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Ibrahim ME. Epidemiology, pathogenicity, risk factors, and management of Helicobacter pylori infection in Saudi Arabia. BIOMOLECULES & BIOMEDICINE 2024; 24:440-453. [PMID: 37787623 PMCID: PMC11088898 DOI: 10.17305/bb.2023.9575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 10/04/2023]
Abstract
Helicobacter pylori (H. pylori) is a gastric microbial pathogen that infects approximately half of the global population. This bacterium significantly contributes to various gastroduodenal diseases, including chronic active gastritis, peptic ulcerations, and malignant transformations. This review focuses on epidemiology, pathogenicity, virulence genes, risk factors, and management of H. pylori infection, specifically within the context of Saudi Arabia. The results presented here are grounded in studies conducted in Saudi Arabia, contrasting with mere bibliographic reviews of findings from other countries. H. pylori infection has been observed in Saudi Arabia, with substantial differences in the prevalence, ranging between 10-96% among various studied populations. Several risk factors for H. pylori infection have been identified, encompassing socioeconomic status, medical history, personal hygiene, and behavioral practices. Among the virulence genes harbored by H. pylori, cytotoxin-associated gene A (cagA) and vacuolating cytotoxin (vacA) are most common, with their presence correlating with the pathogenicity and clinical manifestations of the associated diseases. A range of invasive and non-invasive diagnostic assays have been utilized to identify H. pylori infection, with their employment being influenced by factors like availability, cost, patient age, gastric symptoms, and the specifics of clinical information sought. While detection methods like the H. pylori stool antigen test and the urea breath test offer more accuracy and speed, culturing remains indispensable for determining the antimicrobial susceptibility profile. The emergence of resistant strains across varying regional settings poses a significant challenge to treatment endeavors, necessitating an assessment of local antimicrobial resistance rates prior to formulating treatment strategies. The findings of this review highlight the importance of continuous implementation of screening, control, and prevention of H. pylori infection to combat the spreading infection and other related complications.
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Affiliation(s)
- Mutasim E Ibrahim
- Department of Basic Medical Sciences, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Kabir A, Abdolhosseini S, Zare-Mirzaei A, Pazouki A, Masoodi M, Agah S, Faghihi Kashani A. Selecting the Best Gastric Anatomical Place for Biopsy to Detect Helicobacter Pylori in Iranian Morbid Obese Patients. Med J Islam Repub Iran 2024; 38:13. [PMID: 38586501 PMCID: PMC10999007 DOI: 10.47176/mjiri.38.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Indexed: 04/09/2024] Open
Abstract
Background Obesity and Helicobacter pylori (H. pylori) infection are public health problems in the world and Iran. This study aimed to indicate the anatomical place with the most accurate results for H. pylori. According to gastric mapping, this study will be able to evaluate the prevalence of H. pylori based on the pathology of gastric mapping and the accuracy of the antral rapid urease test (RUT) based on endoscopic findings. Methods In this cross-sectional study, upper digestive endoscopy and gastric pathology were studied in 196 obese patients candidates for bariatric surgery. Statistical analyses were performed using a t-test and Chi-square/fisher's exact test to compare the groups. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) were used to compare RUT and pathological H. pylori test of each of the six areas of the stomach. We set a positive test of the pathology of 6 regions of the stomach as our gold standard (in this study). Results The most common area of the stomach for pathological findings of H. pylori were incisura (116, 59.2%), greater curvature of the antrum (115, 58.3%), lesser curvature of the antrum (113, 57.7%), lesser curvature of the corpus (112, 57.1%), greater curvature of the corpus (111, 56.6%) and cardia (103, 52.6%). The prevalence of H. pylori was 58.2% (114 cases) and 61.2% (120 cases) with RUT and gastric pathology, respectively. Mild, moderate, and severe infection of H. pylori in cardia (58, 29.6%), greater and lesser curvature of the antrum (61, 31.1%), and greater curvature of the antrum (37, 18.9%) had the highest percentages of incidence comparing to other sites of the stomach, respectively. The most sensitive area for pathologic biopsy was incisura (96.6%, 95% confidence interval: 91.7, 98.7). Conclusion According to the highest sensitivity, PLR, NPV, and pathological findings of H. pylori in accordance with the lowest NLR in the incisura compared with other parts of the stomach, it is highly recommended to take the biopsy from the incisura instead of other anatomical places of stomach for detecting H. pylori specifically if our strategy is taking only one biopsy.
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Affiliation(s)
- Ali Kabir
- Minimally Invasive Surgery Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ali Zare-Mirzaei
- Department of Pathology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran
| | - Mohsen Masoodi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
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Alhalabi M, Almokdad R. Efficacy of a 2-week therapy with levofloxacin concomitant versus a levofloxacin sequential regimen for Helicobacter pylori infection in the Syrian population: a study protocol for randomized controlled trial. Trials 2024; 25:55. [PMID: 38225650 PMCID: PMC10789050 DOI: 10.1186/s13063-024-07906-3] [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: 10/07/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Treating Helicobacter pylori is becoming increasingly difficult with the development of bacterial resistance to many established treatment regimens. As a result, researchers are constantly looking for novel and effective treatments. This trial aims to establish the efficacy of levofloxacin-based sequential treatment regimen and concomitant levofloxacin-based regimen as empirical first-line therapy in the Syrian population. METHOD This is an open-label, prospective, single-center, parallel, active-controlled, superiority, randomized clinical trial. The recruitment will target Helicobacter pylori-positive males and females between the ages of 18 and 65 to evaluate the efficacy of empirical first-line therapy in the Syrian population. We are planning to recruit up to 300 patients which is twice the required sample size. One hundred fifty individuals will be randomly assigned to undergo either a sequential levofloxacin-based treatment regimen or a concomitant levofloxacin-based regimen. High-dose dual therapy (proton-pump inhibitor and amoxicillin) will be the rescue therapy in the event of first-line failure. The first-line eradication rate in both groups is the primary outcome, and one of the secondary outcomes is the overall eradication rate of high-dose dual therapy in the event of first-line treatment protocol failure. Intention-to-treat analysis and per-protocol analysis will be used to evaluate the eradication rates of Helicobacter pylori for first-line treatment protocols. DISCUSSION For the first time in the Syrian population, this randomized controlled trial will provide objective and accurate evidence about the efficacy of a sequential levofloxacin-based treatment regimen. TRIAL REGISTRATION ClinicalTrials.gov NCT06065267 . Registered on October 3, 2023. Prospective registered. Enrollment of the first participant has not started yet.
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Affiliation(s)
- Marouf Alhalabi
- Gastroenterology Department, Damascus Hospital, Almujtahed Street, Damascus, Syria.
| | - Rasha Almokdad
- Gastroenterology Department, Damascus Hospital, Almujtahed Street, Damascus, Syria
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Liu M, Gao H, Miao J, Zhang Z, Zheng L, Li F, Zhou S, Zhang Z, Li S, Liu H, Sun J. Helicobacter pylori infection in humans and phytotherapy, probiotics, and emerging therapeutic interventions: a review. Front Microbiol 2024; 14:1330029. [PMID: 38268702 PMCID: PMC10806011 DOI: 10.3389/fmicb.2023.1330029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024] Open
Abstract
The global prevalence of Helicobacter pylori (H. pylori) infection remains high, indicating a persistent presence of this pathogenic bacterium capable of infecting humans. This review summarizes the population demographics, transmission routes, as well as conventional and novel therapeutic approaches for H. pylori infection. The prevalence of H. pylori infection exceeds 30% in numerous countries worldwide and can be transmitted through interpersonal and zoonotic routes. Cytotoxin-related gene A (CagA) and vacuolar cytotoxin A (VacA) are the main virulence factors of H. pylori, contributing to its steep global infection rate. Preventative measures should be taken from people's living habits and dietary factors to reduce H. pylori infection. Phytotherapy, probiotics therapies and some emerging therapies have emerged as alternative treatments for H. pylori infection, addressing the issue of elevated antibiotic resistance rates. Plant extracts primarily target urease activity and adhesion activity to treat H. pylori, while probiotics prevent H. pylori infection through both immune and non-immune pathways. In the future, the primary research focus will be on combining multiple treatment methods to effectively eradicate H. pylori infection.
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Affiliation(s)
- Mengkai Liu
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Hui Gao
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Jinlai Miao
- First Institute of Oceanography Ministry of Natural Resources, Qingdao, China
| | - Ziyan Zhang
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Lili Zheng
- National Engineering Research Centre for Intelligent Electrical Vehicle Power System (Qingdao), College of Mechanical and Electronic Engineering, Qingdao University, Qingdao, China
| | - Fei Li
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Sen Zhou
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Zhiran Zhang
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Shengxin Li
- College of Life Sciences, Qingdao University, Qingdao, China
| | - He Liu
- College of Life Sciences, Qingdao University, Qingdao, China
| | - Jie Sun
- College of Life Sciences, Qingdao University, Qingdao, China
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Mikhail CRG, Abd El Maksoud Mohamed A, Shaker OG, El Desouky E, Shalaby RH. Frequency and risk factors of H. pylori infection among dental students: an observational cross-sectional study. Sci Rep 2023; 13:14264. [PMID: 37653065 PMCID: PMC10471685 DOI: 10.1038/s41598-023-41246-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023] Open
Abstract
Despite Helicobacter pylori infection remains asymptomatic in most people, it is associated with an increased risk of gastric cancer. Considering Egypt had the highest prevalence of H. pylori in healthy asymptomatic population in adults and pediatric age in past studies and currently salivary ELISA could be used for diagnosis of Oral H. pylori infection. Moreover, some researchers speculated that dentists and dental students might be at a higher risk for oral H. pylori infection because they are the most frequently exposed ones to saliva and dental plaque. This study aimed to determine risk factors associated with frequency of H. pylori among a sample of dental students for better management of the disease. 83 participants, with age (21-25 years), attending Faculty of Dentistry, Fayoum University were recruited. A structured questionnaire was used to collect information on sociodemographic parameters and risk factors for H. pylori. Direct inquiry about dyspeptic symptoms were done. Saliva samples were collected and tested for H. pylori antibodies. Overall seroprevalence was 22.9%. Participants in internship were more prone to be positive (p = 0.005). 32.6% of urban residents versus 10.8% of rural were H. pylori positive (p = 0.019). 75.0% of previous history of H. pylori infection versus 14.1% of those with no history were H. pylori positive p < 0.001. 70% of positive H. pylori participants reported positive clinical symptoms that were statistically significant. This study suggests that middle income, previous history of H. pylori and clinical symptoms of dyspepsia are risk factors of oral H. pylori with a decline in its prevalence in Egypt.
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Affiliation(s)
- Christine Raouf George Mikhail
- Oral Medicine and Diagnosis, Department of Oral Medicine, Diagnosis and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | | | - Olfat Gamil Shaker
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman El Desouky
- Epidemiology and Biostatistics, NCI, Cairo University, Cairo, Egypt
| | - Rania Hassan Shalaby
- Oral Medicine and Diagnosis, Department of Oral Medicine, Diagnosis and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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Hibaoui L, Massik A, Yahyaoui G, Mahmoud M, Hmass N, Chbani L, Lakhdar Idrissi M, Hida M. Moroccan Children With Helicobacter pylori Infection: Demographics, Clinical Features, and Histological Findings. Cureus 2023; 15:e40740. [PMID: 37485161 PMCID: PMC10361338 DOI: 10.7759/cureus.40740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Infesting nearly half of the world's population, Helicobacter pylori is thought to cause peptic ulcers and gastric adenocarcinoma. Several studies have examined the association between H. pylori and socioeconomic, clinical, and histological factors in pediatric populations. Similarly, this study aimed to describe the characteristics of H. pylori infection in Moroccan children. METHODS Patients aged 1-17 years who underwent upper gastrointestinal endoscopy over a period of two years from January 2019 to January 2021 were included in this study. Gastric biopsies from the antrum and corpus of the stomach were collected. Detection of H. pylori infection was confirmed by Giemsa stain. Demographic data and clinical and endoscopic characteristics were collected and histopathological findings with gastritis scoring were recorded according to the Sydney System. RESULTS In 213 children, 95 (45%) were found to be infected with H. pylori, and the infection rates increased as the children aged. While no significant relationship between the infection of H. pylori and all symptoms was founded, a significant association was found in nodular gastritis (p<0.05), and 98% of the infected children had chronic inflammation, which was active in 22% and atrophic in 47%. The atrophy and activity were absent or mild, and the inflammation was mild to moderate. CONCLUSION According to this study, nodular gastritis and nonspecific symptoms were related to H. pylori infection in Moroccan children. In addition, the association between this disease and gastric atrophy in our study needs the monitoring of the mucosa of Moroccan children with gastritis and identifying factors that may contribute to gastric cancer.
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Affiliation(s)
- Lahbib Hibaoui
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Abdelhamid Massik
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Ghita Yahyaoui
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Mustapha Mahmoud
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Microbiology and Molecular Biology, Hassan II University Hospital, Fez, MAR
| | - Naoual Hmass
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Surgical Pathology, Hassan II University Hospital, Fez, MAR
| | - Laila Chbani
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Surgical Pathology, Hassan II University Hospital, Fez, MAR
| | - Mounia Lakhdar Idrissi
- Laboratory of Epidemiology, Clinical Research and Community Medicine, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Paediatrics, Hassan II University Hospital, Fez, MAR
| | - Moustapha Hida
- Laboratory of Epidemiology, Clinical Research and Community Medicine, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
- Department of Paediatrics, Hassan II University Hospital, Fez, MAR
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Khan Z, Gul A. Helicobacter Pylori-Associated Gastritis in Middle Eastern Patients: A Case Series. Cureus 2023; 15:e39145. [PMID: 37332427 PMCID: PMC10275615 DOI: 10.7759/cureus.39145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is a common chronic infection responsible for upper gastrointestinal symptoms such as indigestion, belching, heartburn, and abdominal fullness along with nausea and vomiting. It is considered a transmissible infection, although the exact chain of transmission is not clear. H. pylori-associated infection is a major pathogenic factor for gastroduodenal ulcers and gastric carcinoma in most patients, which can be prevented with eradication therapy. Transmission of the bacterium occurs mainly between family members and during childhood. Others may remain asymptomatic or may present with atypical symptoms such as headache, fatigue/weakness, anxiety, and bloating. We present five interesting cases of H. pylori-positive patients who had variable presentations and were successfully treated with first-line therapy and salvage therapy.
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Affiliation(s)
- Zahid Khan
- Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR
- Cardiology, Bart's Heart Centre, London, GBR
- Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
- Cardiology, Royal Free Hospital, London, GBR
| | - Amresh Gul
- General Practice, Lifeline Hospital, Salalah, OMN
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Success of 14-day triple and quadruple therapy for the control of Helicobacter pylori infections in Kohat district. Drug Target Insights 2022; 16:49-53. [PMID: 36582782 PMCID: PMC9768595 DOI: 10.33393/dti.2022.2481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction: Helicobacter pylori is an important medical pathogen present in more than half of the world’s population. Various treatment regimen are in use for the eradication of H. pylori, but due to the emergence of antibiotic resistance, its management is a big issue for clinicians. Methods: In this study all suspected cases that had visited District Headquarters Hospital Kohat were considered for screening of H. pylori infections. Preliminary information about their age, gender, general health conditions, occupation, etc. was taken for consideration. After recording initial signs and symptoms, samples were considered for H. pylori detection using stool antigen test and endoscopy. Fourteen-day proton pump inhibitor base triple and quadruple therapy were administered to each patient. Results: In total (n = 178), there were high numbers of positivity in patients aged below 30 years (82; 46.06%), most of whom belonged to rural areas. Conclusion: This study concludes that there were high numbers of positive patients aged below 30 years, and according to this study MEL (Metronidazole + Esomeprazole + Levofloxacin) is the most effective treatment regimen for the eradication of H. pylori.
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Kuloğlu E, Albayrak B, Dursun H, Albayrak F, Yılmaz Ö. Comparison of Sequential, Hybrid, and Quadruple Therapy Protocols in Helicobacter pylori Eradication: A Single-Center Study. Eurasian J Med 2022; 54:235-238. [PMID: 35975595 PMCID: PMC9797785 DOI: 10.5152/eurasianjmed.2022.20360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Many treatment protocols are used in Helicobacter pylori eradication treatment within the framework of factors such as antibiotic resistance, drug side effects, patient compliance, and regional differences. MATERIALS AND METHODS H. pylori was diagnosed with upper gastrointestinal system endoscopic biopsy in the Internal Diseases Gastroenterology Endoscopy Unit of Atatürk University Medical Faculty Hospital; a total of 229 patients over the age of 18 were evaluated prospectively by dividing them into 3 groups and applying 3 different H. pylori eradication treatment protocols. RESULTS A total of 229 patients who completed the treatment were included in the study. H. pylori eradication was achieved in 186 patients and not achieved in 43 patients. The H. pylori eradication success of our study was found to be 81.2%. Among the 84 patients in group 1, while H. pylori eradication was achieved in 67 of them, it was not achieved in 17 patients. The eradication success of quadruple treatment with bismuth was 79.8%. Also, among the 68 patients in group 2, while H. pylori eradication was achieved in 55 patients, it was not achieved in 13. The eradication success of the 14-day hybrid treatment was 80.9%. Among the 77 patients in group 3, while H. pylori eradication was achieved in 64 patients, it was not achieved in 13. The eradication success of the 10-day sequential treatment was 83.1%. CONCLUSION It is necessary to conduct studies to find the most successful eradication regimen in primary care treatment of H. pylori in our country, to determine the regional antibiotic resistance rates, to individualize the proton pump inhibitor treatment due to metabolism and resistance differences, to examine the factors that stop from achieving the desired eradication success, and especially to avoid unnecessary antibiotic use.
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Affiliation(s)
- Ersin Kuloğlu
- Department of Internal Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Bülent Albayrak
- Department of Gastroentorology, Atatürk University Faculty of Medicine, Erzurum, Turkey,Corresponding author: Bülent Albayrak E-mail:
| | - Hakan Dursun
- Department of Gastroentorology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Fatih Albayrak
- Department of Gastroentorology, Atatürk University Faculty of Medicine, Erzurum, Turkey,Corresponding author: Bülent Albayrak E-mail:
| | - Ömer Yılmaz
- Department of Gastroentorology, Atatürk University Faculty of Medicine, Erzurum, Turkey
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Borka Balas R, Meliț LE, Mărginean CO. Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children. CHILDREN 2022; 9:children9091359. [PMID: 36138669 PMCID: PMC9498111 DOI: 10.3390/children9091359] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/22/2022] [Accepted: 09/03/2022] [Indexed: 01/17/2023]
Abstract
Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide.
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Tran V, Saad T, Tesfaye M, Walelign S, Wordofa M, Abera D, Desta K, Tsegaye A, Ay A, Taye B. Helicobacter pylori (H. pylori) risk factor analysis and prevalence prediction: a machine learning-based approach. BMC Infect Dis 2022; 22:655. [PMID: 35902812 PMCID: PMC9330977 DOI: 10.1186/s12879-022-07625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Although previous epidemiological studies have examined the potential risk factors that increase the likelihood of acquiring Helicobacter pylori infections, most of these analyses have utilized conventional statistical models, including logistic regression, and have not benefited from advanced machine learning techniques. Objective We examined H. pylori infection risk factors among school children using machine learning algorithms to identify important risk factors as well as to determine whether machine learning can be used to predict H. pylori infection status. Methods We applied feature selection and classification algorithms to data from a school-based cross-sectional survey in Ethiopia. The data set included 954 school children with 27 sociodemographic and lifestyle variables. We conducted five runs of tenfold cross-validation on the data. We combined the results of these runs for each combination of feature selection (e.g., Information Gain) and classification (e.g., Support Vector Machines) algorithms. Results The XGBoost classifier had the highest accuracy in predicting H. pylori infection status with an accuracy of 77%—a 13% improvement from the baseline accuracy of guessing the most frequent class (64% of the samples were H. Pylori negative.) K-Nearest Neighbors showed the worst performance across all classifiers. A similar performance was observed using the F1-score and area under the receiver operating curve (AUROC) classifier evaluation metrics. Among all features, place of residence (with urban residence increasing risk) was the most common risk factor for H. pylori infection, regardless of the feature selection method choice. Additionally, our machine learning algorithms identified other important risk factors for H. pylori infection, such as; electricity usage in the home, toilet type, and waste disposal location. Using a 75% cutoff for robustness, machine learning identified five of the eight significant features found by traditional multivariate logistic regression. However, when a lower robustness threshold is used, machine learning approaches identified more H. pylori risk factors than multivariate logistic regression and suggested risk factors not detected by logistic regression. Conclusion This study provides evidence that machine learning approaches are positioned to uncover H. pylori infection risk factors and predict H. pylori infection status. These approaches identify similar risk factors and predict infection with comparable accuracy to logistic regression, thus they could be used as an alternative method. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07625-7.
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Affiliation(s)
- Van Tran
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Tazmilur Saad
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA
| | - Mehret Tesfaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sosina Walelign
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Moges Wordofa
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dessie Abera
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmet Ay
- Department of Mathematics, Colgate University, 13 Oak Dr., Hamilton, NY, USA. .,Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
| | - Bineyam Taye
- Department of Biology, Colgate University, 13 Oak Dr., Hamilton, NY, USA.
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Sadjadi A, Akbarpour E, Alimohammadian M, Masoudi S, Ghanbari R, Rajabi Pour Z, Mohmmad Akbari F, Jafari MD, Feiz-sani A, Hakimi H, Siavooshi F, Massarrat S, Malekzadeh R. A Population-Based Cross-sectional Study on the Prevalence and Associated Risk Factors of Helicobacter pylori Infection in Rafsanjan, a Low Gastric Cancer Area in Southeast Iran. Middle East J Dig Dis 2022; 14:287-293. [PMID: 36619268 PMCID: PMC9489427 DOI: 10.34172/mejdd.2022.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Despite all improvements in sanitation and exposure to antibiotics over time, Helicobacter pylori (HP) prevalence remains high, affecting the lives of about half of the world population, which can gradually lead to serious upper gastrointestinal disorders. Understanding HP's epidemiologic patterns help us to better manage the burden of this infection and to plan more effectively regarding potential screening or eradication strategies. We, therefore, aimed to report the crude and age- and sex-standardized prevalence rate of HP infection, its trend, and possible associated factors among asymptomatic healthy individuals in Rafsanjan city, a low-incidence area of gastric cancer (GC) in the southeast of Iran, from July 2018 to December 2021. Methods: This population-based cross-sectional descriptive study included 2,046 male and female subjects between 3 to 72 years who were in good health condition. Study participants were randomly selected from the Health Houses and each underwent a questionnaire-based interview and provided blood and feces samples. The presence of HP infection was detected by serum IgG antibodies and stool antigen test. Results: The overall and age- and sex-standardized prevalence rates of HP infection were 50.9% and 43%, respectively. The prevalence rate has notably decreased in all age groups compared with 2007. Also, it was significantly higher among men (P=0.033) and increased with advancing age (P<0.001). A higher population density living in a specific room area (P=0.012) increased the likelihood of HP infection. Conclusion: To conclude, the prevalence of HP infection is decreasing over time in Rafsanjan city, which may be due to improvements in living standards in this area. A healthy lifestyle and adherence to hygienic principles, especially during childhood, may be required for a reduction in the prevalence of HP infection.
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Affiliation(s)
- Alireza Sadjadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Akbarpour
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Alimohammadian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Masoudi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghanbari
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Rajabi Pour
- Rafsanjan Cohort Studies Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Faegheh Mohmmad Akbari
- Rafsanjan Cohort Studies Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Minal Dafeh Jafari
- Rafsanjan Cohort Studies Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Akbar Feiz-sani
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Hakimi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,Corresponding Author: Hamid Hakimi, MD Address Faculty of Medicine – Pesteh St. – Persian Gulf St. – Rafsanjan- Iran Tel: +98 34 31315000 Fax:+98 34 313150
| | - Farideh Siavooshi
- Department of Microbiology, School of Biology, University College of Sciences, University of Tehran, Tehran, Iran
| | - Sadegh Massarrat
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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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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14
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Xu WF, Wang Y, Huang H, Wu JW, Che Y, Ding CJ, Zhang Q, Cao WL, Cao LJ. Octreotide-based therapies effectively protect mice from acute and chronic gastritis. Eur J Pharmacol 2022; 928:174976. [PMID: 35487253 DOI: 10.1016/j.ejphar.2022.174976] [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: 12/08/2021] [Revised: 04/09/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022]
Abstract
Gastritis is a common inflammation of stomach with multiple pathogenesis. This study was designed to investigate the protective effects of oral octreotide (OCT) against ethanol-induced acute gastric injury and H. pylori-induced chronic gastritis via promoting gastric mucosa restoration, reducing gastric acid secretion and inflammation. Male C57BL/6J mice were randomly divided and treated with three doses of OCT (0.5, 2.5, 10 mg/kg) alone or combined respectively with 10 mg/kg omeprazole (OME), 0.2 g/L metronidazole (MTZ)/0.1 g/L clarithromycin (CLR) in drinking water. Oxidative stress analysis, bacterial load analysis, qPCR, gastric histopathology examinations were performed in our study. Ethanol-induced acute gastric ulcer was restored by OCT alone at doses of 2.5 mg/kg, or combined with OME as indicated by markedly reducing Gastrin, Il-6 and Il1b expression through induction of Muc5ac and Occludin, significantly improving hyperacidity and gastric bleeding. As well, OCT combined with MTZ/CLR restored the integrity of gastric mucosa damaged by H. pylori via elevating the expression of Muc5ac and somatostatin receptor 2, decreasing inflammation and increasing the number of chorionic or glands. Besides, OCT is more suitable for long-term medication in the treatment of chronic gastritis than OME. In conclusion, our results proved that the newly developed oral OCT-based therapies were more effective to reverse gastric mucosa damage and inflammation in ethanol and H. pylori infection-induced gastric injury, it is of great significance for supplementing new clinical regimens for the treatment of acute and chronic gastritis.
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Affiliation(s)
- Wan-Feng Xu
- Department of Pharmacy, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, Shenzhen, 518001, China; State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Yun Wang
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Hai Huang
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Jia-Wei Wu
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Yuan Che
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Chu-Jie Ding
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Quan Zhang
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China
| | - Wei-Ling Cao
- Department of Pharmacy, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, Shenzhen, 518001, China.
| | - Li-Juan Cao
- State Key Laboratory of Natural Medicines, Key Laboratory of Drug Metabolism, China Pharmaceutical University, Nanjing, 210009, China.
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15
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Ren S, Cai P, Liu Y, Wang T, Zhang Y, Li Q, Gu Y, Wei L, Yan C, Jin G. Prevalence of Helicobacter pylori infection in China: A systematic review and meta-analysis. J Gastroenterol Hepatol 2022; 37:464-470. [PMID: 34862656 DOI: 10.1111/jgh.15751] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Helicobacter pylori (H. pylori) infection rates have been changing with different populations and geographic areas. We systematically evaluated the longitudinal trends in H. pylori prevalence in China over the past decades. METHODS We performed a systematic review of literature reporting the prevalence of H. pylori infection in mainland China from 1990 to 2019 in the PubMed and China National Knowledge Infrastructure databases. We conducted a meta-analysis of qualified studies using a random effects model to estimate the pooled prevalence with a 95% confidence interval (95%CI). RESULTS A total of 412 eligible studies with 1 377 349 subjects were included. The pooled H. pylori prevalence was 44.2% (95%CI: 43.0-45.5%) in mainland China, with an estimated 589 million individuals infected with H. pylori. The prevalence was relatively high in the Northwest (51.8%, 95%CI: 47.5-56.1%), East (47.7%, 95%CI: 45.4-50.0%), and Southwest China (46.6%, 95%CI: 42.1-51.1%). The prevalence significantly decreased from 58.3% (95%CI: 50.7-65.5%) in the period 1983-1994 to 40.0% (95%CI: 38.2-41.8%) in the period 2015-2019. The prevalence increased with age, ranging from 28.0% (95%CI: 23.9-32.5%) in children and adolescents to 46.1% (95%CI: 44.5-47.6%) in adults. CONCLUSION Although the burden of H. pylori infections is still huge in China, the infection rate has been decreasing over the past decades. Targeted H. pylori eradication strategies may be considered in areas or populations with a high incidence of gastric cancer.
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Affiliation(s)
- Shuai Ren
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,School of Public Health, Baotou Medical College, Baotou, China
| | - Pengpeng Cai
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Yaqian Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Tianpei Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Zhang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qian Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yuanliang Gu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Liqin Wei
- School of Public Health, Baotou Medical College, Baotou, China
| | - Caiwang Yan
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Department of Immunology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Guangfu Jin
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Collaborative Innovation Center for Cancer Personalized Medicine, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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16
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Lu D, Wang M, Ke X, Wang Q, Wang J, Li D, Wang M, Wang Q. Association Between H. pylori Infection and Colorectal Polyps: A Meta-Analysis of Observational Studies. Front Med (Lausanne) 2022; 8:706036. [PMID: 35118081 PMCID: PMC8803908 DOI: 10.3389/fmed.2021.706036] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background It has been suggested that Helicobacter pylori (H. pylori) infection is associated with hypergastrinemia and proliferation of colorectal mucosa via direct stimulation, dysbiosis of the gut microbiome, and changes in the gut microbiome, all of which may lead to the formation of colorectal polyps. However, the consensus remains lacking regarding whether H. pylori infection is independently associated with colorectal polyps and whether the association differs according to histological type of colorectal polyps. To summarize the current evidence regarding the relationship between H. pylori infection and colorectal polyps, we conducted a meta-analysis of related observational studies according to the histological types of colorectal polyps. Methods Observational studies investigating the association between H. pylori infection and colorectal polyps using multivariate analyses were included by search of PubMed, Embase, and Web of Science. A random-effects model was adopted to combine the results. Results Seventeen studies that include 322,395 participants were analyzed. It was shown that H. pylori infection was independently associated with overall colorectal polyps (odds ratio [OR]: 1.67, 95% CI: 1.24–2.24, p < 0.001; I2 = 73%). According to the histological type of colorectal polyps, H. pylori infection was independently associated with adenomatous polyps (APs; OR: 1.71, 95% CI: 1.47–1.99, p < 0.001; I2 = 86%), advanced APs (OR: 2.06, 95% CI: 1.56–2.73, p < 0.001; I2 = 0%), and hyperplastic polyps (HPs; OR: 1.54, 95% CI: 1.02–2.30, p = 0.04; I2 = 78%). Evidence based on only one study showed that H. pylori infection was not associated with sessile serrated polyps (SSPs; OR: 1.00, 95% CI: 0.93–1.07, p = 0.99). Conclusions Current evidence from case-control and cross-sectional studies suggested that H. pylori infection was independently associated with colorectal APs, advanced APs, and HPs, but not with SSPs. These findings suggested H. pylori infection may be a possible risk factor of colorectal polyp, which is important for the prevention of colorectal polyp in the adult population.
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Affiliation(s)
- Depeng Lu
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Mingyu Wang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiquan Ke
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qiangwu Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jianchao Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Dapeng Li
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Meng Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qizhi Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- *Correspondence: Qizhi Wang
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Cheha KM, Dib SOA, Alhalabi MM. Pilot study: Comparing efficacy of 14-day triple therapy Clarithromycin versus levofloxacin on eradication of Helicobacter pylori infection in Syrian population single-center experience. Avicenna J Med 2021; 8:14-17. [PMID: 29404268 PMCID: PMC5782415 DOI: 10.4103/ajm.ajm_70_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Context: Goals: To compare the efficacy of standard triple therapy with clarithromycin versus triple therapy with levofloxacin for treatment of Helicobacter pylori-positive infection in a referral hospital in Damascus, Syria. Design: pilot prospective open-label randomized controlled trial. Subjects and Methods: Eighty treatment-naive patients who tested positive for H. pylori gastric infection were randomly assigned to one of two treatment groups with randomization ratio of 50/50. Group (A) was treated with clarithromycin (500 mg), amoxicillin (1000 mg), and esomeprazole (20 mg), each twice/day for 14 days, while Group (B) was treated with levofloxacin (500 mg), amoxicillin (1000 mg), and esomeprazole (20 mg), each twice/day for 14 days.[1] After 6 weeks of treatment, all patients underwent endoscopy and biopsy to evaluate H. pylori infection eradication. Results: Forty patients were allocated in each group; 37 patients completed the follow-up in each group. Thirteen patients in Group (A) were cured, with an eradication rate of 35.1% according to per-protocol analysis (PPA) and 32.5% according to intention-to-treat analysis (ITT), while in Group (B), 11 patients were cured, with an eradication rate of 29.7% according to PPA and 27.5% according to ITT with P = 0.80. No serious adverse events reported in both the groups. Conclusions: Clarithromycin is slightly better than levofloxacin in treatment of H. pylori gastric infection, but both regimens show low effectiveness with suboptimal eradication rates in our selected population.
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18
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Alhalabi M, Alassi MW, Alaa Eddin K, Cheha K. Efficacy of two-week therapy with doxycycline-based quadruple regimen versus levofloxacin concomitant regimen for helicobacter pylori infection: a prospective single-center randomized controlled trial. BMC Infect Dis 2021; 21:642. [PMID: 34218802 PMCID: PMC8254989 DOI: 10.1186/s12879-021-06356-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/18/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Antibiotic-resistance reduces the efficacy of conventional triple therapy for Helicobacter Pylori infections worldwide, which necessitates using various treatment protocols. We used two protocols, doxycycline-based quadruple regimen and concomitant levofloxacin regimen. The aim was to assess the effectiveness of doxycycline-based quadruple regimen for treating Helicobacter Pylori infections compared with levofloxacin concomitant regimen as empirical first-line therapy based on intention-to-treat (ITT) and per-protocol analyses (PPA) in Syrian population. SETTINGS AND DESIGN An open-label, randomised, parallel, superiority clinical trial. METHODS We randomly assigned 78 naïve patients who tested positive for Helicobacter Pylori gastric infection, with a 1:1 ratio to (D-group) which received (bismuth subsalicylate 524 mg four times daily, doxycycline 100 mg, tinidazole 500 mg, and esomeprazole 20 mg, each twice per day for 2 weeks), or (L-group) which received (levofloxacin 500 mg daily, tinidazole 500 mg, amoxicillin 1000 mg, and esomeprazole 20 mg each twice per day for two weeks). We confirmed Helicobacter Pylori eradication by stool antigen test 8 weeks after completing the treatment. RESULTS Thirty-nine patients were allocated in each group. In the D-group, 38 patients completed the follow-up, 30 patients were cured. While in the L-group, 39 completed the follow-up, 32patients were cured. According to ITT, the eradication rates were 76.92%, and 82.05%, for the D-group and L-group respectively. Odds ratio with 95% confidence interval was 1.371 [0.454-4.146]. According to PPA, the eradication rates were 78.9%, and 82.05% for the D-group and L-group respectively. The odds ratio with 95% confidence interval was 1.219 [0.394-3.774]. We didn't report serious adverse effects. CONCLUSIONS Levofloxacin concomitant therapy wasn't superior to doxycycline based quadruple therapy. Further researches are required to identify the optimal first-line treatment for Helicobacter-Pylori Infection in the Syrian population. TRIAL REGISTRATION We registered this study as a standard randomized clinical trial ( Clinicaltrial.gov , identifier- NCT04348786 , date:29-January-2020).
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Affiliation(s)
- Marouf Alhalabi
- Gastroenterologist at Damascus Hospital, Almujtahed street, Damascus, Syria.
| | | | - Kamal Alaa Eddin
- Gastroenterologist at Damascus Hospital, Almujtahed street, Damascus, Syria
| | - Khaled Cheha
- Gastroenterologist at Damascus Hospital, Almujtahed street, Damascus, Syria
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Valizadeh Toosi SM, Yaghobi M, Mohammad Pour RA. Prevalence of Helicobacter Pylori Infection in Patients with Dyspepsia in North of Iran. Middle East J Dig Dis 2021; 13:230-236. [PMID: 36606221 PMCID: PMC9489463 DOI: 10.34172/mejdd.2021.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 03/10/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Dyspepsia is a common complaint among patients who refer to gastroenterology clinics. Studies have shown that there is a strong relationship between dyspepsia and Helicobacter pylori (HP) infection. We have investigated the prevalence of HP infection in patients with dyspepsia and its correlation with age and socioeconomic status (SES) of patients in Mazandaran province, northern Iran. METHODS In this cross-sectional study, patients with dyspepsia who had undergone upper gastrointestinal endoscopy were enrolled. Diagnosis of HP infection was according to the results of rapid urease test (RUT), and Giemsa staining of pathology samples. A questionnaire including endoscopic findings, demographic data, and SES information was completed for each patient. RESULTS The mean age of the 614 patients was 45.8±5 years, and 60% of them were female. Most patients had normal endoscopy (56.1%), and gastric ulcer and erosion was the most common abnormal endoscopic finding (24.7%). The prevalence of HP infection in patients with dyspepsia was about 66.6%. HP infection was associated with a lower prevalence in people aged below 30 years and good SES. CONCLUSION The prevalence of HP infection in patients with dyspepsia was 66.6%. In addition, HP infection rate was lower in people under the age of 30 years and patients with good SES.
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Affiliation(s)
- Seyed Mohammad Valizadeh Toosi
- Non-communicable Diseases Institute, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
,Corresponding Author: Dr Seyed Mohammad Valizadeh Toosi, M D Department of Internal Medicine, Imam Khomeini Hospital, Sari, Iran (Postal Code: 48166-33131) Telefax: + 98 11 33377176
| | - Mahdis Yaghobi
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Ali Mohammad Pour
- Department of Biostatics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
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20
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Khoder G, Mina S, Mahmoud I, Muhammad JS, Harati R, Burucoa C. Helicobacter pylori Infection in Tripoli, North Lebanon: Assessment and Risk Factors. BIOLOGY 2021; 10:biology10070599. [PMID: 34203570 PMCID: PMC8301113 DOI: 10.3390/biology10070599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/13/2021] [Accepted: 06/25/2021] [Indexed: 12/09/2022]
Abstract
Helicobacter pylori (H. pylori) infection occurs among half of the general population worldwide, with high geographic variability. Even though H. pylori is the leading cause of several gastric diseases, ranging from gastritis and peptic ulcers to gastric malignancies, such as gastric cancer and mucosa-associated lymphoid tissue lymphoma, most of the infections remain asymptomatic. Early detection and eradication of H. pylori can definitely prevent severe long-term gastric diseases associated with H. pylori. In Lebanon, the prevalence of H. pylori is not well documented, especially in healthy subjects. The aim of this study is to assess H. pylori infections and the associated risk factors in Tripoli, North Lebanon. A cross-sectional study was conducted on 300 healthy Lebanese volunteers, including both children and adults. The H. pylori stool antigens were detected using the Premier Platinum HpSA test. The socio-demographic data, lifestyle characteristics, and gastrointestinal characteristics of all participants were analyzed. Out of the 300 tested volunteer subjects, 31% were found to be positive for H. pylori. A multivariate binary logistic regression analysis for factors associated with H. pylori infection revealed a significant association between H. pylori infection and gastrointestinal disturbances, the crowding index, and occupation. A significant statistical correlation was found between sheesha smoking (p = 0.001) and H. pylori infection. These findings highlight the need for the development of preventive approaches and strategic indications for the appropriate treatment of H. pylori infections in Tripoli, North Lebanon.
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Affiliation(s)
- Ghalia Khoder
- Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Correspondence:
| | - Sara Mina
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Beirut Arab University, Beirut 11-5020, Lebanon;
| | - Ibrahim Mahmoud
- Department of Family Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Jibran Sualeh Muhammad
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Rania Harati
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Department of Pharmacy Practice and Pharmaceutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Christophe Burucoa
- Laboratoire de bactériologie, Hygiène, EA 4331 LITEC, CHU de Poitiers, Université de Poitiers, 86000 Poitiers, France;
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21
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Gholinia N, Shafikhani AA, Hajiaghamohammadi A. Comparing Regimens Based on Clarithromycin, Furazolidone, and Levofloxacin in Patients With Helicobacter Pylori Infection: A Clinical Trial. INTERNATIONAL JOURNAL OF ENTERIC PATHOGENS 2021. [DOI: 10.34172/ijep.2021.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: There is no current and broad consensus about the eradication of Helicobacter pylori (HP) infection in gastric ulcer and indigestion diseases. Objective: This study aimed to compare three regimens based on clarithromycin, furazolidone, and levofloxacin in patients with HP infection. Materials and Methods: This study was a randomized clinical trial examining 102 patients with gastrointestinal diseases. They were randomly assigned to three equal groups. In the first group, basic medication (i.e., a combination of esomeprazole 40 mg and amoxicillin 1000 mg) with clarithromycin 1000 mg was prescribed. The second group was treated with basic medication regimen along with furazolidone 400 mg. And the third group was given the basic medication with levofloxacin 500 mg. Eradication rates of the HP infection and incidence rates of drug side-effects in the three groups were compared after two-week and the obtained data were analyzed using appropriate statistical methods. Results: According to our study results, the HP infection eradication rates revealed by the per-protocol (PP) and intention-to-treat (ITT) analyses for the levofloxacin group were 91.2% and 93.8%, respectively, which were significantly different from those found for the furazolidone group by PP analysis and for the clarithromycin group by PP and ITT analyses (P<0.05). Moreover, there were no significant differences among the three groups regarding the side effects (P>0.05). Conclusion: It was concluded that two-week regimen of levofloxacin together with a single-dose of esomeprazole and amoxicillin was desirable (90%-95%) and more effective than furazolidone and clarithromycin in eradicating HP.
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Affiliation(s)
- Nazanin Gholinia
- Department of Internal Medicine, Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Akbar Shafikhani
- Department of Occupational Health Engineering, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliakbar Hajiaghamohammadi
- Gastroenterologist Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Rakha M, Saleh O, Abdelgawad MS, El Baiomy A. Helicobacter pylori infection in patients with metabolic syndrome, with or without nonalcoholic fatty liver disease. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-020-00071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract
Background
Helicobacter pylori (HP) infection is considered a risk factor of GIT diseases, e.g., gastric and duodenal ulcers and gastric carcinomas. It is transmitted through feco/oral route and can be diagnosed by many methods, e.g., stool antigen test (SAT). Metabolic syndrome (MET S) is considered a circle of metabolic derangements that can cause some complications as ischemic changes and heart diseases. Metabolic syndrome may also cause nonalcoholic fatty liver disease (NAFLD) resulting in liver fibrosis, cirrhosis, and HCC.
Results
The study included 300 subjects recruited from Obesity Clinic and Diabetes & Endocrinology Unit, Specialized Medical Hospital, Mansoura University. Two hundred of metabolic syndrome patients were subdivided into two groups according to the presence or absence of NAFLD, in addition to 100 subjects not having metabolic syndrome and served as control group. We found that HP infection is more frequent in MET S with NAFLD patients (73%) than in MET S without NAFLD (47%) with (P value < 0.001) emphasizing that HP infection increases the risk of NAFLD development in patients with MET S.
The study proved that HP infection is associated with increased degree of fibrosis significantly (P value < 0.001) with progression to marked fibrosis which may complicate with NASH with over all predictive value of 75% especially in patients with hyperglycemia.
Conclusions
Our findings show that a circle of metabolic abnormalities seems to be attributed to HP infection in MET S patients increasing the risk of fatty liver and progression to marked fibrosis especially with coexistent hyperglycemia, dyslipidemia, and upper body obesity.
Diagnosis and early eradication of HP infection will help in decreasing metabolic disturbances and possibility of NAFLD, and protect against marked fibrosis progression.
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Pourfarzi F, Zahirian Moghadam T, Zandian H, Malekzadeh R, Yazdanbod A. Cost-effectiveness analysis of two routine therapeutic methods for Helicobacter pylori eradication: a Persian cohort-based study. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2021; 14:250-259. [PMID: 34221265 PMCID: PMC8245840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022]
Abstract
AIM This study aimed to analyze the cost-effectiveness of two routine therapeutic methods for H. pylori eradication in Iran. BACKGROUND Because of the importance of Helicobacter pylori (H. pylori) eradication on gastric cancer prevalence and costs, an economic analysis of the eradication methods is essential for health systems. METHODS This cross-sectional study was conducted on 7,496 participants with positive Hepadnaviridae (HPsAg) test results for H. pylori; 6,163 of them were treated with furazolidone (group A), and 1,333 participants were treated with clarithromycin (group B). Data on GP visits, medications, and HPsAg costs as direct costs and absence from work and transportation as indirect costs was collected by researcher-made questionnaire. Indirect costs were calculated based on face-to-face interviews with 365 patients of the Persian Cohort Center. Successful eradication of H. pylori infection (negative HPsAg) was defined as the effectiveness of the interventions. Incremental cost-effectiveness ratio (ICER) was used to compare the overall results. RESULTS The total direct cost of H. pylori for groups A and B were estimated at 13.7 and 5.83 billion IRR, respectively. The highest and lowest percentages of total costs were the cost of diagnostic services and the time cost, respectively. There was a significant difference between the two groups in drug costs (p<0.001). The effect ratio for groups A and B was 85.93% and 96.54%, respectively. Cost per effectiveness was higher for clarithromycin (CE=3,250,170 IRR) than for furazolidone (CE=2,988,488 IRR), and ICER showed that 5.1 Million IRR per participant is needed to eradicate H. pylori. CONCLUSION Based on the results, furazolidone was more cost-effective than clarithromycin for H. pylori treatment. Therefore, due to the high prevalence of H. pylori and the economic conditions of the health system in Iran, furazolidone can be a cost-effective choice between the two conventional treatment methods considering the results of further research and possible side effects.
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Affiliation(s)
- Farhad Pourfarzi
- Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences School of Commerce, Tehran, Iran
| | - Abbas Yazdanbod
- Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
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Vishnu P, Duncan J, Connell N, Cooper N, Lim W, Rodeghiero F, Tomiyama Y, Grace RF, Bakchoul T, Arnold DM. International survey on Helicobacter pylori testing in patients with immune thrombocytopenia: Communication of the platelet immunology scientific and standardization committee. J Thromb Haemost 2021; 19:287-296. [PMID: 33070448 DOI: 10.1111/jth.15136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023]
Abstract
Essentials When to test and treat H pylori among patients with ITP is controversial. We report the results of an international survey administered to physicians with experience treating ITP across 39 countries. The decision to test for H pylori was influenced by country, country of origin, and concomitant gastrointestinal symptoms. Testing and treating for H pylori among patients with ITP varied across geographic regions. ABSTRACT: Background Investigations for patients suspected of immune thrombocytopenia (ITP) lack standardization. A controversial issue is whether such patients should be tested for Helicobacter pylori, a known cause of secondary ITP. Objectives This Scientific and Standardization Committee Communication reports the results of an international survey to describe patterns of practice with respect to screening and treatment of H pylori among patients with ITP. Patients/Methods A 17-item scenario-based questionnaire was delivered to hematologists in countries across the world. The questionnaire was pilot tested before use. We used snowball sampling and a contact list of physicians from the Platelet Disorders Support Association to identify survey respondents. Data were analyzed descriptively. Results A total of 186 respondents from 39 countries completed the survey. Response rate from the snowball sample was 53.6%. Twenty-nine percent (n = 55) of respondents always tested ITP patients for H pylori, and 53% (n = 98) sometimes tested. Of the 37 respondents from Asia and the Middle East, 51.4% (n = 19) always tested for H pylori for the stated reasons of high local prevalence and perceived benefit of treatment on platelet count levels. Respondents were more likely to test patients who were from Asia (145/177, 80%) and who had concomitant gastrointestinal symptoms (133/183, 72%). For eradication therapy, 71 of 118 (60.2%) respondents used the combination of a proton pump inhibitor, clarithromycin, and amoxicillin for 14 days. Conclusions This international survey showed that testing for H pylori was most common in Asia and in patients from Asia. Testing and treating practices varied across geographic regions.
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Affiliation(s)
| | - Joanne Duncan
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
| | - Nathan Connell
- Hematology Division, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Nichola Cooper
- Department of Haematology, Imperial College London, London, UK
| | - Wendy Lim
- Hematology & Thromboembolism, McMaster University, Hamilton, ON, Canada
| | - Francesco Rodeghiero
- Hematology Project Foundation, Hematology Department, San Bortolo Hospital, Vicenza, Italy
| | | | - Rachael F Grace
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Tamam Bakchoul
- Medical Faculty of Tubingen, Institute for Clinical and Experimental Transfusion Medicine, Tubingen, Germany
| | - Donald M Arnold
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster Centre for Transfusion Research, McMaster University, Hamilton, ON, Canada
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Kharel S, Bist A, Shrestha S, Homagain S. Helicobacter pylori healthy South Asians. JGH Open 2020; 4:1037-1046. [PMID: 33319035 PMCID: PMC7731813 DOI: 10.1002/jgh3.12426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/19/2020] [Accepted: 09/26/2020] [Indexed: 11/09/2022]
Abstract
We aimed to estimate the pooled prevalence of Helicobacter pylori among asymptomatic South Asians based on available literature and highlight the importance of screening asymptomatic individuals and implementing preventive strategies for eradicating H. pylori. Electronic databases such as PubMed and Embase, a regional database of WHO South Asian Region, and gray literature sites were searched for relevant studies from 1983 to 5 May 2020. In addition, references of the included studies were thoroughly searched. The random-effect model was used to calculate the pooled prevalence with a 95% confidence interval (CI) along with subgroup analysis. Analysis of 19 studies showed a pooled prevalence of 56.5%, ranging from 10.3 to 91.7%. In subgroup analysis by country, the highest prevalence rate was reported from Bangladesh (86.3%, 95% CI: 0.806-0.921), whereas the lowest prevalence was from Sri Lanka (10.3%, 95% CI: 0.072-0.135). No differences were found between males and females. Prevalence among children and adolescents was 65.3% (95% CI: 0.529-0.777), greater than adults, 56.9% (95% CI: 0.353-0.785). The prevalence rate showed a decreasing trend upon comparison of studies conducted before and after 2000. Our analysis reveals the high prevalence of H. pylori infection among asymptomatic healthy populations in South Asia, particularly in children and adolescents. Public health awareness and sanitation interventions, pure drinking water, and respective strategies on a policy level to eradicate H. pylori and additional extensive multicentric cohort studies are necessary.
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Affiliation(s)
- Sanjeev Kharel
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Anil Bist
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Suraj Shrestha
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
| | - Sushan Homagain
- Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal
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Elkhodary NM, Farrag KA, Elokaby AM, Omran GAEH. Efficacy and safety of 7 days versus 10 days triple therapy based on levofloxacin-dexlansoprazole for eradication of Helicobacter pylori: A pilot randomized trial. Indian J Pharmacol 2020; 52:356-364. [PMID: 33283766 PMCID: PMC8025764 DOI: 10.4103/ijp.ijp_364_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/01/2019] [Accepted: 10/12/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Levofloxacin-based triple therapies are considered the standard regimen for eradication of Helicobacter pylori (H. pylori) due to decreased sensitivity to clarithromycin and the optimal duration of therapy is still controversial. Besides, there is no complete evidence about dexlansoprazole efficacy in the eradication of H. pylori. AIM Our study aimed to determine the effectiveness of triple therapy based on levofloxacin-dexlansoprazole as a standard treatment for H. pylori infection and estimate the effect of H. pylori on lipid profile and hemoglobin (Hb). MATERIALS AND METHODS A pilot prospective randomized trial of a triple therapy based on levofloxacin-dexlansoprazole for H. pylori eradication was conducted at Damanhour Medical National Institute, Egypt; 66 participants with H. pylori infection received levofloxacin (500 mg/day) plus amoxicillin (1 g/12 h) plus dexlansoprazole (60 mg/day). All medications administrated orally for either 7 days or 10 days. Four weeks after treatment, the eradication was assessed by the stool antigen test. RESULTS The rate of eradication was 63.6% in levofloxacin, amoxicillin, and dexlansoprazole (LAD) 7-day group, and 90.9% in LAD 10-day group. In addition, laboratory test results showed a significant difference in Hb, low-density lipoprotein, high-density lipoprotein, triglyceride, and total cholesterol levels before and after treatment (P < 0.05). CONCLUSION LAD 10 days is the least duration that provides maximum efficacy for H. pylori in Egyptian participants. In addition, successful treatment of H. pylori infection may reduce the risk of anemia and dyslipidemia. Furthermore, all members of the patient's family should be screened for H. pylori to prevent recurrent infection.
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Affiliation(s)
- Noha Mahmoud Elkhodary
- Department of Clinical Pharmacy and Pharmacy Practice, Damanhour University, Damanhour, Egypt
| | - Khaled Abdalkader Farrag
- Tropical Medicine and Hygiene Department, Damanhour Medical National Institute, Damanhour, Egypt
| | - Amany Mahmoud Elokaby
- Department of Clinical Pharmacy and Pharmacy Practice, Damanhour University, Damanhour, Egypt
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Alihosseini S, Jaberinezhad M, SadeghpourHeravi F, Ghotaslou R, Ebrahimzadeh Leylabadlo H. Invasive and non-invasive Helicobacter pylori diagnostic methods in Iran. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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HISTOPATHOLOGICAL FINDINGS AND CLINICAL OUTCOMES OF PATIENTS AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.732733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Grande R, Sisto F, Puca V, Carradori S, Ronci M, Aceto A, Muraro R, Mincione G, Scotti L. Antimicrobial and Antibiofilm Activities of New Synthesized Silver Ultra-NanoClusters (SUNCs) Against Helicobacter pylori. Front Microbiol 2020; 11:1705. [PMID: 32849359 PMCID: PMC7411087 DOI: 10.3389/fmicb.2020.01705] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/29/2020] [Indexed: 02/05/2023] Open
Abstract
Helicobacter pylori colonizes approximately 50% of the world’s population, and it is the cause of chronic gastritis, peptic ulcer disease, and gastric cancer. The increase of antibiotic resistance is one of the biggest challenges of our century due to its constant increase. In order to identify an alternative or adjuvant strategy to the standard antibiotic therapy, the in vitro activity of newly synthesized Silver Ultra-NanoClusters (SUNCs), characterized by an average size inferior to 5 nm, against clinical strains of H. pylori, with different antibiotic susceptibilities, was evaluated in this study. MICs and MBCs were determined by the broth microdilution method, whereas the effect of drug combinations was determined by the checkerboard assay. The Minimum Biofilm Eradication Concentration (MBEC) was measured using AlamarBlue (AB) assay and colony-forming unit (CFU) counts. The cytotoxicity was evaluated by performing the MTT assay on the AGS cell line. The inhibitory activity was expressed in terms of bacteriostatic and bactericidal potential, with MIC50, MIC90, and MBC50 of 0.33 mg/L against planktonic H. pylori strains. Using the fractional inhibitory concentration index (FICI), SUNCs showed potential synergism with metronidazole and clarithromycin. The biofilm eradication was obtained after treatment with 2×, 3×, and 4× MIC values. Moreover, SUNCs showed low toxicity on human cells and were effective in eradicating a mature biofilm produced by H. pylori. The data presented in this study demonstrate that SUNCs could represent a novel strategy for the treatment of H. pylori infections either alone or in combination with metronidazole.
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Affiliation(s)
- Rossella Grande
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Francesca Sisto
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Valentina Puca
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Department of Medicine and Aging Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Simone Carradori
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Maurizio Ronci
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Antonio Aceto
- Department of Medical, Oral, and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Raffaella Muraro
- Department of Medical, Oral, and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Gabriella Mincione
- Department of Medical, Oral, and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Luca Scotti
- Department of Medical, Oral, and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Alihosseini S, Ghotaslou R, Heravi FS, Ahmadian Z, Leylabadlo HE. Management of antibiotic-resistant Helicobacter pylori infection: current perspective in Iran. J Chemother 2020; 32:273-285. [PMID: 32657237 DOI: 10.1080/1120009x.2020.1790889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Helicobacter pylori is a common gastric bacterial pathogen implicated in the pathogenesis of many digestive tract disorders. H. pylori infection prevalence has been reported alarmingly in Iran. A plethora of studies have been conducted to evaluate the efficiency of first-line and second-line eradication attempts in patients diagnosed with H. pylori infections in Iran. The present study, was evaluated the efficacy of first-line and second-line therapy in H. pylori infections in Iran. We aimed to consider the literature review of the various library and electronic databases (Science Direct, PubMed, and Google Scholar) until 2020. The frequency of bacterial resistance to tetracycline, ampicillin, trimethoprim, erythromycin, ofloxacin, and metronidazolewas found to be high in Iran, while the most effective antibiotics were clarithromycin, rifampin, rifampicin, tetracycline, amoxicillin, ciprofloxacin, levofloxacin, moxifloxacin, and azithromycin. The therapeutic choice for H. pylori eradication in Iran could be quadruple therapy using two antibiotics amoxicillin and metronidazole/clarithromycin for the first-line regimen, and a combination of furazolidone plus tetracycline/amoxicillin and bismuth plus proton pump inhibitor for the second-line regimen. Due to increased antibiotic resistance in our region, empirical therapy must be replaced by more targeted treatment based on antimicrobial drug resistance profiles obtained from patients. Although we limited our investigation on the H. pylori eradication regimens in Iran, the results can be generalized to any region as long as the patterns of resistance are the same.
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Affiliation(s)
- Samin Alihosseini
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghotaslou
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Zainab Ahmadian
- Department of Pharmaceutics, School of Pharmacy, Zanjan University of Medical Science, Zanjan, Iran
| | - Hamed Ebrahimzadeh Leylabadlo
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Altamimi E, Alsharkhat N, AlJawarneh A, Abu Hamad MR, Assi AA, Alawneh S, Al-Ahmad M. Declining prevalence of Helicobacter pylori infection in Jordanian children, report from developing country. Heliyon 2020; 6:e04416. [PMID: 32715122 PMCID: PMC7378580 DOI: 10.1016/j.heliyon.2020.e04416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 04/20/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Helicobacter pylori (H. pylori) is a Gram-negative bacteria that is harbored in the stomach and linked to chronic gastritis, peptic ulcer disease, and gastric malignancy. Most Helicobacter infections are acquired during early infancy. This study aimed to establish the prevalence of H. pylori infection in Jordanian children using the 13C-urea breath test. MATERIALS AND METHODS We prospectively enrolled children between the ages of 4 and 17 years from April 2019 to July 2019. Enrolled children were patients with nongastrointestinal complaints at the pediatric clinics of two hospitals and at community centers caring for healthy children in Irbid, Jordan. Questionnaires obtaining data on sociodemographics, clinical symptomatology, and hygienic risk factors were completed. Recruited children underwent a urea breath test (UBT). RESULTS Of 340 children who were recruited, 328 (96.5%) were included in the final analysis. The mean age (±standard deviation) was 9.56 (±3.98) years (range, 4.0-17 years), and 168 (51.2%) were males. Only 48 children (14.6%) tested positive. There were no gender differences. Living in an urban area and a family history of previous H. pylori infection were risk factors for the acquisition of infection (P = 0.007 and 0.001, respectively). Although gastrointestinal symptoms were more common in H. pylori-infected children, only hiccups and constipation were statistically significant (P = 0.035 and 0.038, respectively). CONCLUSION H. pylori infects at least 15% of Jordanian children, suggesting a significant drop in infection rates in this group. Larger-scale studies combined with clinical evaluations will be important for further understanding the reasons for the observed decrease in H. pylori infections in Jordanian children.
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Affiliation(s)
- Eyad Altamimi
- Pediatric Department, Jordan University of Science and Technology, Irbid, Jordan
- Pediatric Department, King Abdullah University Hospital, Irbid, Jordan
| | | | | | | | - Anas Abu Assi
- King Hussein Cancer Foundation and Center, Amman, Jordan
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Salavati S, Ahmadi Hedayati M, Ahmadi A, Fakhari S, Jalili A. Relationship between Helicobacter pylori cagA Genotypes Infection and IL-10 and TGFβ1 Genes' Expression in Gastric Epithelial Cells. Int J Prev Med 2020; 11:20. [PMID: 32175060 PMCID: PMC7050228 DOI: 10.4103/ijpvm.ijpvm_536_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/14/2019] [Indexed: 11/04/2022] Open
Abstract
Background The correlation of Helicobacter pylori infection with gastritis, peptic ulcer, and gastric cancer has been proven. The aim of this study was to determine the effects of cagA + and cagA - genotypes of H. pylori on genes expression of interleukin (IL) -10 and tumor growth factor (TGF) β1 in gastric epithelial cells of patients with gastritis and H. pylori infection. Methods In all, 45 gastric biopsy samples were collected from patients with gastritis and H. pylori infection admitted to Tohid Hospital in Sanandaj city. Status of urease and cagA genes of H. pylori were directly determined from the biopsy samples using polymerase chain reaction (PCR) method. Expression of IL-10 and TGF-β1 genes in gastric epithelial cells of patients with gastritis and cagA + and cagA- genotypes of H. pylori infection was serveyed using real-time PCR method. Results Overall, 25 samples had infection with H. pylori cagA + and 20 with cagA - genotypes. This study showed that there is a positive correlation between cagA - genotypes of H. pylori and increasing of IL-10 gene expression in gastric epithelial cells of patients with gastritis (P = 0.001). Conclusions Level of gene expression of IL-10 as an anti-inflammatory cytokine in gastric epithelial cells of patients with H. pylori infection is connected to cagA- genotypes.
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Affiliation(s)
- Saeed Salavati
- Liver and Digestive Research Center, Reaserch Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Manouchehr Ahmadi Hedayati
- Liver and Digestive Research Center, Reaserch Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Ahmadi
- Liver and Digestive Research Center, Reaserch Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shohreh Fakhari
- Liver and Digestive Research Center, Reaserch Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Jalili
- Liver and Digestive Research Center, Reaserch Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Milivojevic V, Milosavljevic T. Burden of Gastroduodenal Diseases from the Global Perspective. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2020; 18:148-157. [PMID: 31993967 DOI: 10.1007/s11938-020-00277-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW We reviewed the recent medical literature to show global burden of gastroduodenal disease, potential strategies, and further perspectives. RECENT FINDINGS Gastrointestinal and liver diseases are growing health problems, and cause more than 8 million deaths per year worldwide; encompass a range of long-term health conditions, such as digestive cancers, gastroesophageal reflux disease, Helicobacter pylori infection, peptic ulcer disease, liver diseases, inflammatory bowel disease, coeliac disease, and functional gastrointestinal disorders. Scientific knowledge demonstrates that the noncommunicable disease burden can be greatly reduced if cost-effective preventive and curative actions, along with interventions for prevention and control of noncommunicable diseases already available, are implemented in an effective and balanced manner. SUMMARY Future research will have to elaborate on simple methods for preselection of patients at high risk to allow their implementation in strategies and respect all demand of cost-effectiveness. Understanding trends in GI illnesses could be helpful to meet the needs of patients and decrease the disease burden.
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Affiliation(s)
- Vladimir Milivojevic
- Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, School of Medicine, Belgrade University, Koste Todorovic N 2, Belgrade, Serbia.
- School of Medicine, Belgrade University, Belgrade, Serbia.
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Ahmed S, Belayneh YM. Helicobacter pylori And Duodenal Ulcer: Systematic Review Of Controversies In Causation. Clin Exp Gastroenterol 2019; 12:441-447. [PMID: 31819586 PMCID: PMC6873956 DOI: 10.2147/ceg.s228203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background There are controversies on the causal role of H. pylori in duodenal ulceration. Helicobacter pylori are curved gram-negative microaerophilic bacteria found at the layer of gastric mucous or adherent to the epithelial lining of the stomach. It’s a public health significance bacteria starting from discovery, and the prevalence and severity of the infection varies considerably among populations. H. pylori are a risk for various diseases, while the extent of host response like gastric inflammation and the amount of acid secretion by parietal cells affects the outcome of infection. Method Relevant literature were searched from databases such as Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct. Result The review evidence supports a strong causal relation between H. pylori infection and duodenal ulcer, as patients are more likely to be infected by virulent strains which later cause duodenal ulceration. Thus, eradication of H. pylori infection decreases the incidence of duodenal ulcers, and prevents its recurrence by reducing both basal gastrin release and acid secretion without affecting parietal cell sensitivity. On the other hand, some studies show that H. pylori infection is not associated with the development of duodenal ulcers and such a lack of association revealed that duodenal ulceration has different pathogenesis. Conclusion Despite controversies observed in the causal role of H. pylori to duodenal ulceration by various studies, Hill criteria of causation proved the presence of a causal relation between H. pylori infection and duodenal ulcers. Other factors are also responsible for the development of duodenal ulcers and such factors are responsible for the differences in the prevalence of the diseases.
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Affiliation(s)
- Solomon Ahmed
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yaschilal Muche Belayneh
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Öner Rİ, Özdaş S. Histopathological Findings in Morbid Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy: Does H. pylori Infection Effective on Pathological Changes? Obes Surg 2019; 28:3136-3141. [PMID: 29663251 DOI: 10.1007/s11695-018-3250-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AıM: To determine the prevalence of histopathological findings requiring clinical follow-up in morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG) and evaluate the relationship between these findings and Helicobacter pylori as well as to add more data to the published literature in this regard. MATERıAL AND METHODS: Overall, 161 morbidly obese patients with body mass index (BMI) > 40 kg/m2 who underwent LSG between May 1, 2014 and May 31, 2017 were retrospectively included in the study. The findings of the histopathological evaluation of the resected gastric material and the relationship between these findings and histopathologically detected H. pylori infection were investigated. RESULTS The study included 114 women (70.8%) and 47 men (29.2%). The mean age of the patients was 36.82 ± 10.41 years, and the mean BMI was 46.05 ± 3.76 kg/m2. H. pylori infection was detected in 103 (64%), chronic gastritis in 156, chronic active gastritis in 47, intestinal metaplasia in eight, and atrophy in seven patients. The rate of H. pylori-associated chronic gastritis was 64%, that of chronic active gastritis was 24.2%, that of lymphoid aggregation was 62.2%, and that of intestinal metaplasia and atrophy was 3.1%. There was a significant relationship between H. pylori infection and chronic gastritis, chronic active gastritis, and lymphoid aggregation; however, no significant relationship was found between intestinal metaplasia and atrophy. CONCLUSıON: Clinicians should be aware of the histopathological findings requiring clinical follow-up for LSG-treated patients. Given the complications of H. pylori infection such as lymphoma and malignancy, periodic follow-up of patients and eradication therapy may be a suitable approach for treating intestinal metaplasia and atrophic changes.
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Affiliation(s)
- Ramazan İlyas Öner
- Department of Internal Medicine, Faculty of Medicine, Adiyaman University, Yunus Emre Mah, Şifa Cad, 024000, Adiyaman, Turkey.
| | - Sabri Özdaş
- Department of General Surgery, Faculty of Medicine, Adiyaman University, Adıyaman, Turkey
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Sharifi A, Azizi M, Moradi-Choghakabodi P, Aghaei S, Azizi A. In vitro anti-Helicobacter pylori activity of aqueous extract from Persian Oak testa. CHINESE HERBAL MEDICINES 2019. [DOI: 10.1016/j.chmed.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ghosn Y, Hussein Kamareddine M, Tawk A, Bou-Ayash N, Bou-Ayash H, Mokamer N, Yared R, Aoun M, Khoury S, Cortas G, Jabbour G, Bedran K, Farhat S. Analysis of gastric and duodenal biopsy results in patients presenting with dyspepsia: a cross-sectional study in a middle eastern population. BMJ Open Gastroenterol 2019; 6:e000330. [PMID: 31645989 PMCID: PMC6781958 DOI: 10.1136/bmjgast-2019-000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Correa's cascade is a 'Model for Gastric Cancer Development' described by Peleyo Correa. The reversibility of Correa's cascade remains debatable. The literature contains insufficient data on the specific stage of the cascade during which Helicobacter pylori is detected, treated, and the effect on prognosis. Herein, we aim to determine the prevalence of various precancerous and cancerous gastric lesions in patients presenting with dyspepsia, the prevalence of gastritis and H. pylori infection, the prevalence of duodenal pathology in patients presenting with dyspepsia, identify the stage of H. pylori detection in relation to Correa's cascade, and investigate a possible relationship between H. pylori and celiac disease. DESIGN Retrospective cross-sectional study conducted on a middle eastern population at a Lebanese tertiary hospital centre. 1428 patients presenting with dyspepsia underwent gastroscopy with gastric and duodenal biopsies. Variables include age, sex, presence/absence of H. pylori infection, and histopathological analysis of gastric and duodenal biopsies. RESULTS Being above 40 years of age was associated with increased likelihood of exhibiting abnormal gastric biopsy result. Gastritis and metaplasia were detected more frequently than glandular atrophy (p<0.001) with gastritis being present the most (p<0.001). The presence of H. pylori and the gastric biopsy results were not associated with any of the duodenal biopsy results. CONCLUSION The burden of H. pylori infection in patients with dyspepsia was high. H. pylori was detected at various precancerous lesions with varying significance. The prevalence of duodenal adenocarcinoma in dyspeptic patients is unexpectedly high. No association between gastric and duodenal pathologies was found.
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Affiliation(s)
- Youssef Ghosn
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | | | - Antonios Tawk
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Naseem Bou-Ayash
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Haneen Bou-Ayash
- Faculty of Health and Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nader Mokamer
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Rawad Yared
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Mouna Aoun
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Salem Khoury
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - George Cortas
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Gide Jabbour
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Khalil Bedran
- Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Said Farhat
- Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
- Saint George Hospital University Medical Center, Beirut, Lebanon
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Eed EM, Hawash YA, Khalifa AS, Alsharif KF, Alghamdi SA, Saber T, Ismail KA, Shehab-Eldeen SA. Molecular diagnosis of Helicobacter pylori antibiotic resistance in the Taif region, Saudi Arabia. Microbiol Immunol 2019; 63:199-205. [PMID: 31045263 DOI: 10.1111/1348-0421.12686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/28/2019] [Indexed: 12/13/2022]
Abstract
Success in eradication of Helicobacter pylori is declining globally because H. pylori has developed resistance against most of the antibiotics proposed for eradication regimens, mainly through point mutations. The present study included 200 patients with dyspepsia attending Taif Hospital. Gastric biopsies were obtained during gastroscopy and subjected to rapid urease testing. Molecular methods were used to confirm diagnoses of H. pylori infection and to identify resistance gene variants of four antibiotics; namely, clarithromycin, metronidazole, fluoroquinolones and tetracycline (23S rRNA, gyrA, rdxA and 16S rRNA respectively). Of all investigated patients, Molecular diagnoses were made in 143 of all investigated patients; thus, the prevalence was .5%. The overall rate of resistance to clarithromycin among the H. pylori-positive patients was high (39.9%) and the rate of resistance significantly greater (48.2%) among the secondary resistance group, secondary resistance being defined as resistance as a result of previous exposure to the relevant antibiotic. The rate of resistance to fluoroquinolones was considered moderate; the difference in rate of resistance between the primary and secondary resistance groups (8.4% and 9.5%, respectively) was not significant Also, there was a low prevalence of both primary and the secondary tetracycline resistance in the study cohort. In contrast, the prevalence of metronidazole resistance was considered high with no significant difference between the two resistance groups. H. pylori showed an increased prevalence of resistance to all four of the commonly used therapeutic agents. Thus, eradication therapy should be based on the regional results of susceptibility testing. Moreover, treatment tailored according to individually determined H. pylori susceptibility may be a reasonable future goal.
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Affiliation(s)
- Emad M Eed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.,Medical Microbiology and Immunology Department, Faculty of Medicine, Menoufia University, Al Menoufia, Egypt
| | - Yousry A Hawash
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.,Molecular and Clinical Parasitology Department, National Liver Institute, Menoufia University, Al Menoufia, Egypt
| | - Amany S Khalifa
- Clinical Pathology Department, Faculty of Medicine, Menoufia University, Al Menoufia, Egypt.,Medical Microbiology and Immunology Department, Faculty of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Khalaf F Alsharif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Saleh A Alghamdi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Taisir Saber
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.,Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Khadiga A Ismail
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.,Department of Parasitology, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Somaia A Shehab-Eldeen
- Tropical Medicine Department, Faculty of Medicine, Menoufia University, Al Menoufia, Egypt
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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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Investigations of families of patients diagnosed with gastric carcinoma in Bulgaria. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Prevalence and Risk Factors of Helicobacter pylori Infection among Children Aged 1 to 15 Years at Holy Innocents Children's Hospital, Mbarara, South Western Uganda. J Trop Med 2019; 2019:9303072. [PMID: 30984271 PMCID: PMC6431523 DOI: 10.1155/2019/9303072] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/20/2019] [Indexed: 02/07/2023] Open
Abstract
Background Helicobacter pylori infection affects more than half of the world's population. The infection is generally acquired during childhood but can remain asymptomatic, with long-term clinical sequelae including gastritis, peptic ulcer disease, and stomach cancer. Methods The study was approved by Institutional Review Committee of Mbarara University of Science and Technology. After obtaining informed consent from parents/legal guardians, illegible children who presented with gastrointestinal complaints at Holy Innocents Children's Hospital were recruited; structured questionnaires were administered to the parents/guardians to collect information on sociodemographic data and risk factors of H. pylori infection. Four (4) millilitres of blood was collected from each child and tested for H. pylori blood Antibody test and stool specimens were used for H. pylori antigen test. Results The prevalence of H. pylori infection among the study participants was 24.3%. The infection rate increased with increase in age of the participants, from 16.2% among 1to 5 years old to 27.2% among 6 to 10 years. Infections were higher among school going children (68/74, p=0.003, OR 3.9; CI: 1.5 to 10.6) and children from crowded households (59/74, p<0.001, OR 2.6, and CI 1.3 to 5.0), unsafe source of drinking water at schools (46/74, p=0.003), and lack of sanitary facility at homes (57/74, p=0.001, and OR 1.6 CI 0.7 to 3.6). Conclusion The prevalence of H. pylori infection among children aged 1 to 15 years at Holy Innocents Children's Hospital was high and increases with age. School attendance, lack of sanitary facility, lack of safe drinking water, and overcrowding were the risk factors associated with H. pylori infection.
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Abangah G, Raughani A, Asadollahi P, Asadollahi K. Comparison between the two drug regimens of PPI+Amoxicillin+ Rifampicin and PPI+Amoxicillin+ Levofloxacin for the treatment of H. pylori infections resistant to the first line drug regimen among patients referred to Ilam clinics. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2019; 12:209-216. [PMID: 31528304 PMCID: PMC6668768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Abstract
AIM This study compares the effects of two drug regimens for Helicobacter pylori (H. pylori) infection resistant to the first line drug regimen among patients referred to Ilam clinics, Iran. BACKGROUND Single drug regimen is not effective for H. pylori infection and therefore, application of triple or quadruple drug regimens are currently applied. METHODS This study was performed by a before-after comparative method and patients were randomly selected among those consecutively referred to Ilam gastrointestinal clinics. Patients with failure in the first line treatment, were randomly divided into two equal groups and each group was treated by one of the PPI+Amoxicillin+Rifampicin or PPI+Amoxicillin+Levofloxacin drug regimens for 14 days. Six weeks after treatment, patients were tested for H. pylori stool antigen and the results were compared between two groups. RESULTS In this study, 100 patients including 49 (49%) men and 51 (51%) women were examined. There was no statistical difference between the two groups for gender, age and living location at the start of study (p = 0.068). The mean age of the patients was 44.55 ±15.1 years old ranging from 17 to 85 years. Response to treatment among the levofloxacin group, was 90% and in rifampicin group 72% with a significant difference (p<0.04). CONCLUSION The response rate of H. pylori infection to the Levofloxacin based regimen was 90%; however, the application of rifampicin in combination with other drugs against H. pylori infection (72% response rate), should be limited to reduce the possibility of drug resistance in case of tuberculosis infection.
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Affiliation(s)
- Ghobad Abangah
- Department of Internal Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Alireza Raughani
- Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Parisa Asadollahi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Khairollah Asadollahi
- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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Ranjbar R, Chehelgerdi M. Genotyping and antibiotic resistance properties of Helicobacter pylori strains isolated from human and animal gastric biopsies. Infect Drug Resist 2018; 11:2545-2554. [PMID: 30588039 PMCID: PMC6296207 DOI: 10.2147/idr.s187885] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose The present study was done to assess the prevalence rate, antibiotic resistance pattern and genotyping status of the Helicobacter pylori strains isolated from human and animal gastric biopsy samples. Patients and methods A total of 1,150 gastric biopsy samples were randomly collected from humans (children and adults) and animals (cows, sheep and goats). All samples were subjected to culture, urease test and histopathologic examination. H. pylori isolates were also confirmed using the 16S rRNA gene PCR-amplification. Antibiotic resistance pattern was assessed by the disk diffusion method. Distribution of different genotypes was studied by PCR. Results The prevalence of H. pylori in gastric biopsy samples which were studied using urease test, culture and histological examination were 57.04%, 55.40% and 60.80%, respectively. Samples that were collected from adult humans (78%) and sheep (70%) had the highest prevalence of H. pylori strains, while those of goats (0.6%) and cows (4%) had the lowest. Findings of the culture method were confirmed using PCR-based amplification of 16S rRNA. Distribution of H. pylori among the gastric ulcers, duodenal ulcers, chronic gastritis gastric cancer and chronic cancer samples were 10.40%, 15.70%, 96.50%, 0.60% and 3.14%, respectively. H. pylori strains harbored the highest prevalence of resistance against ampicillin (74.4%), clarithromycin (63.4%), trimethoprim (61.5%) and metronidazole (61.5%). The most commonly detected genotypes among the H. pylori strains isolated from different types of biopsy samples were cagA (84.79%), vacA m2 (55.95%), vacA s1a (49.84%), cagE (48.58%), iceA1 (47.02%) and iceA2 (47.02%). Conclusion High prevalence of antibiotic resistance and virulent genotypes indicates an important public health issue. Similarities in antibiotic resistance and genotyping pattern of H. pylori strains isolated from humans and animals may show their similar routes of infection.
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Affiliation(s)
- Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran,
| | - Mohammad Chehelgerdi
- Biotechnology Research Center, Shahr-e Kord Branch, Islamic Azad University, Shahr-e Kord, Iran
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Attention to Technical Details Is Important for Best Outcomes with One Anastomosis Gastric Bypass. Obes Surg 2018; 28:2920-2921. [DOI: 10.1007/s11695-018-3367-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Farjam M, Sharafi M, Bahramali E, Rezaei S, Hassanzadeh J, Rezaeian S. Socioeconomic Inequalities in Gastroesophageal Reflux Disorder: Results from an Iranian Cohort Study. Middle East J Dig Dis 2018; 10:180-187. [PMID: 30186582 PMCID: PMC6119839 DOI: 10.15171/mejdd.2018.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Despite progress in the health indexes in recent years, health inequalities remain as a global challenge within and between regions and countries. This study is the first to quantify the socioeconomic inequity in gastroesophageal reflux disease (GERD) using the concentration index. METHODS In this cross-sectional study, we used baseline data (7012 subjects) from the Fasa Cohort Study (the Southern Iran). The principal component analysis was used to construct socioeconomic status of the participants. The concentration index and concentration curve were used to measure socioeconomic-related inequality in GERD. Decomposition of concentration index was also done to identify the contribution of each explanatory variable to the wealth-related inequality in GERD prevalence. RESULTS The prevalence of GERD was 16.9% (95% CI: 15.9-17.7%). The overall concentration index for GERD was 0.093 (95% CI: 0.062-0.166]. Correspondingly, this figure for men and women were 0.116 (95% CI: 0.062-0.171%) and 0.091 (95% CI: 0.044-0.137%), respectively. The main contributors of socioeconomic-related inequality in GERD prevalence were socioeconomic status (64.4%), alcohol drinking (29%), and age (8.4%). CONCLUSION GERD is significantly more concentrated among richest people. There was significant socioeconomic inequality in GERD according to some individual factors. These inequalities need to be addressed by policy makers to identify the vulnerable subgroups and to reduce the disease burden in the community.
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Affiliation(s)
- Mojtaba Farjam
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Sharafi
- Center for Diseases Control and Prevention, Deputy of Health Services, Fasa University of Medical Sciences, Fasa, Iran
| | - Ehsan Bahramali
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jafar Hassanzadeh
- Research Centre for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahab Rezaeian
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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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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Mohammadi Saravle S, Ahmadi Hedayati M, Mohammadi E, Sheikhesmaeili F, Nikkhou B. Sirt1 Gene Expression and Gastric Epithelial Cells Tumor Stage in Patients with Helicobacter pylori Infection. Asian Pac J Cancer Prev 2018; 19:913-916. [PMID: 29693338 PMCID: PMC6031779 DOI: 10.22034/apjcp.2018.19.4.913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: The World Health Organization has categorized Helicobacter pylori as a carcinogen for gastric
cancer, which causes human mortality worldwide. A number of studies have shown that H. pylori affects cell signaling
in gastric epithelial cells and changes the expression of some proteins such as proinflammatory cytokines. Bacterial
infections may alter sirt1 and sirt2 genes expression in inflammatory tissues and cancer cells. In this study, sirt1 and
sirt2 genes expression in gastric cancers was surveyed with reference to H. pylori status. Methods: Stomach biopsies
were collected from 50 gastric cancer patients, 25 H. pylori-positive and 25 H. pylori-negative as determined by the
urea rapid test. Tumor grade was determined by a pathologist. After total RNA extraction from gastric cancer biopsy
samples and cDNA synthesis, sirt1 and sirt2 genes expression levels were determined by Real Time PCR and ΔΔCT
methods. Results: There was no statistically significant link between H. pylori infection and sirt1 (P<0.899) and sirt2
(P<0.169) genes expression in gastric epithelial cells. However, pathologic findings showed that there is a statistically
significant relationship between sirt1 gene expression and the tumor grade (P<0.024). Discussion: A statistically
significant association was found between sirt1 gene expression and tumor grade of gastric cancers that could be due
to effects on progression of cancer cells infected with H. pylori.
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Affiliation(s)
- Saman Mohammadi Saravle
- Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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COELHO LGV, MARINHO JR, GENTA R, RIBEIRO LT, PASSOS MDCF, ZATERKA S, ASSUMPÇÃO PP, BARBOSA AJA, BARBUTI R, BRAGA LL, BREYER H, CARVALHAES A, CHINZON D, CURY M, DOMINGUES G, JORGE JL, MAGUILNIK I, MARINHO FP, MORAES-FILHO JPD, PARENTE JML, PAULA-E-SILVA CMD, PEDRAZZOLI-JÚNIOR J, RAMOS AFP, SEIDLER H, SPINELLI JN, ZIR JV. IVTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:97-121. [DOI: 10.1590/s0004-2803.201800000-20] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 02/06/2023]
Abstract
ABSTRACT Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders with a special emphasis on gastric cancer; and reassess the epidemiological and diagnostic aspects of H. pylori infection. Participants were allocated into four groups as follows: 1) Epidemiology and Diagnosis, 2) Dyspepsia, intestinal microbiota and other afections, 3) Gastric Cancer, and, 4) Treatment. Before the consensus meeting, participants received a topic to be discussed and prepared a document containing a recent literature review and statements that should be discussed and eventually modified during the face-to-face meeting. All statements were evaluated in two rounds of voting. Initially, each participant discussed the document and statements with his group for possible modifications and voting. Subsequently, during a second voting in a plenary session in the presence of all participants, the statements were voted upon and eventually modified. The participants could vote using five alternatives: 1) strongly agree; 2) partially agree; 3) undecided; 4) disagree; and 5) strongly disagree. The adopted consensus index was that 80% of the participants responded that they strongly or partially agreed with each statement. The recommendations reported are intended to provide the most current and relevant evidences to management of H. pylori infection in adult population in Brazil.
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Zamani M, Ebrahimtabar F, Zamani V, Miller WH, Alizadeh-Navaei R, Shokri-Shirvani J, Derakhshan MH. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther 2018; 47:868-876. [PMID: 29430669 DOI: 10.1111/apt.14561] [Citation(s) in RCA: 417] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 01/01/2018] [Accepted: 01/22/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The epidemiology of Helicobacter pylori infection is poorly understood. AIM To establish the reported regional and national prevalence of H. pylori infection, stratified by age and gender. METHODS All relevant English publications from 2000 to 2017 cited by PubMed and Scopus were retrieved using comprehensive combinations of keywords. The overall prevalence of H. pylori was estimated using both random effect and fixed effect meta-analyses, and presented as prevalence rate (% and 95% CI). The analyses were extended by separation into gender and age groups. RESULTS A total of 14 056 records were obtained initially. After applying exclusion criteria in several steps, 183 studies were selected. Analysis of 410 879 participants from 73 countries in six continents revealed an overall prevalence of 44.3% (95% CI: 40.9-47.7) worldwide. This rate ranged from 50.8% (95% CI: 46.8-54.7) in developing countries compared with 34.7% (95% CI: 30.2-39.3) in developed countries. The global H. pylori infection rate was 42.7% (95% CI: 39-46.5) in females compared to 46.3% (95% CI: 42.1-50.5) in males. The prevalence in adults (≥18 years) was significantly higher than in children (48.6% [95% CI: 43.8-53.5] vs 32.6% [95% CI: 28.4-36.8], respectively). There was a statistically nonsignificant decrease in the prevalence in 2009-2016 compared with the 2000-2009 period. CONCLUSIONS The observed differences between countries appear to be due to economic and social conditions. H. pylori infection can be a benchmark for the socioeconomic and health status of a country. Further studies are suggested to investigate the natural history of the acquisition of H. pylori infection from childhood into adult life.
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Affiliation(s)
- M Zamani
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - F Ebrahimtabar
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - V Zamani
- Vice-Chancellery for Health, Babol University of Medical Sciences, Babol, Iran
| | - W H Miller
- Faculty of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - R Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - J Shokri-Shirvani
- Department of Internal Medicine, Rohani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - M H Derakhshan
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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Tarhini M, Fayyad-Kazan M, Fayyad-Kazan H, Mokbel M, Nasreddine M, Badran B, Kchour G. First-line treatment of Helicobacter pylori in Lebanon: Comparison of bismuth-containing quadruple therapy versus 14-days sequential therapy. Microb Pathog 2018; 117:23-26. [DOI: 10.1016/j.micpath.2018.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 02/04/2018] [Accepted: 02/06/2018] [Indexed: 02/07/2023]
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