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Shmuely H, Shvartsman Y, Berdinstein R, Yahav J, Melzer E. The epidemiology of Helicobacter pylori resistance in a university affiliated hospital: a comparison between two time periods-a cross-sectional design. Eur J Med Res 2023; 28:538. [PMID: 38001550 PMCID: PMC10668426 DOI: 10.1186/s40001-023-01500-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE During the last few decades, the increased use of various types of antibiotics in the general population caused a significant change in regional Helicobacter pylori (H. pylori) antibiotic resistance. Our aim is to study the changes in H. pylori resistance in patients who had undergone an esophagogastroduodenoscopy (EGD) and susceptibility testing and found positive for H. pylori. The study was conducted in a university affiliated hospital between 2013-2020. METHODS A cross-sectional study was performed on all consecutive patients who had undergone an EGD and tested positive for H. pylori at the Kaplan Medical Center, Israel. The study period was divided into two sub-periods: 2013-2016 and 2017-2020. Data on age, sex, comorbidities, previous treatments, and antimicrobial susceptibility testing for six antimicrobial agents were compared. RESULTS The resistance rates of H. pylori to clarithromycin and dual resistance to clarithromycin and metronidazole were found significantly higher during the late period. Multivariable analysis showed that the later period, older age, and diabetes mellitus were independent predictors for antimicrobial resistance. CONCLUSIONS Our study has shown that there is an increasing resistance of H. pylori to clarithromycin and metronidazole while its susceptibility is unaffected with time to other antibiotics. More recent cross-sectional studies with larger samples are warranted in order to evaluate the changes in the resistance patterns of H. pylori to various antibiotics with time.
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Affiliation(s)
- Haim Shmuely
- Department of Internal Medicine D, and Helicobacter Research Institute, Kaplan Medical Center, Rehovot, Israel.
- Faculty of Medicine, Hebrew University, Jerusalem, Israel.
| | - Yekaterina Shvartsman
- Department of Internal Medicine D, and Helicobacter Research Institute, Kaplan Medical Center, Rehovot, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Rita Berdinstein
- Microbiology Laboratory, Kaplan Medical Center, Rehovot, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Jacob Yahav
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Ehud Melzer
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Department of Gastroenterology, Kaplan Medical Center, Rehovot, Israel
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Sirkeci Ö, Erkuş Sirkeci E, Ulaş T. The Prevalence of <i>Helicobacter pylori</i> in Northern Cyprus: A Retrospective Study. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2021.3565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Jonaityte IR, Ciupkeviciene E, Jonaitis P, Kupcinskas J, Petkeviciene J, Jonaitis L. Changes in the Seroprevalence of Helicobacter pylori among the Lithuanian Medical Students over the Last 25 Years and Its Relation to Dyspeptic Symptoms. ACTA ACUST UNITED AC 2021; 57:medicina57030254. [PMID: 33803389 PMCID: PMC8001799 DOI: 10.3390/medicina57030254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
Background and Objectives: The prevalence of Helicobacter pylori infection is decreasing in the Western world, while remaining high in developing countries. There is limited up-to-date information about the prevalence of H. pylori in Central and Eastern Europe. The aim of our study was to assess the seroprevalence of H. pylori and its trend over the past 25 years among students of the Lithuanian University of Health Sciences (LUHS) and to assess its relation to dyspeptic symptoms. Materials and Methods: In the years 1995, 2012, 2016 and 2020, students from Medical and Nursing Faculties of LUHS were tested for the presence of antibodies against H. pylori by performing serological tests from finger capillary blood. In addition, in the years 2012, 2016 and 2020, the students completed a gastrointestinal symptom rating scale (GSRS) questionnaire in order to assess dyspeptic symptoms. The study population consisted of 120 students in the year 1995 (mean age—21.3 ± 1.0 years), 187 students in the year 2012 (mean age—22.4 ± 0.7 years), 262 students in the year 2016 (mean age—20.4 ± 1.0 years) and 148 students in the year 2020 (mean age—20.4 ± 1.7 years). Results: The seroprevalence for H. pylori was positive in 62 (51.7%) students in 1995, in 57 (30.4%) students in 2012, in 69 (26.3%) students in 2016 and in 21 (14.2%) students in 2020. The statistically significant difference was found between all study years, except between 2012 and 2016. There were no significant differences in frequency and intensity of upper dyspeptic symptoms between H. pylori positive and negative students. Conclusions: Over the last 25 years the seroprevalence of H. pylori among students of LUHS has decreased significantly. No consistent differences in dyspeptic symptoms among H. pylori positive and negative subgroups were found.
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Affiliation(s)
- Ieva Renata Jonaityte
- Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus str. 9, 44307 Kaunas, Lithuania;
| | - Eglė Ciupkeviciene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 44307 Kaunas, Lithuania; (E.C.); (J.P.)
| | - Paulius Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50009 Kaunas, Lithuania; (P.J.); (J.K.)
| | - Juozas Kupcinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50009 Kaunas, Lithuania; (P.J.); (J.K.)
| | - Janina Petkeviciene
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes str. 18, 44307 Kaunas, Lithuania; (E.C.); (J.P.)
| | - Laimas Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50009 Kaunas, Lithuania; (P.J.); (J.K.)
- Correspondence: ; Tel.: +370-37326264
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Wang L, Chen J, Jiang W, Cen L, Pan J, Yu C, Li Y, Chen W, Chen C, Shen Z. The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis. Can J Gastroenterol Hepatol 2021; 2021:8886085. [PMID: 33505946 PMCID: PMC7806380 DOI: 10.1155/2021/8886085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/04/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) is proved to be the main pathogenic agent of various diseases, including chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. In addition, chronic cholecystitis and cholelithiasis are common worldwide, which are supposed to increase the total mortality of patients. Epidemiologic evidence on the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis still remains unclear. We conducted a systematic review and meta-analysis of overall studies to investigate the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis. Two researchers searched PubMed, Embase, and Cochrane Library databases to obtain all related and eligible studies published before July 2020. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by the random-effects model. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also conducted. Twenty studies were included in the meta-analysis, involving 1735 participants and 1197 patients with chronic cholecystitis/cholelithiasis. Helicobacter species infection of the gallbladder was positively correlated with increased risk of chronic cholecystitis and cholelithiasis, especially H. pylori (OR = 3.05; 95% CI, 1.81-5.14; I 2 = 23.5%). Besides, country-based subgroup analysis also showed a positive correlation between the gallbladder H. pylori positivity and chronic cholecystitis/cholelithiasis risk. For Asian and non-Asian country studies, the ORs were 4.30 (95% CI, 1.76-10.50; I 2 = 37.4%) and 2.13 (95% CI, 1.23-3.70; I 2 = 0.0%), respectively. The association was more obvious using the bile sample and urease gene primer. In conclusion, this meta-analysis provided evidence that there is a positive correlation between H. pylori infection in the gallbladder and increased risk of chronic cholecystitis and cholelithiasis.
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Affiliation(s)
- Liang Wang
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Endoscopy Center, Cangzhou Central Hospital of Hebei Province, Cangzhou, Hebei Province, China
| | - Junyin Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Gastroenterology, The Affiliated Hospital, Shaoxing College of Arts and Sciences, Shaoxing, Zhejiang Province, China
| | - Wenxi Jiang
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Li Cen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiaqi Pan
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chaohui Yu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Youming Li
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Weixing Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxiao Chen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Shen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Prevalence of Helicobacter pylori Infection and Diagnostic Methods in the Middle East and North Africa Region. ACTA ACUST UNITED AC 2020; 56:medicina56040169. [PMID: 32283700 PMCID: PMC7230269 DOI: 10.3390/medicina56040169] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 12/15/2022]
Abstract
Background and Objectives:Helicobacter pylori (H. pylori) infection is common worldwide and may cause gastroduodenal complications, including cancer. In this review, we examine the prevalence and distribution of various H. pylori genotypes and the risk factors for H. pylori infection, particularly in the Middle East and North Africa (MENA) region. We also introduce different global screening methods and guidelines and compare them to those currently in use in the MENA region. Materials and Methods: We searched the Google Scholar, PubMed, and Saudi Digital Library (SDL) databases for clinical trials and articles published in English. The data collection was mainly focused on MENA countries. However, for H. pylori genotypes and diagnostic methods, studies conducted in other regions or reporting global practices and guidelines were also included to allow a comparison with those in the MENA region. We also included studies examining the prevalence of H. pylori infection in healthy participants. Results:H. pylori infection is highly prevalent in the MENA region, mainly because of the accumulation of risk factors in developing countries. Herein, we highlight a lack of good quality studies on the prevalence of various H. pylori genotypes in the MENA region as well as a need for standard diagnostic methods and screening guidelines. Due to the complications associated with H. pylori, we recommend routine screening for H. pylori infection in all gastroenterology patients admitted in the MENA region. Conclusion: Concerted effort will first be required to validate affordable, non-invasive, and accurate diagnostic methods and to establish local guidelines with adapted cut-off values for the interpretation of the test results.
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Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem. Epidemiol Infect 2019; 147:e276. [PMID: 31552815 PMCID: PMC6807302 DOI: 10.1017/s0950268819001456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%–85.5%) and 61.4% (95% CI 57.7%–65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%–45.8%) and 32.5% (95% CI 28.2%–37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.
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Obaidat MM, Roess AA. First nationwide seroepidemiology and risk factors report of Helicobater pylori in Jordan. Helicobacter 2019; 24:e12572. [PMID: 30868689 DOI: 10.1111/hel.12572] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/16/2019] [Accepted: 01/24/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Helicobacter pylori inhabits the gastric mucosa of humans and causes 89% of all gastric cancers. This is the first study of the seroprevalence, spatial distribution, and risk factors for H pylori in Jordan. MATERIALS AND METHODS This is a cross-sectional study of 460 healthy participants (aged between 15 and 81 years) proportionately sampled across each region of Jordan. Sera samples were tested for H pylori using Enzygnost® anti-H pylori immunoglobulin G enzyme-linked immunosorbent assay. Participants completed a validated questionnaire about potential risk factors including food consumption habits and environmental and animal exposure. Multivariate generalized linear models identified risk factors for infection. RESULTS The results showed a high seroprevalence (88.6%; 95% confidence interval [CI]: 85.3-91.2) of H pylori in the study population. After adjusting for possible confounders, age, consumption of raw milk, and location of residence were significantly associated with seropositivity. Older participants aged 30-49 years had an 11% greater risk of seropositivity compared to participants aged 15-29 years. Participants who consume raw milk and dairy products have a 9% decreased risk in seropositivity (prevalence ratio = 0.92; 95% CI: 0.84-0.99) compared to those who do not consume these products. CONCLUSION This study reports a negative association between consumption of raw milk and seropositivity, and this is in line with several studies that report consumption of raw milk may be protective against H pylori. However, because of the risk of other serious pathogens associated with the consumption of raw dairy products, this study recommends pasteurization of raw milk. Future studies on the effect of fermented dairy products on H pylori colorization in gastric mucosa are recommended.
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Affiliation(s)
- Mohammad M Obaidat
- Department of Veterinary Pathology and Public Health, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Amira A Roess
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
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Muhsen K, Sinnreich R, Merom D, Beer-Davidson G, Nassar H, Cohen D, Kark JD. Prevalence and determinants of serological evidence of atrophic gastritis among Arab and Jewish residents of Jerusalem: a cross-sectional study. BMJ Open 2019; 9:e024689. [PMID: 30700483 PMCID: PMC6352795 DOI: 10.1136/bmjopen-2018-024689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Understanding the correlates of premalignant gastric lesions is essential for gastric cancer prevention. We examined the prevalence and correlates of serological evidence of atrophic gastritis, a premalignant gastric condition, using serum pepsinogens (PGs) in two populations with differing trends in gastric cancer incidence. METHODS In a cross-sectional study, using ELISA we measured serum PGI and PGII concentrations (Biohit, Finland), Helicobacter pylori serum IgG and cytotoxin-associated gene A (CagA) antigen IgG antibodies in archived sera of 692 Jews and 952 Arabs aged 25-78 years, randomly selected from Israel's population registry in age-sex and population strata. Multivariable logistic regression analyses were performed. RESULTS Using cut-offs of PGI <30µg/L or PGI:PGII <3.0, the prevalence of atrophic gastritis was higher among Arab than Jewish participants: 8.8% (95% CIs 7.2% to 10.8%) vs 5.9% (95% CI 4.4% to 7.9%), increasing with age in both groups (p<0.001 for trend). Among Jewish participants, infection with H. pylori CagA phenotype was positively related to atrophic gastritis: adjusted OR (aOR) 2.16 (95% CI 0.94 to 4.97), but not to non-CagA infections aOR 1.17 (95% CI 0.53 to 2.55). The opposite was found among Arabs: aOR 0.09 (95% CI 0.03 to 0.24) for CagA positive and aOR 0.15 (95% CI 0.06 to 0.41) for Cag A negative phenotypes (p<0.001 for interaction). Women had a higher atrophic gastritis prevalence than men. Obesity and smoking were not significantly related to atrophic gastritis; physical activity tended to be inversely associated in Arabs (p=0.08 for interaction). CONCLUSIONS The prevalence of atrophic gastritis was higher among Arabs than Jews and was differently associated with the CagA phenotype.
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Affiliation(s)
- Khitam Muhsen
- Epidemiology and Preventive Medicine, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Ronit Sinnreich
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Dafna Merom
- School of Science and Health, Western Sydney University, Sydney, Australia
| | - Gany Beer-Davidson
- Epidemiology and Preventive Medicine, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Hisham Nassar
- St. Joseph Hospital, East Jerusalem and Department of Cardiology, Hadassah-Hebrew University Medical Center, Ein Karem, Jerusalem, Israel
| | - Dani Cohen
- Epidemiology and Preventive Medicine, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Jeremy D Kark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
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Miernyk KM, Bulkow LR, Gold BD, Bruce MG, Hurlburt DH, Griffin PM, Swerdlow D, Cook K, Hennessy T, Parkinson AJ. Prevalence of Helicobacter pylori among Alaskans: Factors associated with infection and comparison of urea breath test and anti-Helicobacter pylori IgG antibodies. Helicobacter 2018; 23. [PMID: 29537130 PMCID: PMC6640139 DOI: 10.1111/hel.12482] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Helicobacter pylori is one of the most common human infections in the world, and studies in Alaska Native people, as well as other Indigenous peoples, have shown a high prevalence of this gastric infection. This study was undertaken to determine the prevalence of H. pylori infection by urea breath test (UBT) and anti- H. pylori IgG among Alaskans living in four regions of the state and to identify factors associated with infection. METHODS A convenience sample of persons > 6 months old living in five rural and one urban Alaskan community were recruited from 1996 to 1997. Participants were asked about factors possibly associated with infection. Sera were collected and tested for anti- H. pylori IgG antibodies; a UBT was administered to participants > 5 years old. RESULTS We recruited 710 people of whom 571 (80%) were Alaska Native and 467 (66%) were from rural communities. Rural residents were more likely to be Alaska Native compared with urban residents (P < .001). Of the 710 people, 699 (98%) had a serum sample analyzed, and 634 (97%) persons > 5 years old had a UBT performed. H. pylori prevalence was 69% by UBT and 68% by anti- H. pylori IgG. Among those with a result for both tests, there was 94% concordance. Factors associated with H. pylori positivity were Alaska Native racial status, age ≥ 20 years, rural region of residence, living in a crowded home, and drinking water that was not piped or delivered. CONCLUSIONS Helicobacter pylori prevalence is high in Alaska, especially in Alaska Native persons and rural residents. Concordance between UBT and serology was also high in this group. Two socioeconomic factors, crowding and drinking water that was not piped or delivered, were found to be associated with H. pylori positivity.
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Affiliation(s)
- KM Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
| | - LR Bulkow
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
| | - BD Gold
- Children’s Center for Digestive Healthcare, LLC; Atlanta, Georgia USA
| | - MG Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
| | - DH Hurlburt
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
| | - PM Griffin
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Atlanta, Georgia USA
| | - D Swerdlow
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Atlanta, Georgia USA
| | - K Cook
- Kiel Laboratories, Inc.; Flowery Branch, Georgia USA
| | - T Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
| | - AJ Parkinson
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention; Anchorage, Alaska USA
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Helicobacter pylori infection is positively associated with an increased BMI, irrespective of socioeconomic status and other confounders: a cohort study. Eur J Gastroenterol Hepatol 2018; 30:143-148. [PMID: 29120907 DOI: 10.1097/meg.0000000000001014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Data on the association of Helicobacter pylori infection and BMI are conflicting. The fact that both H. pylori infection and BMI are associated with low socioeconomic status (SES) makes this relationship difficult to characterize. MATERIALS AND METHODS We aimed to evaluate the association between BMI and H. pylori infection after adjusting for multiple covariates. We analyzed a cohort of 235 107 individuals aged 18 years or older, who performed a C urease breath test (C-UBT), from 2007 to 2014. Data on BMI, age, sex, SES, ethnicity, and medications were extracted from a nationwide population-based database. BMIs were classified according to the WHO recommendations: underweight (<18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25-29.9 kg/m), obese class I (30-34.9 kg/m), and obese class II or more (>35 kg/m). STUDY RESULTS The positivity rate for H. pylori among underweight, normal weight, overweight, and obese class I and class II or more was 55.6, 58.5, 63.0, 64.5, and 65.5%, respectively (P<0.001, Plinear trend 0.007). The association between BMI and H. pylori infection was significant across all SES, sex, ethnicity, and age categories. After adjusting for age, sex, ethnicity, and SES, being overweight and obese class I and class II or more were associated significantly with H. pylori positivity: odds ratio 1.13 [95% confidence interval (CI): 1.11-1.15], 1.14 (95% CI: 1.11-1.17), and 1.15 (95% CI: 1.11-1.19), respectively, P value less than 0.001 for all. CONCLUSION Among individuals who were referred to a C-UBT by primary care physician, after adjusting for multiple covariates including SES, we found a positive association between H. pylori infection and an increased BMI.
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Eisdorfer I, Shalev V, Goren S, Chodick G, Muhsen K. Sex differences in urea breath test results for the diagnosis of Helicobacter pylori infection: a large cross-sectional study. Biol Sex Differ 2018; 9:1. [PMID: 29291751 PMCID: PMC5749022 DOI: 10.1186/s13293-017-0161-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/14/2017] [Indexed: 12/15/2022] Open
Abstract
Background Helicobacter pylori causes peptic ulcer disease and gastric cancer only in a subset of infected persons. Sex differences were shown in results of urea breath test (UBT), a commonly used test for the diagnosis of H. pylori infection. However, factors that might explain these differences, or affect UBT values, are not fully understood. We examined differences in UBT values between H. pylori-infected men and women while adjusting for background characteristics such as age, body mass index (BMI), and smoking. Methods A cross-sectional study was undertaken using coded data from the computerized database of Maccabi Health Services in Israel. Included were adults examined for UBT during 2002–2012 and were found H. pylori positive (UBT > 3.5‰). Multivariable linear mixed models were performed to assess the relationship between sex and UBT quantitative results, while adjusting for background characteristics. Results A total of 76,403 patients were included (52% of examined patients during the study period). Adjusted mean UBT value was significantly higher in women 33.8‰ (95% CI 33.4, 34.1) than in men 24.9‰ (95% CI 24.5, 25.3). A significant (P < 0.001) interaction was found between sex and smoking, showing diminished sex-differences in UBT results in smokers. Adjusted mean UBT values increased significantly with age and decreased with BMI, and it was higher in people who lived in low vs high socioeconomic status communities and lower in smokers vs non-smokers. Conclusions Systemic differences exist between men and women in quantitative UBT results. Host-related and environmental factors might affect UBT quantitative results. These findings have clinical implications regarding confirmation of the success of H. pylori eradication after treatment in various subgroups.
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Affiliation(s)
- Ido Eisdorfer
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Varda Shalev
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.,Medical Informatics Division, Maccabi Health Services, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Gabriel Chodick
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.,Medical Informatics Division, Maccabi Health Services, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
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Zabala Torrres B, Lucero Y, Lagomarcino AJ, Orellana-Manzano A, George S, Torres JP, O'Ryan M. Review: Prevalence and dynamics of Helicobacter pylori infection during childhood. Helicobacter 2017. [PMID: 28643393 DOI: 10.1111/hel.12399] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Long-term persistent Helicobacter pylori infection has been associated with ulceropeptic disease and gastric cancer. Although H. pylori is predominantly acquired early in life, a clear understanding of infection dynamics during childhood has been obfuscated by the diversity of populations evaluated, study designs, and methods used. AIM Update understanding of true prevalence of H. pylori infection during childhood, based on a critical analysis of the literature published in the past 5 years. METHODS Comprehensive review and meta-analysis of original studies published from 2011 to 2016. RESULTS A MEDLINE® /PubMed® search on May 1, 2016, using the terms pylori and children, and subsequent exclusion, based on abstract review using predefined criteria, resulted in 261 citations. An Embase® search with the same criteria added an additional 8 citations. In healthy children, meta-analysis estimated an overall seroprevalence rate of 33% (95% CI: 27%-38%). Seven healthy cohort studies using noninvasive direct detection methods showed infection prevalence estimates ranging from 20% to 50% in children ≤5 and 38% to 79% in children >5 years. The probability of infection persistence after a first positive sample ranged from 49% to 95%. Model estimates of cross-sectional direct detection studies in asymptomatic children indicated a prevalence of 37% (95% CI: 30%-44%). Seroprevalence, but not direct detection rates increased with age; both decreased with increasing income. The model estimate based on cross-sectional studies in symptomatic children was 39% (95% CI: 35%-43%). CONCLUSIONS The prevalence of H. pylori infection varied widely in the studies included here; nevertheless, model estimates by detection type were similar, suggesting that overall, one-third of children worldwide are or have been infected. The few cohort and longitudinal studies available show variability, but most studies, show infection rates over 30%. Rather surprisingly, overall infection prevalence in symptomatic children was only slightly higher, around 40%. Studies including only one positive stool sample should be interpreted with caution as spontaneous clearance can occur.
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Affiliation(s)
- Beatriz Zabala Torrres
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile.,Universidad de Aysén, Campus Rio Simpson, Coyhaique, Chile
| | - Yalda Lucero
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Anne J Lagomarcino
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Andrea Orellana-Manzano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida (FCV), Campus Gustavo Galindo Km. 30.5 Vía Perímetral, P. O. Box 09-01-5863, Guayaquil, Ecuador
| | - Sergio George
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Juan P Torres
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Miguel O'Ryan
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
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Haj S, Chodick G, Refaeli R, Goren S, Shalev V, Muhsen K. Associations of Helicobacter pylori infection and peptic disease with diabetic mellitus: Results from a large population-based study. PLoS One 2017; 12:e0183687. [PMID: 28850590 PMCID: PMC5574557 DOI: 10.1371/journal.pone.0183687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/09/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Evidence is conflicting regarding the association between Helicobacter pylori infection and diabetes mellitus. The study objective was to examine associations of H. pylori infection, gastric ulcers and duodenal ulcers, with diabetes mellitus. METHODS This cross-sectional study was undertaken using coded data from the computerized database of Maccabi Health Services in Israel, on 147,936 individuals aged 25-95 years who underwent the urea breath test during 2002-2012. Multiple logistic regression models were conducted, while adjusting for known risk factors for diabetes mellitus. RESULTS A H. pylori positive test was recorded for 76,992 (52.0%) individuals and diabetes for 12,207 (8.3%). The prevalence of diabetes was similar in individuals with and without H. pylori infection, but this association was modified (P for heterogeneity 0.049) by body mass index (BMI): adjusted odds ratio (aOR) 1.16 (95% confidence intervals (CI) 1.04-1.29) in persons with BMI<25 kg/m2 versus aOR 1.03 (95% CI 0.98-1.08) in persons with BMI≥25 kg/m2. Diabetes mellitus prevalence was higher in persons with gastric (aOR 1.20 (95% CI 1.06-1.34)) and duodenal ulcers (aOR 1.20 (95% CI 1.12-1.28)) compared to persons without these diagnoses. CONCLUSIONS In this large population-based study, we demonstrated significant positive associations, albeit of small magnitude, of H. pylori infection and peptic disease with diabetes. The long-term gastric inflammation and associated-damage to the gastric mucosa might play a role in such associations.
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Affiliation(s)
- Saeda Haj
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Chodick
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical division, Maccabi Health Services, Tel Aviv, Israel
| | - Rotem Refaeli
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Varda Shalev
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical division, Maccabi Health Services, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
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14
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Broide E, Richter V, Mendlovic S, Shalem T, Eindor-Abarbanel A, Moss SF, Shirin H. Lymphoid follicles in children with Helicobacter pylori-negative gastritis. Clin Exp Gastroenterol 2017; 10:195-201. [PMID: 28860835 PMCID: PMC5560569 DOI: 10.2147/ceg.s133421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The prevalence of Helicobacter pylori gastritis has been declining, whereas H. pylori-negative gastritis has become more common. We evaluated chronic gastritis in children with regard to H. pylori status and celiac disease (CD). Patients and methods Demographic, clinical, endoscopic, and histologic features of children who underwent elective esophagogastroduodenoscopy were reviewed retrospectively. Gastric biopsies from the antrum and corpus of the stomach were graded using the Updated Sydney System. H. pylori presence was defined by hematoxylin and eosin, Giemsa, or immunohistochemical staining and urease testing. Results A total of 184 children (61.9% female) met the study criteria with a mean age of 10 years. A total of 122 (66.3%) patients had chronic gastritis; 74 (60.7%) were H. pylori-negative. Children with H. pylori-negative gastritis were younger (p=0.003), were less likely to present with abdominal pain (p=0.02), and were mostly of non-Arabic origin (p=0.011). Nodular gastritis was found to be less prevalent in H. pylori-negative gastritis (6.8%) compared with H. pylori-positive gastritis (35.4%, p<0.001). The grade of mononuclear infiltrates and neutrophil density was more severe in the H. pylori-positive group (p<0.001). Pan-gastritis and lymphoid follicles were associated most commonly with H. pylori. Although less typical, lymphoid follicles were demonstrated in 51.3% of H. pylori-negative patients. The presence or absence of CD was not associated with histologic findings in H. pylori-negative gastritis. Conclusion Our findings suggest that lymphoid follicles are a feature of H. pylori-negative gastritis in children independent of their CD status.
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Affiliation(s)
- Efrat Broide
- Pediatric Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler School of Medicine, Tel Aviv University
| | - Vered Richter
- Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Sonia Mendlovic
- Pathology Institute, Assaf Harofeh Medical Center, Tzrifin, Israel
| | - Tzippora Shalem
- Pediatric Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Department of Pediatrics, Assaf Harofeh Medical Center, Tzrifin, Israel
| | | | - Steven F Moss
- Division of Gastroenterology, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA
| | - Haim Shirin
- Gastroenterology Service, Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center, Tzrifin, Israel.,Sackler School of Medicine, Tel Aviv University
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15
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Abstract
Helicobacter pylori is an important human pathogen, associated with a substantial burden from both malignant and non-malignant diseases. The bacterium is classed as a human carcinogen, being strongly linked with gastric cancer, the third most common cause of cancer death worldwide and is also associated with common conditions such as dyspepsia and peptic ulcer. Eradication of H. pylori reduces the incidence of gastric cancer and peptic ulcer, as well as the prevalence and costs of managing dyspepsia. Economic analyses suggest that eradication of H. pylori as a means of controlling gastric cancer is cost-effective in high-risk populations. Even in populations at low risk of gastric cancer, there might be other benefits arising from screening and treatment, owing to the effects on non-malignant upper gastrointestinal diseases. However, public health authorities have been slow to consider the benefits of population-based screening and treatment as a means of reducing the morbidity and mortality associated with the infection. There are also concerns about widespread use of eradication therapy, including antimicrobial resistance and a rise in the prevalence of diseases that are negatively associated with H. pylori, such as GERD, Barrett oesophagus, asthma and obesity. This Review summarizes these issues.
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16
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Abstract
An association between Helicobacter pylori (H pylori) infection as environmental risk factors for Hashimoto thyroiditis (HT) has been reported. We investigated this hypothesis in women in which HT is more common. Serum immunoglobulin G antibodies against H pylori (enzyme-linked immunosorbent assay), CagA protein (Western blot assay), circulating antibodies to thyroid antigens, mainly thyroperoxidase (TPOAbs) and thyroglobulin (TgAbs), were tested in 101 females with HT and 111 non-HT control women without a history of autoimmune disease. Thyroid function, socioeconomic status at childhood, and family history of thyroid malfunction were also studied. Forty-seven HT women (46.5%) tested seropositive for H pylori versus 48 controls (43.2%; P = 0.63). The prevalence of anti-CagA antibodies was 21.3% in HT-infected patients and 31.2% in infected controls (P = 0.352). Women with HT were older than the controls at a significance level of 0.03, and higher prevalence of hypothyroidism (69% vs 13.5%, respectively) and family history of thyroid malfunction (59% vs 34%, respectively) (P < 0.001 in both). Body mass index, diaphragmatic hernia, peptic ulcer, heartburn, use of proton pump inhibitors, childhood socioeconomic background, and crowding index showed no significant difference between HT-positive or negative individuals. Multivariate analysis demonstrated that H pylori seropositivity was not associated with HT (odds ratio 1.15, 95% confidence interval 0.57-1.83, P = 0.95) and that family thyroid malfunction was independently associated with an increased risk of HT (odds ratio 3.39, 95% confidence interval 1.86-6.18, P < 0.001). No association was found between H pylori infection and HT in women. Family history of thyroid malfunction is a risk factor for HT.
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Affiliation(s)
- Haim Shmuely
- Department of Internal Medicine D, Helicobacter Institute, Kaplan Medical Center, Rehovot and the Faculty of Medicine, Hebrew University, Jerusalem, Rehovot, Israel
- Correspondence: Haim Shmuely, Department Medicine D, Kaplan Medical Center, Rehovot 76100, Israel (e-mail: )
| | - Ilan Shimon
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Limor Azulay Gitter
- Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
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Shirin D, Matalon S, Avidan B, Broide E, Shirin H. Real-world Helicobacter pylori diagnosis in patients referred for esophagoduodenoscopy: The gap between guidelines and clinical practice. United European Gastroenterol J 2016; 4:762-769. [PMID: 28408993 DOI: 10.1177/2050640615626052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/13/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Histopathology is the most accurate test to detect H. pylori when performed correctly with unknown validity in daily practice clinic settings. We aimed to determine the rate of potentially false-negative H. pylori results that might be due to continued use of proton pump inhibitors (PPIs) in routine endoscopy practice. We also aimed to establish whether gastroenterologists recommend routine cessation of PPIs before esophagogastroduodenoscopy (EGD) and whether they regularly document that biopsies for H. pylori testing have been taken while the patients are on PPI treatment. METHODS Detailed information about three known factors (PPIs, antibiotics and prior H. pylori eradication treatment), which may cause histology or rapid urease test (RUT) to be unreliable, had been prospectively collected through interviews using a questionnaire before each test. Gastric biopsies were stained with H&E for histological analysis. RESULTS A total of 409 individuals at three academic gastroenterology institutions were tested 200 times with histology. Fifty-six per cent (68 of 122) of all negative tests fell in the category of continuing PPI use, which had the potential to make the histology and RUT results unreliable. CONCLUSIONS These data demonstrate a clear and important gap between current guidelines and real-world practice with regards to the diagnosis of H. pylori during EGD. A negative histology or RUT should be considered false negative until potential protocol violations are excluded. Documentation of PPI use during the EGD should be an integral part of the EGD report. The current practice of taking biopsies for H. pylori testing in patients under PPIs should be reevaluated.
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Affiliation(s)
- Dor Shirin
- The Kamila Gonczarowski Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Shay Matalon
- The Kamila Gonczarowski Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Benjamin Avidan
- Gastroenterology Institute, Sheba Medical Center, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Efrat Broide
- The Kamila Gonczarowski Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Shirin
- The Kamila Gonczarowski Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Boltin D, Perets TT, Elheiga SA, Sharony A, Niv Y, Shamaly H, Dickman R. Helicobacter pylori infection amongst Arab Israeli women with hyperemesis gravidarum—a prospective, controlled study. Int J Infect Dis 2014; 29:292-5. [DOI: 10.1016/j.ijid.2014.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/22/2014] [Accepted: 10/25/2014] [Indexed: 01/27/2023] Open
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Trends in secondary antibiotic resistance of Helicobacter pylori from 2007 to 2014: has the tide turned? J Clin Microbiol 2014; 53:522-7. [PMID: 25428158 DOI: 10.1128/jcm.03001-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The current guidelines recommend culture and antibiotic susceptibility testing of Helicobacter pylori following two failed eradication attempts. Where testing is unavailable, epidemiological data for secondary H. pylori resistance are essential to allow for the rational use of antibiotics. The aim of this study was to describe the temporal changes in antibiotic resistance among adults previously treated for H. pylori infections and to identify predictors of resistance. Between 2007 and 2014, consecutive patients undergoing gastroscopy with H. pylori culture and susceptibility testing at our institution following at least two treatment failures were retrospectively identified. Antibiotic susceptibilities were recorded and linked to the demographic data. A total of 1,042 patients were identified, including 739 (70.9%) males, aged 39.3 ± 18.9 years. Resistance to clarithromycin, metronidazole, and levofloxacin was found in 57.2%, 64.4%, and 5.1% of isolates, respectively. Dual resistance to clarithromycin and metronidazole was seen in 39.9%. Over the study period, clarithromycin resistance increased annually in a linear manner (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.03 to 1.14; P < 0.01), levofloxacin resistance decreased annually (OR, 0.78; 95% CI, 0.61 to 0.92; P < 0.01), and metronidazole resistance was nonlinear. Age was an independent predictor of resistance to all antibiotics. Time elapsed predicted resistance for clarithromycin and levofloxacin and dual resistance for clarithromycin-metronidazole. Secondary resistance of H. pylori to clarithromycin and metronidazole remains high. The low secondary resistance to levofloxacin makes it an attractive treatment option in our region for patients following two failed eradication attempts.
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Alvarado-Esquivel C, Ramos-Nevárez A, Cerrillo-Soto SM, Martínez-Ramírez L, Guido-Arreola CA, Muñoz-González FA. Seroepidemiology of <i>Helicobacter pylori</i> infection in general population in a northern Mexican city. Health (London) 2014. [DOI: 10.4236/health.2014.61005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Levi Z, Kark JD, Shamiss A, Derazne E, Tzur D, Keinan-Boker L, Liphshitz I, Niv Y, Furman M, Afek A. Body mass index and socioeconomic status measured in adolescence, country of origin, and the incidence of gastroesophageal adenocarcinoma in a cohort of 1 million men. Cancer 2013; 119:4086-93. [DOI: 10.1002/cncr.28241] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 04/16/2013] [Accepted: 04/26/2013] [Indexed: 02/06/2023]
Affiliation(s)
- Zohar Levi
- Medical Corps; Israeli Defense Force; Jerusalem Israel
- Gastroenterology Department; Rabin Medical Center; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Jeremy D. Kark
- Hebrew University-Hadassah School of Public Health and Community Medicine; Jerusalem Israel
| | - Ari Shamiss
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Sheba Medical Center; Tel Hashomer Israel
| | - Estela Derazne
- Medical Corps; Israeli Defense Force; Jerusalem Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Dorit Tzur
- Medical Corps; Israeli Defense Force; Jerusalem Israel
| | | | | | - Yaron Niv
- Gastroenterology Department; Rabin Medical Center; Petach Tikva Israel
| | - Moshe Furman
- Medical Corps; Israeli Defense Force; Jerusalem Israel
| | - Arnon Afek
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Sheba Medical Center; Tel Hashomer Israel
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Alvarado-Esquivel C. Helicobacter Pylori Infection in Waste Pickers: A Case Control Seroprevalence Study. Gastroenterology Res 2013; 6:174-179. [PMID: 27785250 PMCID: PMC5051092 DOI: 10.4021/gr578e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 12/31/2022] Open
Abstract
Background The epidemiology of Helicobacter pylori (H. pylori) infection in waste pickers had not been previously studied. This study aims to determine the association of H. pylori seropositivity and waste picking activity; and to determine socio-demographic, clinical, work, and behavioral characteristics associated with H. pylori seropositivity in waste pickers. Methods Through a case-control study design, we examined 90 waste pickers and 90 age- and gender-matched control subjects for the presence of anti-H. pylori IgG antibodies using enzyme-linked immunoassays. Seroprevalence association with socio-demographic, clinical, work and behavioral characteristics of the waste pickers were also investigated. Results Antibodies to H. pylori were found in 60 (66.7%) of the 90 waste pickers and in 51 (56.7%) of the 90 controls (P = 0.16). Stratification by age showed that waste pickers aged 14 -30 years old had significantly higher frequency of H. pylori infection than controls of the same age group (56.5% versus 35.6%, respectively; P = 0.04). The seroprevalence of H. pylori infection was not influenced by gender, age, educational level, socioeconomic status, residence, or housing conditions of waste pickers. The presence of underlying diseases and the frequency of gastritis were similar among H. pylori positive and H. pylori negative waste pickers. Logistic regression analysis showed that the duration (years) in the waste picking activity was positively associated with H. pylori exposure (OR = 2.76; 95% CI: 1.22 - 6.25; P = 0.01). In contrast, consumption of alcohol was negatively associated with H. pylori exposure (OR = 0.27; 95% CI: 0.09 - 0.78; P = 0.01). Other work or behavioral characteristics of waste pickers including washing hands before eating, eating from the garbage, animal contacts, consumption of unpasteurized milk, unwashed raw vegetables, fruits, or untreated water, and contact with soil were not associated with H. pylori exposure. Conclusions This is the first report on the seroprevalence of H. pylori infection among waste pickers and the factors contributing to such exposure. Results warrant for further research on the potential role of contact with garbage for H. pylori infection.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico
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Abstract
This review concerned the important pediatric studies published between April 2012 and March 2013. Symptomatology in Helicobacter pylori-positive children is nonspecific, except for those suffering from peptic ulcer diseases. Investigation of H. pylori status in children and adolescents with sideropenic anemia is recommended, and it is the aim of several studies worldwide. Associations of H. pylori with plasma ghrelin levels as well as the negative association of H. pylori with atopic disease were interesting objectives for several studies this year. Success rates of sequential therapy tended to be lower in recent studies than in previous trials, which probably reflects the increase in macrolide resistance. A beneficial effect of probiotics was reported although not all trials supported this result in children. Intrafamilial transmission and young age could be major risk factors associated with reinfection in children.
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Affiliation(s)
- Teresa Alarcón
- Department of Microbiology, Hospital Universitario de La Princesa, Madrid, Spain
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Alvarado-Esquivel C. Seroepidemiology of Helicobacter pylori infection in a Mennonite community in Durango State, Mexico. Helicobacter 2013; 18:215-21. [PMID: 23279313 DOI: 10.1111/hel.12032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The epidemiology of Helicobacter pylori infection among Mennonites (an ethnic group of German descent living in rural communities in Mexico) has not been previously studied. MATERIALS AND METHODS The prevalence of anti-H. pylori IgG antibodies was examined in 152 Mennonite individuals in Durango State, Mexico, using enzyme-linked immunoassays. Seroprevalence association with sociodemographic, clinical, and behavioral characteristics of the Mennonite community was also investigated. RESULTS In total, 77 (50.7%) of the 152 Mennonite participants (mean age, 38.4 ± 15.5 years) had H. pylori IgG antibodies, 35 (45.4%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. Males and females had comparable seroprevalence rates of H. pylori and H. pylori IgG antibody levels. On the other hand, seroprevalence of H. pylori increased significantly with age and was significantly higher among women with history of deliveries and abortions than among those with no such obstetric characteristics. Logistic regression analysis of behavioral characteristics showed that H. pylori infection was associated with a low frequency of eating at restaurants and at fast food outlets (up to 10 times/year) (OR = 2.77; 95% CI: 1.28-5.98; p = .009), and eating meat (up to 3 days/week) (OR = 2.84; 95% CI: 1.36-5.91; p = .005). CONCLUSIONS This is the first report on the seroprevalence of H. pylori among Mennonites, factors contributing to such infection, and the association of H. pylori infection with abortions and low frequencies of eating out of home and meat. Further research should be conducted on this topic.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Faculty of Medicine and Nutrition, Juárez University of Durango State, Dgo, Durango, Mexico.
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25
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Abstract
Medline, PubMed and the Cochrane databases were searched on epidemiology and diagnosis of Helicobacter pylori for the period of April 2011-March 2012. Several studies have shown that the prevalence of H. pylori infection is decreasing in adults and children in many countries. Various diagnostic tests are available, and most of them have high sensitivity and specificity. The Maastricht IV/Florence consensus report states that the urea breath test using (13)C urea remains the best test to diagnose H. pylori infection. Among the stool antigen tests, the ELISA monoclonal antibody test is recommended. All these tests were used, either as a single diagnostic test or in combination, to investigate H. pylori infection among different populations throughout the world. Of particular interest, current improvements in high-resolution endoscopic technologies enable increased diagnostic accuracy for the detection of H. pylori infection, but none of these techniques, at present, are specific enough for obtaining a real-time diagnosis of H. pylori infection.
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Affiliation(s)
- Ante Tonkic
- Division of Gastroenterology, Department of Internal Medicine, University Hospital Split, School of Medicine, University of Split, Split, Croatia
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