldwide regarding CagA+ status of H. pylori in gastric carcinoma Objective: No study relating CagA+ status and gastric carcinoma has been carried out in our country yet. This study has been designed to see the association between CagA+ H. pylorl strain and gastric carcinomaMethods: For this purpose, a total number of 80 (eighty) patients were selected. Of the 80 (eighty) patients, 40 (forty) were selected as cases (malignant) and the remainder 40 (forty) were selected as controls (non malignant). H. pylori was detected by applying non invasive (H. pylori IgG serology and CagA-IgG serology) and invasive (Histology and rapid urease test) technique. Of them Histology was done by Modified giemsa stain which was regarded as gold standard, CagA IgG was detected by ELISA method.Results: In this study, among the 40 cases, 35 (thirty five) possess the CagA+ H. pylori strain and among the 40 controls, 33 (thirty three) bear the CagA+ H. pylori strain. In this study, no significant difference between case and control on the point of CagA-IgG status was found.Conclusion: H.pylori may be a simple initiator and not the actual cause of gastric carcinoma.Bang Med J (Khulna) 2016; 49 : 13-17
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Takatsuna, Masafumi, Rie Azumi, Takeshi Mizusawa, Hiroki Sato, Ken-Ichi Mizuno, Takashi Kato, Junji Yokoyama, Yoichi Ajioka, and Shuji Terai. "A case of Helicobacter pylori-negative early gastric adenocarcinoma with gastrointestinal phenotype." Endoscopy International Open 09, no. 06 (May 27, 2021): E863—E866. http://dx.doi.org/10.1055/a-1396-3854.
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AbstractA 40-year-old man with slightly depressed (0-IIc) type gastric cancer of the pyloric anterior gastric area underwent pre-operative screening for tetralogy of Fallot and endoscopic submucosal dissection (ESD) and was tested for Helicobacter pylori antigens and antibodies. Both tests were negative. He did not have a history of eradication. Pathological diagnosis of ESD showed a well-differentiated adenocarcinoma. The tumor was CD10-positive, MUC5AC-negative, and MUC6-confocal positive; it showed differentiation with gastrointestinal phenotype. Moreover, the tumor cells were lysozyme-positive, resembling Paneth cells. Mucosal glands exhibited intestinal metaplasia on the anal side of the tumor lesion. On the oral side of the tumor, metaplasia was non-existent, with normal pyloric glands present in the mucosal layer. The patient was not infected with H. pylori; however, intestinal metaplasia existed around the early gastric cancer. This suggested that the intestinal metaplasia occurred due to bile reflux, and the gastric neoplasia arose with the metaplasia without an H. pylori infection. This case may potentially help explain gastric cancer development in the absence of H. pylori infection.
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Kosai, Nik Ritza, Hardip Singh Gendeh, Abdul Rashid Norfaezan, Jamin Razman, Paul Anthony Sutton, and Srijit Das. "Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction." International Surgery 100, no. 6 (June 1, 2015): 1148–52. http://dx.doi.org/10.9738/intsurg-d-14-00205.1.
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Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)–associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.
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I.M., Saracino, Pavoni M., Zullo A., Fiorini G., Saccomanno L., Lazzarotto T., Cavallo R., Antonelli G., and Vaira D. "Antibiotic Resistance and Therapy Outcome in H. pylori Eradication Failure Patients." Antibiotics 9, no. 3 (March 13, 2020): 121. http://dx.doi.org/10.3390/antibiotics9030121.
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Helicobacter pylori (H. pylori) eradication fails in a definite amount of patients despite one or more therapeutic attempts. Curing these patients is progressively more difficult, due to development of antibiotic resistance. Current guidelines suggest testing antibiotic susceptibility in H. pylori isolates following two therapeutic attempts. Aim: to evaluate the development of antibiotic resistance, MIC values trends and therapeutic outcomes in patients who failed at least one H. pylori eradication therapy. Methods: consecutive patients, referred to perform upper gastrointestinal endoscopy (UGIE) to our Unit from January 2009 to January 2019 following at least one therapeutic attempt were considered. Bacterial resistance towards clarithromycin, metronidazole and levofloxacin was tested. Patients received either a susceptibility-guided therapy or Pylera®. Results: a total of 1223 patients were H. pylori positive, and antibiotic susceptibility was available for 1037. The rate of antibiotic resistance and MIC values significantly increased paralleling the number of previous therapeutic attempts. Eradication rates of antibiogram-tailored therapies remained stable, except for the sequential therapy if used as a third line. As a rescue treatment, the Pylera® therapy achieved cure rates comparable to those of the other culture-guided therapies. Conclusions: A significant increase in the secondary resistance towards the three tested antibiotics was observed, both as rate and MIC values, in correlation with the number of therapy failures. These findings should be considered when administering an empirical second-line therapy. Pylera® therapy eradication rates are comparable to culture-tailored therapies.
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Fiorini, Giulia, Ilaria Maria Saracino, Angelo Zullo, Matteo Pavoni, Laura Saccomanno, Tiziana Lazzarotto, Rossana Cavallo, Guido Antonelli, and Berardino Vaira. "Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy." Journal of Clinical Medicine 9, no. 5 (May 1, 2020): 1299. http://dx.doi.org/10.3390/jcm9051299.
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Background: Helicobacter pylori (H. pylori) infection is the leading cause of both peptic ulcers and gastric tumors, including low-grade MALT-lymphoma and adenocarcinoma. Although it is decreasing in developed countries, H. pylori prevalence remains high in developing areas, mainly due to low socio-economic levels, and the potential consumption of contaminated water. Moreover, a different pattern of primary antibiotic resistance is expected in their H. pylori isolates, potentially affecting the efficacy of standard eradication therapies. Indeed, a previous study showed the eradication rate following triple therapy was distinctly lower in dyspeptic H. pylori infected immigrants living in Italy as compared to Italian patients. Aims: to evaluate the resistance pattern in H. pylori isolates from immigrant patients in Italy, and the success rate of first-line therapy in these patients. Materials and Methods: This retrospective study evaluated data of consecutive immigrant patients, diagnosed with H. pylori infection in a single center (Bologna, Italy) between January 2009 and January 2019. Patients underwent first-line therapy with either sequential or Pylera® (Allergan USA, Inc. Madison, NJ, USA) therapy. Results: A total of 609 immigrants were diagnosed with H. pylori infection during the study period, but 264 previously received an eradication therapy. Therefore, the study was focused on 294 out of 345 naïve patients with a successful bacterial culture with antibiogram. Latin America immigrants had the highest overall resistance rate. Levofloxacin resistance rate was significantly higher in Latin Americans and Asians as compared with Europeans. Based on resistance patterns, sequential therapy showed a clear decreasing trend in eradication rates. Conclusions: while antibiotic resistance rates are generally increasing worldwide, Pylera® seems to achieve a good performance as first-line treatment in all naïve foreigner patients, except for Africans.
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Di Ciaula, Agostino, Giuseppe Scaccianoce, Marino Venerito, Angelo Zullo, Leonilde Bonfrate, Theodore Rokkas, and Piero Portincasa. "Eradication Rates in Italian Subjects Heterogeneously Managed for Helicobacter pylori Infection. Time to Abandon Empiric Treatments in Southern Europe." Journal of Gastrointestinal and Liver Diseases 26, no. 2 (June 1, 2017): 129–37. http://dx.doi.org/10.15403/jgld.2014.1121.262.itl.
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Background & Aims: H. pylori eradication is strongly affected by various factors, including the ongoing antibiotic resistance. We describe a “real life” scenario in patients managed for H. pylori-related conditions, living in a southern Italian region (Apulia), an area with clarithromycin resistance >15%.Methods: 2,224 subjects were studied in two tertiary referral centers in Apulia. Analyses included: reason for referral, H. pylori infection rates (13C-urea breath test – UBT or upper endoscopy), and eradication rates following distinct regimens previously prescribed or prospectively prescribed (such as the bismuth-based quadruple therapy Pylera®, recently marketed in Italy).Results. Over 80% of the patients were referred by family physicians (60% naïve subjects). The overall infection rate was 32.5% and it was similar in asymptomatic patients (31.1%) or with H. pylori-related symptoms/clinical conditions (34.3%). In the 987 H. pylori+ve patients receiving therapy, the overall eradication rate was 80.2% (ITT). Observed eradication rate varied greatly across different regimens: 57.1% (2nd line levofloxacin), 59.6% (unconventional), 70.7% (7-day triple), 73.2% (7-day undefined), 89% (10-day sequential) and 96.9% (ITT, 10 day Pylera®, 1st to 5th line regimens given to 227 patients).Conclusions. A heterogeneous “real life” scenario in Southern Europe shows that H. pylori+ve patients are put at risk of poor outcomes and points to the need of a susceptibility-based therapy according to guidelines and local microbial resistance. In the present setting (i.e. high clarithromycin resistance), despite the high observed eradication rate, sequential therapy should not be recommended (absent in guidelines, unneeded antibiotic). Bismuth-based quadruple treatment (1st, 2nd or subsequent lines) yields the highest eradication rates.Abbreviations: ALT: Altamura; BA: Bari; EGDS: esophagogastroduodenoscopy; GERD: gastro-esophageal reflux disease; H. pylori: Helicobacter pylori; ITT: intention-to-treat; PP: per-protocol; PPI: proton pump inhibitor; UBT: urea breath test.
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German, Serafima V., A. V. Modestova, I. E. Zykova, I. P. Bobrovnitsky, and M. Yu Yakovlev. "ON THE POSSIBLE PARTICULARITY OF HELICOBACTER PYLORI INFECTION TO GALLSTONE DISEASE." Hygiene and sanitation 97, no. 11 (November 15, 2018): 1076–79. http://dx.doi.org/10.18821/0016-9900-2018-97-11-1076-79.
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Introduction. Up to now, it has not been established whether Helicobacter pylori, the most common bacterial pathogen of human, is involved in cholelithiasis. Material and Methods. Based on the analysis of prophylactic medical examination of working people in the Moscow region, the determination the pyloric Helicobacter infection and assessment of the virulence of bacteria there were studied the associations of H. pylori infection and gallstones. The infection was detected by the presence of serum specific antibodies of IgG class, the virulence of the strain H. pylori - by the presence of total antibodies to the protein associated with the cytotoxic gene CagA. There was used enzyme-linked immunosorbent assay. The study included 1,487 people, 931 men and 556 women aged 21-77 years. Results. The H. pylori infection was detected in 1348 (90,6%), CagA protein in - 392 (56.2 %) cases. Gallstones were diagnosed in 72 patients, 21 men (2.3%) and 51 women (9.2%), 67 were seropositive (5% of all infected) and 5 - seronegative (3.6% uninfected). In cholelithiasis cases, the presence of CagA positive strain of H. pylori was investigated in 35 patients. A virulent strain of bacteria was detected in 26 cases (74%), much more often than in the rest examined persons. Conclusion. There were no statistically significant differences in the incidence of cholelithiasis in infected H. pylori and non-infected individuals. A significantly higher prevalence of infection with pathogenic strains of H. pylori in patients with gallstones was found in comparison with the whole group of examined patients, that indicates to the favor of possible involvement of H. pylori infection in this pathology. Confirmation of the role of H. pylori infection as a cumulative risk factor for the gallstones cholecystitis, as well as for other extragastral pathologies, may have an epidemiological, prophylactic, clinical application, due to its widespread prevalence. Further research is needed.
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&NA;. "Treating H. pylori." Inpharma Weekly &NA;, no. 1125 (February 1998): 16. http://dx.doi.org/10.2165/00128413-199811250-00029.
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&NA;. "H. pylori update." Inpharma Weekly &NA;, no. 933 (April 1994): 15. http://dx.doi.org/10.2165/00128413-199409330-00037.
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&NA;. "H. pylori update." Inpharma Weekly &NA;, no. 946 (July 1994): 5. http://dx.doi.org/10.2165/00128413-199409460-00006.
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Delaney, Brendan, and Paul Moayyedi. "Eradicating H pylori." BMJ 328, no. 7453 (June 10, 2004): 1388–89. http://dx.doi.org/10.1136/bmj.328.7453.1388.
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&NA;. "Eradicating H. pylori." Inpharma Weekly &NA;, no. 816 (December 1991): 11. http://dx.doi.org/10.2165/00128413-199108160-00032.
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Desai, Tusar, Ahmed I. Edhi, and Seifeldin Hakim. "Eradicating H. pylori." American Journal of Gastroenterology 114, no. 12 (December 2019): 1827–28. http://dx.doi.org/10.14309/ajg.0000000000000424.
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Labenz, Joachim. "H. pylori bändigen." Der Hausarzt 49, no. 4 (February 29, 2012): 49–52. http://dx.doi.org/10.1007/s15200-012-0201-7.
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Fennerty, MB. "Is the only good H. pylori a dead H. pylori?" Gastroenterology 111, no. 6 (December 1996): 1773–74. http://dx.doi.org/10.1016/s0016-5085(96)70047-1.
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Coconnier, Marie-Helene, Vanessa Lievin, Elisabeth Hemery, and Alain L. Servin. "Antagonistic Activity againstHelicobacter Infection In Vitro and In Vivo by the HumanLactobacillus acidophilus Strain LB." Applied and Environmental Microbiology 64, no. 11 (November 1, 1998): 4573–80. http://dx.doi.org/10.1128/aem.64.11.4573-4580.1998.
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ABSTRACT The purpose of the present study was to examine the activity of the human Lactobacillus acidophilus strain LB, which secretes an antibacterial substance(s) against Helicobacter pyloriin vitro and in vivo. The spent culture supernatant (SCS) of the strain LB (LB-SCS) dramatically decreased the viability of H. pylori in vitro independent of pH and lactic acid levels. Adhesion of H. pylori to the cultured human mucosecreting HT29-MTX cells decreased in parallel with the viability of H. pylori. In conventional mice, oral treatment with the LB-SCS protected against infection with Helicobacter felis. Indeed, at both 8 and 49 days post-LB-SCS treatment (29 and 70 days postinfection), inhibition of stomach colonization by H. felis was observed, and no evidence of gastric histopathological lesions was found. LB-SCS treatment inhibits theH. pylori urease activity in vitro and in H. pylori that remained associated with the cultured human mucosecreting HT29-MTX cells. Moreover, a decrease in urease activity was detected in the stomach of the mice infected with H. felis and treated with LB-SCS.
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Saler, Tayyibe, Şakir Özgür Keşkek, Sibel Kırk, Süleyman Ahbab, and Gülay Ortoğlu. "H. pyloriMay Not Be Associated with Iron Deficiency Anemia in Patients with Normal Gastrointestinal Tract Endoscopy Results." Advances in Hematology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/375915.
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Background. The aim of this study was to investigate the association between iron deficiency anemia andH. pyloriin patients with normal gastrointestinal tract endoscopy results.Materials and Methods. A total of 117 male patients with normal gastrointestinal tract endoscopy results were included in this retrospective study. The study and control groups included 69 and 48 patients with and without iron deficiency anemia, respectively. The prevalence ofH. pylori, the number of RBCs, and the levels of HGB, HTC, MCV, iron, and ferritin were calculated and compared.Results. There was no statistically significant difference found between the groups according to the prevalence ofH. pylori(65.2% versus 64.6%,P=0.896). Additionally, the levels of RBCs, HGB, HTC, MCV, iron, and ferritin in the patients in the study group were lower than those in the control group (P<0.05). Finally, there was no association between iron deficiency anemia andH. pylori(OR 1.02, Cl 95% 0.47–2.22, andP=0.943).Conclusion.H. pyloriis not associated with iron deficiency anemia in male patients with normal gastrointestinal tract endoscopy results.
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Akcakavak, Gokhan, Mehmet Tuzcu, Nevin Tuzcu, Zeynep Celik, Aysenur Tural, and Osman Dagar. "Investigation with Real-Time PCR and Histopathology on the presence of H. felis, H. heilmannii and H. pylori in dogs." Revista Científica de la Facultad de Ciencias Veterinarias XXXIII, no. 1 (February 7, 2023): 1–7. http://dx.doi.org/10.52973/rcfcv-e33214.
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Helicobacter species such as H. heilmannii, H. pylori, H. felis, H. bizzozeronii and H. salomonis have been identified in cats and dogs, and research suggesting that these species may be zoonotic agents and has been studied intensified in recent years. The aim of this study was to reveal the presence, comparing the histopathological findings and Real-time PCR results of H. felis, H. heilmannii, and H. pylori in the stomach and liver tissues taken during the necropsies of owned, stray or shelter dogs. The material of the study consisted of stomach and liver tissues taken from 35 dogs that died for different reasons and were brought for necropsy. DNA copies of H. heilmannii were detected by Real-time PCR in the liver samples of 30 dogs using H. heilmannii-specific primers. In the case of gastric samples, Real-time PCR detected H. heilmannii in 13 cases, H. pylori in 3 cases, both H. heilmannii and H. pylori in 13 cases, and H. felis, H. heilmannii and H. pylori in 3 cases. Microscopically, neutrophil leukocyte infiltration, epithelial degeneration, fibrosis and oedema in the lamina propia, and lymphoplasmacytic cell infiltration were determined in the stomachs. In the Hemotoxylin Eosin staining of the sections, 5 cases and 14 cases in the Warthin–Starry staining were found positive for Helicobacter-like microorganisms. Microscopically, dissociation of the remark cords and hydropic degeneration in hepatocytes, and focal mononuclear cell infiltrations in some sections were determined in the livers. In conclusion, with this study, it was understood that Real-time PCR analyzes are very useful in the diagnosis of H. felis, H. heilmannii, and H. pylori. However, histopathological examinations are necessary to associate the presence of bacteria with the development of the disease.
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Tao, Liping, Hai Zou, and Zhimin Huang. "Effects ofHelicobacter pyloriand Heat Shock Protein 70 on the Proliferation of Human Gastric Epithelial Cells." Gastroenterology Research and Practice 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/794342.
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Infection ofHelicobacter pylori (H. pylori)changed the proliferation of gastric epithelial cells and decreased the expression of heat shock protein 70 (HSP70). However, the effects ofH. pylorion the proliferation of gastric epithelial cells and the roles of HSP70 during the progress need further investigation.Objective.To investigate the effects ofHelicobacter pylori (H. pylori)and heat shock protein 70 (HSP70) on the proliferation of human gastric epithelial cells.Methods. H. pyloriand a human gastric epithelial cell line (AGS) were cocultured. The proliferation of AGS cells was quantitated by an MTT assay, and the expression of HSP70 in AGS cells was detected by Western blotting. HSP70 expression in AGS cells was silenced by small interfering RNA (siRNA) to investigate the role of HSP70. ThesiRNA-treated AGS cells were cocultured withH. pyloriand cell proliferation was measured by an MTT assay.Results.The proliferation of AGS cells was accelerated by coculturing withH. pylorifor 4 and 8 h, but was suppressed at 24 and 48 h. HSP70 expression was decreased in AGS cells infected byH. pylorifor 48 h. The proliferation in HSP70-silenced AGS cells was inhibited after coculturing withH. pylorifor 24 and 48 h compared with the control group.Conclusions.Coculture ofH. pylorialtered the proliferation of gastric epithelial cells and decreased HSP70 expression. HSP70 knockdown supplemented the inhibitory effect ofH. pylorion proliferation of epithelial cells. These results indicate that the effects ofH. pylorion the proliferation of gastric epithelial cells at least partially depend on the decreased expression of HSP70 induced by the bacterium.
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Chicherin, I. Yu, I. P. Pogorelskiy, E. P. Kolevatykh, I. A. Lundovskikh, and M. R. Shabalina. "First experience with the metaprebiotic Stimbifid plus used for eradication of Helicobacter pylori in patients with gastric ulcer." Infekcionnye bolezni 19, no. 3 (2021): 92–103. http://dx.doi.org/10.20953/1729-9225-2021-3-92-103.
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Objective. To analyze the relationships between probiotic microorganisms and H. pylori KM-11 (RifR) and evaluate their effect on the structural organization of the pathogen and natural colonization resistance of the stomach both independently and with the metaprebiotic Stimbifid plus using bacteriological methods and electron microscopy. Our findings can be potentially used for effective eradication of H. pylori KM-11 (RifR) and treatment of gastric ulcer in volunteers during metaprebiotic therapy. Materials and methods. The following strains of microorganisms were used in this study: Lactobacillus plantarum 8P-A3, Bifidobacterium bifidum No 1, and Helicobacter pylori, isolated from a biopsy specimen of the pyloric antrum collected from a patient with gastritis. A rifampicin-resistant strain of H. pylori KM-11 (RifR) growing on a solid medium with rifampicin (160 μg∙mL–1) was obtained by spontaneous mutagenesis. H. pylori and H. pylori КМ-11 (RifR) were cultivated on hemin containing solid medium with special nutrients at 37°C in an anaerobic cultivation system. Microorganisms were identified by their morphological assessment and using kits for biochemical identification of bacteria. The relationships between probiotic bacteria and H. pylori KM-11 (RifR) were analyzed using the method of paired cultivation on solid and liquid media. The metaprebiotic Stimbifid plus was used in these experiments. Electron microscopy of all microorganisms was performed using a scanning electron microscope. Data analysis was conducted using the Kerber method modified by I.P. Ashmarin and A.A.Vorobyov. Results. Our in vitro experiments with paired cultivation of L. plantarum 8P-A3 and B. bifidum No.1 with H. pylori КМ-11 (RifR) on solid and liquid media containing Stimbifid plus showed that probiotic microorganisms were bioincompatible with H. pylori, i.e. there was an antagonism between a probiotic strain and a pathogenic microorganism. Stimbifid plus added to the cultivation medium acted as an anti-H. pylori agent; moreover, it promoted the restoration of colonization resistance and was a source of exclusive nutrients for probiotic bacteria. Bacteriological testing and electron microscopy demonstrated that the metabolites produced by L. plantarum 8P-A3 can damage the cell wall of H. pylori КМ-11 (RifR) during their co-cultivation in a liquid medium containig Stimbifid plus. This damage appeared as specific changes on the surface of the cell wall and resulted in the loss of viability. Oral administration of Stimbifid plus in six volunteers with gastric ulcer and concomitant severe dysbiosis (with 4 of them tested positive for H. pylori), ensured not only H. pylori eradication and treatment of gastric ulcer, but also confirmed the efficacy of an experimental dose of Stimbifid plus (3000 mg daily for 14 days). Conclusion. The results of our in vitro experiments with cocultivation of probiotic strains L. plantarum 8P-A3 and B. bifidum No 1 with H. pylori КМ-11 (RifR) on solid and liquid media containing Stimbifid plus, as well as experiments with oral administration of Stimbifid plus for H. pylori eradication and treatment of gastric ulcer, demonstrated a substantial therapeutic potential of this metaprebiotic, in particular as a therapy for chronic H. pylori infection and gastric ulcer scarring. Our current results and previous findings on the restoration of colonization resistance, gastric mucosa, and indigenous microbiota, as well as the data on the clearance of pathogenic bacteria in mammals, suggest that Stimbifid plus has a high eradication potential and can be used in clinical practice as a therapeutic agent for acute and chronic infections caused by H. pylori. Key words: Helicobacter pylori, microbiota, colonization resistance, gastric ulcer, eradication, metaprebiotic Stimbifid plus, volunteers
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Krishnamurthy, Partha, Mary Parlow, Jason B. Zitzer, Nimish B. Vakil, Harry L. T. Mobley, Marilyn Levy, Suhas H. Phadnis, and Bruce E. Dunn. "Helicobacter pylori Containing Only Cytoplasmic Urease Is Susceptible to Acid." Infection and Immunity 66, no. 11 (November 1, 1998): 5060–66. http://dx.doi.org/10.1128/iai.66.11.5060-5066.1998.
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ABSTRACT Helicobacter pylori, an important etiologic agent in a variety of gastroduodenal diseases, produces large amounts of urease as an essential colonization factor. We have demonstrated previously that urease is located within the cytoplasm and on the surface of H. pylori both in vivo and in stationary-phase culture. The purpose of the present study was to assess the relative contributions of cytoplasmic and surface-localized urease to the ability of H. pylori to survive exposure to acid in the presence of urea. Toward this end, we compared the acid resistance in vitro of H. pylori cells which possessed only cytoplasmic urease to that of bacteria which possessed both cytoplasmic and surface-localized or extracellular urease. Bacteria with only cytoplasmic urease activity were generated by using freshly subcultured bacteria or by treating repeatedly subcultured H. pylori with flurofamide (1 μM), a potent, but poorly diffusible urease inhibitor. H. pyloriwith cytoplasmic and surface-located urease activity survived in an acid environment when 5 mM urea was present. In contrast, H. pylori with only cytoplasmic urease shows significantly reduced survival when exposed to acid in the presence of 5 mM urea. Similarly,Escherichia coli SE5000 expressing H. pyloriurease and the Ni2+ transport protein NixA, which expresses cytoplasmic urease activity at levels similar to those in wild-typeH. pylori, survived minimally when exposed to acid in the presence of 5 to 50 mM urea. We conclude that cytoplasmic urease activity alone is not sufficient (although cytoplasmic urease activity is likely to be necessary) to allow survival of H. pyloriin acid; the activity of surface-localized urease is essential for resistance of H. pylori to acid under the assay conditions used. Therefore, the mechanism whereby urease becomes associated with the surface of H. pylori, which involves release of the enzyme from bacteria due to autolysis followed by adsorption of the enzyme to the surface of intact bacteria (“altruistic autolysis”), is essential for survival of H. pylori in an acid environment. The ability of H. pylori to survive exposure to low pH is likely to depend on a combination of both cytoplasmic and surface-associated urease activities.
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Lee, Woo-Kon, Keiji Ogura, John T. Loh, Timothy L. Cover, and Douglas E. Berg. "Quantitative Effect of luxS Gene Inactivation on the Fitness of Helicobacter pylori." Applied and Environmental Microbiology 72, no. 10 (August 25, 2006): 6615–22. http://dx.doi.org/10.1128/aem.01291-06.
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ABSTRACT Furanone metabolites called AI-2 (autoinducer 2), used by some bacterial species for signaling and cell density-regulated changes in gene expression, are made while regenerating S-adenosyl methionine (SAM) after its use as a methyl donor. The luxS-encoded enzyme, in particular, participates in this activated methyl cycle by generating both a pentanedione, which is transformed chemically into these AI-2 compounds, and homocysteine, a precursor of methionine and SAM. Helicobacter pylori seems to contain the genes for this activated methyl cycle, including luxS, but not genes for AI-2 uptake and transcriptional regulation. Here we report that deletion of luxS in H. pylori reference strain SS1 diminished its competitive ability in mice and motility in soft agar, whereas no such effect was seen with an equivalent ΔluxS derivative of the unrelated strain X47. These different outcomes are consistent with H. pylori's considerable genetic diversity and are reminiscent of phenotypes seen after deletion of another nonessential metabolic gene, that encoding polyphosphate kinase 1. We suggest that synthesis of AI-2 by H. pylori may be an inadvertent consequence of metabolite flux in its activated methyl cycle and that impairment of this cycle and/or pathways affected by it, rather than loss of quorum sensing, is deleterious for some H. pylori strains. Also tenable is a model in which AI-2 affects other microbes in H. pylori's gastric ecosystem and thereby modulates the gastric environment in ways to which certain H. pylori strains are particularly sensitive.
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Siregar, Gontar Alamsyah, Sahat Salim, and Ricky Rivalino Sitepu. "Comparison of IL-6, IL-8 Concentrations in H. pylori- and non-H. pylori-associated Gastritis." Indonesian Biomedical Journal 6, no. 3 (December 1, 2014): 163. http://dx.doi.org/10.18585/inabj.v6i3.29.
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BACKGROUND: Helicobacter pylori is a non-invasive microorganism causing intense gastric mucosal inflammatory and immune reaction. The gastric mucosal levels of the proinflammatory cytokines Interleukin 6 (IL-6) and IL-8 have been reported to be increased in H. pylori infection, but the serum levels in H. pylori infection is still controversial. The purpose of this study was to investigate the serum levels of IL-6 and IL-8 in H. pylori infection.METHODS: A cross sectional study was done on eighty consecutive gastritis patients admitted to endoscopy units at Adam Malik General Hospital and Permata Bunda Hospital, Medan, Indonesia from May-October 2014. Histopathology was performed for the diagnosis of gastritis. Rapid urease test for diagnosis of H. pylori infection. Serum samples were obtained to determine circulating IL-6 and IL-8. Univariate and bivariate analysis (independent t test) were done.RESULTS: There were 41.25% patients infected with H. pylori. Circulatory IL-6 levels were significantly higher in H. pylori-infected patients compared to H. pylori negative, but there were no differences between serum levels of IL-8 in H. pylori positive and negative patients.CONCLUSION: The immune response to H. pylori promotes systemic inflammation, which was reflected in an increased level of serum IL-6. Serum levels of IL-8 were not significantly different between H. pylori positive and negative.KEYWORDS: Helicobacter pylori, gastritis, IL-6, IL-8, cytokine
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Kafeel, Asma, Jamshed Bashir, Ishfaq Ahmad Khan, Muhammad Adnan Bawany, Muhammad Javaid Rashid, and Jahana Ara. "Assessment of the Simultaneous Presence of Helicobacter Pylori in the Gastric Mucosa and Gallbladder Mucosa in Patients Suffering from Cholecystitis: a cross Sectional Study." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 30, 2022): 627–29. http://dx.doi.org/10.53350/pjmhs22161627.
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Aim: The current study was designed to assess the simultaneous presence of H. pylori in gastric and gallbladder mucosa in the patients of acute cholecystitis or symptomatic cholelithiasis. Study design: Cross sectional study Place and duration: This study was conducted at Liaquat University Hospital Hyderabad, Pakistan from March 2020 to March 2021. Methodology: A total of 43 patients suffering from acute cholecystitis and symptomatic cholelithiasis were selected. Their age, gender, and the presence of H. pylori in the gallbladder and gastric mucosa was determined and recorded. The results were statistically analyzed by SPSS version 22. Results: Out of the 43 patients, 20 were male, and 23 were female. Recorded mean age was 54.8±9.9 years and 22 (51.2%) had acute cholecystitis and the remaining 21 (48.8%) had cholelithiasis. In the gastric mucosa, in 14 patients (32.6%) H. pylori was positive. Similarly, in the gall bladder; it was positive in 19 patients (44.2%). In 6 patients (13.9%) i.e. in 4 men and 2 women, H pylori was simultaneously present in both gallbladder and gastric mucosa. No particular relationship was observed in the H. pylori’s presence or absence in gallbladder and gastric mucosa. Conclusion: The presence of H. pylori in gallbladder plays a critical role in the gallbladder’s infection. However, its simultaneous presence in gastric mucosa is not a good standard to assess biliary diseases. Keywords: H. pylori, Cholecystitis, Cholelithiasis, Gallbladder, Gastric mucosa
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Malik, G. M., M. Mubarik, and S. A. Kadla. "Helicobacter pylori Infection in Endoscopic Biopsy Specimens of Gastric Antrum: Laboratory Diagnosis and Comparative Efficacy of Three Diagnostic Tests." Diagnostic and Therapeutic Endoscopy 6, no. 1 (January 1, 1999): 25–29. http://dx.doi.org/10.1155/dte.6.25.
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Aims and objectives The present study was undertaken to compare the diagnostic yield of three available test procedures for detecting Helicobacter pylori (H. pylori) infection in endoscopic biopsies.Methods H. pylori infection was sought in 150 patients referred for upper gastrointestinal (GI) endoscopy. Multiple (about six) biopsy specimens were taken from pyloric antrum in each patient. Two biopsy specimens were subjected to one minute endoscopy room test – OMERT (a modified form of urease test), two were sent for histopathological analysis, where multiple sections were subjected to Giemsa staining and two were sent for microbiological evaluation after Gram's staining of heat fixed biopsy material.Results H. pylori positivity using histology, microbiology and OMERT was observed to be 33%, 30% and 27% respectively. However, overall 40% patients were infected when the results from three test procedures were combined, as H. pylori positivity was repeated more than once by these procedures separately. Histology was found to be superior to other two tests in our study, especially when multiple sections were examined, for the distribution of the organism was patchy. Amongst the infected, H. pylori was seen in only 30% of all 3–8 sections cut from a biopsy, whereas in 70% it was noted in a single section only.Conclusion The study revealed that histology has the highest detection rate and can be chosen as the “gold standard” amongst the three low cost test procedures available at present in our setup.
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Iwai, Komei, Tetsuji Azuma, Takatoshi Yonenaga, Kazutoshi Watanabe, Akihiro Obora, Fumiko Deguchi, Takao Kojima, and Takaaki Tomofuji. "Association between dental caries and Helicobacter pylori infection in Japanese adults: A cross-sectional study." PLOS ONE 17, no. 7 (July 14, 2022): e0271459. http://dx.doi.org/10.1371/journal.pone.0271459.
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Helicobacter pylori (H. pylori) is widely known as a cause of gastric disorders. Presence of H. pylori in dental pulp has been reported. Dental caries may influence the presence or absence of systemic H. pylori infection by serving as a source of H. pylori. In this cross-sectional study, we examined whether H. pylori infection in blood were associated with dental caries in Japanese adults. The participants were 752 individuals (513 males and 239 females, mean age 53.8 years) who underwent both H. pylori testing (H. pylori antibody test and pepsinogen test) and dental checkups at the Asahi University Hospital Human Health Center between April 2018 and March 2019. Those diagnosed as positive for H. pylori antibody test or positive for serum pepsinogen test as H. pylori test in the human health checkup were judged as those with H. pylori infection in the blood. In our study, 83 participants (11%) were determined to be infected with H. pylori in the blood. The proportion of those with decayed teeth was higher in participants with H. pylori infection in blood than in those without H. pylori infection in blood (p< 0.001). The logistic analysis showed that presence of H. pylori infection in blood was positively associated with those with decayed teeth (OR, 5.656; 95% CI, 3.374 to 9.479) after adjusting for age, gender, gastric disease, regular dental checkups, antibiotic medication history, and decayed teeth. Furthermore, the proportion of H. pylori infection in blood increased according to number of decayed teeth (p< 0.001). The results indicate that H. pylori infection in blood were associated with decayed teeth. Untreated dental caries may have an impact on systemic H. pylori infection.
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De Francesco, Vincenzo, Angelo Zullo, Luigi Gatta, Raffaele Manta, Matteo Pavoni, Ilaria Maria Saracino, Giulia Fiorini, and Dino Vaira. "Rescue Therapies for H. pylori Infection in Italy." Antibiotics 10, no. 5 (May 3, 2021): 525. http://dx.doi.org/10.3390/antibiotics10050525.
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Background/Aims: Curing Helicobacter pylori infection remains challenging for clinicians, as no proposed first-line therapy achieves bacterial eradication in all treated patients so that several patients need two or more consecutive treatments. Bacterial culture with antibiotics susceptibility testing is largely unachievable in Italy, and empiric second-line and rescue therapies are generally used. This study aimed to identify what eradication regimens perform better in Italy, following first-line therapy failure. Methods: We performed a literature search on PubMed for studies on standard therapy regimens used as second-line or rescue treatments performed in adult patients. Studies including modified drug combinations were not considered. Both intention-to-treat and per- protocol analyses were computed for each therapy subgroup. Results: Data from 35 studies with a total of 4830 patients were eventually considered. As a second-line therapy, Pylera® (90.6%) and a sequential regimen (89.8%) achieved eradication rates significantly higher than other therapies. For third-line therapy, a levofloxacin-based regimen and Pylera® achieved comparable eradication rates (88.2% vs. 84.7%; p = 0.2). Among therapies used as fourth (or more) attempts, Pylera® and a rifabutin-based therapy achieved 77.4% and 66.4% cure rates, respectively (p = 0.013). A therapy sequence based on the type of first-line therapy used was proposed. Conclusions: Data obtained through our review indicate that standard therapies for H. pylori eradication can be used when following an appropriate sequence, allowing clinicians to improve the cure rate without resorting to bacterial culture.
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Shafrir, Asher, Michal Shauly-Aharonov, Lior H. Katz, Ora Paltiel, Yishai Pickman, and Zvi Ackerman. "The Association between Serum Vitamin D Levels and Helicobacter pylori Presence and Eradication." Nutrients 13, no. 1 (January 19, 2021): 278. http://dx.doi.org/10.3390/nu13010278.
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Background: The success of Helicobacter pylori (H. pylori) eradication depends on several host and treatment factors. Serum vitamin D levels may be associated with H. pylori infection and eradication rates. We investigated the association between vitamin D and H. pylori infection and eradication, using a large electronic database based on medical records from a population-based health maintenance organization. Methods: Data regarding adults who underwent H. pylori testing and had vitamin D measurements within one month of H. pylori testing were collected. H. pylori infection was ascertained using urea breath or stool antigen tests. A negative H. pylori test following a positive result implied eradication. Multivariate regression models were constructed to assess associations between H. pylori infection, eradication, and vitamin D. Results: Among 150,483 members who underwent H. pylori testing from 2009 to 2018, 27,077 (18%) had vitamin D measurements. Vitamin D levels were inversely associated with H. pylori infection, p < 0.001. The odds of a positive H. pylori test were 31% higher among patients with vitamin D levels <20 ng/mL, compared with those with levels ≥20 ng/mL (OR 1.31, 99% CI 1.22–1.4, p < 0.001). Purchase of vitamin D supplements was associated with a negative subsequent H. pylori test (p < 0.001). Mean vitamin D levels were moderately higher in those with successful vs. failed H. pylori eradication (19.34 ± 9.55 vs. 18.64 ± 9.61, p < 0.001). Conclusions: Vitamin D levels are associated with H. pylori infection. Increased vitamin D levels are associated with successful H. pylori eradication. Vitamin D may have a role in H. pylori eradication.
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Tongtawee, Taweesak, Wareeporn Wattanawongdon, and Theeraya Simawaranon. "Effects of periodontal therapy on eradication and recurrence of Helicobacter pylori infection after successful treatment." Journal of International Medical Research 47, no. 2 (January 7, 2019): 875–83. http://dx.doi.org/10.1177/0300060518816158.
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Objectives This study aimed to evaluate the effects of periodontal therapy on the efficacy of Helicobacter pylori eradication and on the recurrence of infection after eradication. Methods We conducted a prospective randomized trial on 698 gastric H. pylori-infected patients, of whom 347 received gastric H. pylori treatment alone and 342 received gastric H. pylori treatment plus periodontal therapy. The presence of H. pylori and associated virulence genes were detected by real-time polymerase chain reaction. Results After eradication of gastric H. pylori infection, the recurrence of gastric H. pylori was significantly lower in the gastric H. pylori treatment plus periodontal therapy group than in the group receiving gastric H. pylori treatment alone (OR 0.67; 95% CI 0.45 to 0.99), whereas the eradication rate was not significantly different (OR 0.87; 95% CI 0.68 to 0.98). There was a close relationship between the presence of H. pylori in saliva and its presence in the stomach. Conclusions The oral cavity is an important reservoir for gastric H. pylori infection. Adjunctive periodontal therapy could enhance the efficiency of H. pylori treatment and reduce the recurrence of gastric H. pylori infection.
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Syam, Ari F. "Current situation of Helicobacter pylori infection in Indonesia." Medical Journal of Indonesia 25, no. 4 (January 25, 2017): 263–6. http://dx.doi.org/10.13181/mji.v25i4.1408.
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Data epidemiologi infeksi Helicobacter pylori (H. pylori) terus berubah dalam beberapa dekade terakhir. Indonesia dilaporkan memiliki prevalensi infeksi H. pylori yang rendah dibandingkan dengan negara lain di Asia. Beberapa penelitian di Indonesia melaporkan bahwa sanitasi yang buruk, usia, agama, etnis merupakan faktor risiko untuk infeksi H. pylori. Dibandingkan dengan tes diagnostik lainnya, tes urine merupakan tes yang dapat diandalkan untuk mendeteksi H. pylori di Indonesia karena tes tersebut bersifat non-invasif dengan harga yang cukup terjangkau dan memiliki akurasi yang tinggi. Meskipun banyak penelitian telah dilakukan mengenai prevalensi infeksi H. pylori pada beberapa etnis di Indonesia, peneliti masih memiliki beberapa pertanyaan yang belum terjawab mengenai infeksi H. pylori di Indonesia. Oleh karena itu, diperlukan untuk membangun pusat penelitian H. pylori yang menyediakan fasilitas untuk kultur, evaluasi resistensi antibiotik, dan memperoleh informasi genotipe yang dapat menjelaskan perbedaan dalam infeksi H. pylori di antara berbagai etnis di Indonesia The epidemiology of Helicobacter pylori (H. pylori) has been changing over the past decades. Indonesia was reported have a low prevalence of H. pylori infection compared to other countries in Asia. Some studies in Indonesia have evaluated that poor sanitation, age, religion, ethnicity are the risk factors for H. pylori infection. Compared to other diagnostic tests, the urine test will be reliable for the detection of H. pylori in Indonesia because it is non-invasive and low cost with high accuracy. Although we have already performed studies on the prevalence of H. pylori infection in several ethnics, we still have some questions that remain unclear regarding H. pylori infection in Indonesia. Therefore, we have a need to build a H. pylori center that provide facilities for culturing, evaluating antibiotic resistance, and obtaining the genotype information that may explain the differences in H. pylori infection among ethnic groups in Indonesia.
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Waqas, Muhammad, Umair Riaz Ahmad, Shayan Rashid Khawaja, Asma Mushtaq, Awais Rasheed, and Lubna Rafique. "Comparison of Vonoprazan Based H Pylori Eradication Regimen and Omeprazole Based H Pylori Eradication Regimen: A Novel Option." Pakistan Journal of Medical and Health Sciences 16, no. 3 (March 30, 2022): 1151–53. http://dx.doi.org/10.53350/pjmhs221631151.
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Background: H Pylori causes a number of conditions related to gastric mucosa. Owing to emerging antibiotic resistance, more treatment options are needed. Vonoprazan (VPZ) is potassium based acid inhibitor and showing promise in H Pylori eradication regimens. Results: The study comprise of total 300. Mean Age of study population was 33.04 + 13.01 years and mean age of VPZ based H. Pylori eradication regimen group was 31.78 + 12.384 and mean age of PPI based H. Pylori eradication regimen group was 34.30 + 13.535 (P-Value 0.428) given in table 1. Gender distribution in study population was 54.3% females and 48% males. Gender Distribution in VPZ based H. Pylori eradication regimen group was 52% females and 48% males and in PPI based H. Pylori eradication regimen group, females were 56.7% and males were 43.3% (P-Value 0.487). Comparison of efficacy of VPZ based H. Pylori eradication regimen and PPI based eradication regimen shows that vonoprazan is more effective in H Pylori eradication as compared to PPI based H.Pylori eradication regimen (P-Value 0.028) Conclusion: Vonoprazan is equally superior as first line therapy H.pylori eradication regimes as PPIs based regime. Eradication rate was higher as compared to PPI. More studies with large sample size in multiple ethnicities are required to establish more effective vonoprazan based regimens against H. Pylori. Keywords: H. Pylori, Omeprazole, Proton Pump inhibitor (PPI), Vonoprazan (VPZ), H. Pylori eradication
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Uthansingh, Kanishka, Ratna Kumari, Girish Kumar Pati, Manas Kumar Behera, Mahesh Chandra Sahu, Jimmy Narayan, Swarup Kumar Patnaik, Pradeep Mallick, and Manoj Kumar Sahu. "Molecular Docking of Anti Helicobacter pylori Antibiotics and Proton Pump Inhibitor: A Single Center Survey." Journal of Pure and Applied Microbiology 15, no. 4 (October 2, 2021): 2103–16. http://dx.doi.org/10.22207/jpam.15.4.33.
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Helicobacter pylorus (H. pylori) is a deadly bacterium responsible for significant worldwide Gastric Cancer (GC) related mortality. The present study aimed to screen all the anti-microbial drugs used to eradicate H .pylori infection and to identify the most efficient drug by using computational methods through molecular docking analysis. The 3-D structure of protein chorismate synthase of H. pylori was downloaded from the Protein data bank (PDB) online browser. The x-ray crystallography structures of 13 common drugs used against H.pylori infection were also downloaded from the drug bank. We screened all 13 common drugs through molecular docking to know the most efficient binding interaction between the diverse ligand-protein complexes. The results were further compared with clinical survey data from the patients with diverse gastrointestinal H. pylori infected cases. Among the screened compounds, by in-silico approach we found that fluoroquinolone (FLRQ) and tetracycline (TET) manifested more significant interactions with chorismate synthase (CS) protein along with binding energies of -9.2 and -8.1 kcal/mole respectively. Further, the drugs were also corroborated with the survey data from patients with varied gastrointestinal disorders in our study. With this computational study, we could find FLRQ and TET may be the most efficient drug for H. pylori treatment, which can be tried in case of anti H. Pylori treatment failure due to resistance. Hence, effective inter-analysis between the experimental and computational approaches is crucial to build up a strong inhibitor.
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Terebiznik, M. R., C. L. Vazquez, K. Torbicki, D. Banks, T. Wang, W. Hong, S. R. Blanke, M. I. Colombo, and N. L. Jones. "Helicobacter pylori VacA Toxin Promotes Bacterial Intracellular Survival in Gastric Epithelial Cells." Infection and Immunity 74, no. 12 (September 25, 2006): 6599–614. http://dx.doi.org/10.1128/iai.01085-06.
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ABSTRACT Helicobacter pylori colonizes the gastric epithelium of at least 50% of the world's human population, playing a causative role in the development of chronic gastritis, peptic ulcers, and gastric adenocarcinoma. Current evidence indicates that H. pylori can invade epithelial cells in the gastric mucosa. However, relatively little is known about the biology of H. pylori invasion and survival in host cells. Here, we analyze both the nature of and the mechanisms responsible for the formation of H. pylori's intracellular niche. We show that in AGS cells infected with H. pylori, bacterium-containing vacuoles originate through the fusion of late endocytic organelles. This process is mediated by the VacA-dependent retention of the small GTPase Rab7. In addition, functional interactions between Rab7 and its downstream effector, Rab-interacting lysosomal protein (RILP), are necessary for the formation of the bacterial compartment since expression of mutant forms of RILP or Rab7 that fail to bind each other impaired the formation of this unique bacterial niche. Moreover, the VacA-mediated sequestration of active Rab7 disrupts the full maturation of vacuoles as assessed by the lack of both colocalization with cathepsin D and degradation of internalized cargo in the H. pylori-containing vacuole. Based on these findings, we propose that the VacA-dependent isolation of the H. pylori-containing vacuole from bactericidal components of the lysosomal pathway promotes bacterial survival and contributes to the persistence of infection.
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Elfira, Vanda, Dwi Prasetyo, Dzulfikar DLH, and Kusnandi Rusmil. "Perbedaan Status Gizi dan Perawakan Pendek pada Anak Sakit Perut Berulang dengan Helicobacter Pylori Positif dan Negatif." Sari Pediatri 20, no. 5 (March 19, 2019): 303. http://dx.doi.org/10.14238/sp20.5.2019.303-8.
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Latar belakang. Sakit perut berulang (SPB) merupakan keluhan yang paling sering pada anak. Infeksi Helicobacter pylori (H. pylori) saat ini merupakan salah satu penyebab organik terbanyak pada anak SPB. Infeksi H. pylori dapat menyebabkan malnutrisi dan perawakan pendek, tetapi hal ini masih kontroversial.Tujuan. Mengetahui perbedaan status gizi dan perawakan pendek antara anak SPB dengan infeksi H. pylori positif dan negatif.Metode Penelitian potong lintang analitik dilakukan pada anak SMP dan SMA di Bandung yang mengalami SPB. Infeksi H. pylori berdasarkan pemeriksaan serologis menggunakan kit BioM pylori. Analisis perbedaan status gizi dan perawakan pendek antara anak SPB dengan infeksi H. pylori positif dan negatif menggunakan uji chi square.Hasil. Terdapat 224 subjek mengalami SPB dari 1658 subjek yang disurvey. Sebanyak 99 subjek memenuhi kriteria inklusi. H. pylori positif pada 45 subjek. Uji beda memperlihatkan perbedaan proporsi pada status gizi kurang dan infeksi H. pylori positif, namun belum bermakna secara statistik. Pada uji beda perawakan pendek dengan infeksi H. pylori positif tidak didapatkan perbedaan bermakna.Kesimpulan. Tidak terdapat perbedaan bermakna status gizi dan perawakan pendek pada anak SPB dengan infeksi H. pylori positif dan infeksi H. pylori negatif.
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Lemke, Laura B., Zhongming Ge, Mark T. Whary, Yan Feng, Arlin B. Rogers, Sureshkumar Muthupalani, and James G. Fox. "Concurrent Helicobacter bilis Infection in C57BL/6 Mice Attenuates Proinflammatory H. pylori-Induced Gastric Pathology." Infection and Immunity 77, no. 5 (February 17, 2009): 2147–58. http://dx.doi.org/10.1128/iai.01395-08.
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ABSTRACT Because coinfections can alter helicobacter gastritis, we investigated whether enterohepatic Helicobacter bilis modulates Helicobacter pylori gastritis in C57BL/6 mice. Thirty mice per group were sham dosed, H. bilis or H. pylori infected, or H. bilis infected followed in 2 weeks by H. pylori and then evaluated at 6 and 11 months postinfection (mpi) for gastritis and premalignant lesions. Compared to H. pylori-infected mice, H. bilis/H. pylori-infected mice at 6 and 11 mpi had less severe gastritis, atrophy, mucous metaplasia and hyperplasia (P < 0.01) and, additionally, at 11 mpi, less severe intestinal metaplasia and dysplasia (P < 0.05). H. bilis/H. pylori-infected mice at 11 mpi exhibited less Ki67 labeling of proliferating epithelial cells, reduced numbers of FoxP3+ T-regulatory (TREG) cells, and lower FoxP3+ mRNA levels than did H. pylori-infected mice (P < 0.05). Proinflammatory interleukin-1β (IL-1β), gamma interferon, and tumor necrosis factor alpha mRNA levels were attenuated in H. bilis/H. pylori-infected mice at 6 and 11 mpi (P < 0.01), although anti-inflammatory IL-10, IL-13, and transforming growth factor β1 mRNA levels were not consistently impacted by H. bilis coinfection. Decreased pathology in H. bilis/H. pylori-infected mice correlated with higher gastric H. pylori colonization at 6 mpi (P < 0.001) and lower Th1-associated immunoglobulin G2c responses to H. pylori at 6 and 10 mpi (P < 0.05). We hypothesized that reduced pathology in H. bilis/H. pylori-infected mice was due to H. bilis-primed TREG cells in the lower bowel that migrated to the gastric compartment and inhibited Th1 responses to subsequent H. pylori infection. Thus, H. pylori-induced gastric lesions may vary in mouse models of unknown enteric helicobacter infection status and, importantly, variable sequelae to human H. pylori infection, particularly in developing countries, may occur where coinfection with lower bowel helicobacters and H. pylori may be common.
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Hiengrach, Pratsanee, Wimonrat Panpetch, Ariya Chindamporn, and Asada Leelahavanichkul. "Helicobacter pylori, Protected from Antibiotics and Stresses Inside Candida albicans Vacuoles, Cause Gastritis in Mice." International Journal of Molecular Sciences 23, no. 15 (August 2, 2022): 8568. http://dx.doi.org/10.3390/ijms23158568.
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Due to (i) the simultaneous presence of Helicobacter pylori (ulcer-induced bacteria) and Candida albicans in the stomach and (ii) the possibility of prokaryotic–eukaryotic endosymbiosis (intravacuolar H. pylori in the yeast cells) under stresses, we tested this symbiosis in vitro and in vivo. To that end, intravacuolar H. pylori were induced by the co-incubation of C. albicans with H. pylori under several stresses (acidic pH, non-H. pylori-enrichment media, and aerobic environments); the results were detectable by direct microscopy (wet mount) and real-time polymerase chain reaction (PCR). Indeed, intravacuolar H. pylori were predominant under all stresses, especially the lower pH level (pH 2–3). Interestingly, the H. pylori (an amoxicillin-sensitive strain) inside C. albicans were protected from the antibiotic (amoxicillin), while extracellular H. pylori were neutralizable, as indicated by the culture. In parallel, the oral administration of intravacuolar H. pylori in mice caused H. pylori colonization in the stomach resulting in gastritis, as indicated by gastric histopathology and tissue cytokines, similar to the administration of free H. pylori (extra-Candida bacteria). In conclusion, Candida protected H. pylori from stresses and antibiotics, and the intravacuolar H. pylori were able to be released from the yeast cells, causing gastric inflammation with neutrophil accumulations.
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Ahmed, Suha Hussein, and Saad Abdul Kareem Mohammed. "Helicobacter pylori infection in pregnant women and it’s correlation with the alterations of some trace elements levels in the serum at Maternity Teaching Hospital in Erbil City." Al Mustansiriyah Journal of Pharmaceutical Sciences 18, no. 2 (December 30, 2018): 41–50. http://dx.doi.org/10.32947/ajps.v18i2.474.
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Helicobacter pylori (H. pylori) is a spiral-shaped pathogenic bacterium found on the human gastric mucosa, Warren and Marshall isolated H pylori for the first time in 1982. It is one of the most common worldwide human infections [1].H. pylori play a vital role in the development of chronic gastritis, gastric ulcer, duodenal ulcer, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma [2]. The current study included (120) pregnant women, (50) positive anti -H. Pylori Ig and (70) negative anti- H. Pylori Ig with pregnancy for first, second and third semester at mean age/ years 28.36 for the positive anti-H. Pylori and 26.17 for the negative anti-H. Pylori appeared that an alteration of zinc level in serum of positive anti- H. Pylori Ig groups was (48.904 ± 18.3486) (μg/dl) comparing with the negative groups (90.757 ± 9.2727) with the highly significant difference (P < 0.01). While serum copper levels of positive anti-H. Pylori Ig group was (μg/dl), (100.412 ± 23.8234), documented as normal highly significant (P < 0.01) compared to the negative anti- H. Pylori Ig group (114.971 ± 20.4995).In this study, the GIT disorder with anti-H. Pylori Ig positive groups were (32, 64%) and anti-H. Pylori Ig negative groups were (32, 45.7%), with significant difference (P < 0.05).
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Zullo, Angelo, Vincenzo De Francesco, Annamaria Bellesia, Roberto Vassallo, Audenzio D’Angelo, Giuseppe Scaccianoce, Rodolfo Sacco, et al. "Bismuth-based Quadruple Therapy Following H. pylori Eradication Failures: a Multicenter Study in Clinical Practice." Journal of Gastrointestinal and Liver Diseases 26, no. 3 (September 1, 2017): 225–29. http://dx.doi.org/10.15403/jgld.2014.1121.263.zul.
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Background & Aims: Helicobacter pylori (H. pylori) eradication in patients who failed one or more therapeutic attempts remains challenging. This study aimed to assess the efficacy of three-in-one capsules bismuth-based quadruple therapy (Pylera®) in these patients managed in clinical practice.
Methods: This was a prospective, open-label, multicenter study enrolling consecutive, adult patients with persistent H. pylori infection following at least one standard therapy. All patients received a rescue quadruple therapy with Pylera (3 capsules four times daily) and esomeprazole 20 mg (1 tablet twice daily) for 10 days. H. pylori eradication was assessed by using Urea Breath Test 4-6 weeks following therapy ending. H. pylori eradication rates, compliance, and side-effects were calculated.
Results: A total of 208 patients in the 9 participating centres were enrolled. Overall, 180 patients were successfully cured from the infection, accounting for 86.5% (95% CI 81.9-91.2) and 92.3% (95% CI 88.6-96.1) eradication rates at intention-to-treat analysis and at per protocol analysis, respectively. Cure rates were similar across patients who failed one to three previous therapy attempts, but the success rate fell to 67% after 4 or more therapy failures. Compliance to therapy was good in 198 (95.2%) patients, whilst in 7 (5.3%) cases the therapy was interrupted within 5 days due to side effects. A total of 97 (46.6%) patients complained of at least one side effect; nausea, diarrhea and vomiting were the most frequently reported.
Conclusions: Our study found that this bismuth-based quadruple therapy is highly effective as second-line and rescue therapy for H. pylori eradication in clinical practice.
Abbreviations: CI: confidence intervals; ITT: intention-to-treat; PP: per protocol; UBT: urea breath test.