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Ferdaus SJ, Paul SK, Nasreen SA, Haque N, Sadekuzzaman M, Karim MR, Islam SM, Al Mamun A, Sathi FA, Basak P, Nahid RB, Aktar S, Kobayashi N. The Prevalence, Risk Factors, and Antimicrobial Resistance Determinants of Helicobacter pylori Detected in Dyspeptic Patients in North-Central Bangladesh. Infect Dis Rep 2024; 16:181-188. [PMID: 38525761 PMCID: PMC10961801 DOI: 10.3390/idr16020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/03/2024] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Chronic infection of Helicobacter pylori represents a key factor in the etiology of gastrointestinal diseases, with high endemicity in South Asia. The present study aimed to determine the prevalence of H. pylori among dyspeptic patients in north-central Bangladesh (Mymensingh) and analyze risk factors of infection and antimicrobial resistance (AMR) determinants in the pathogen. Endoscopic gastrointestinal biopsy samples were collected from dyspeptic patients for a one-year period from March 2022 and were checked for the presence of H. pylori via the rapid urease test and PCR and further analyzed for the status of virulence factors vacA/cagA and genetic determinants related to AMR via PCR with direct sequencing or RFLP. Among a total of 221 samples collected, 80 (36%) were positive for H. pylori, with the vacA+/cagA+ genotype being detected in almost half of them. H. pylori was most prevalent in the age group of 41-50-year-olds, with it being more common in males and rural residents with a lower economic status and using nonfiltered water, though the rates of these factors were not significantly different from those of the H. pylori-negative group. Relatively higher frequency was noted for the A2147G mutation in 23S rRNA, related to clarithromycin resistance (18%, 7/39). Amino acid substitutions in PBP-1A (T556S) and GyrA (N87K and D91N) and a 200 bp deletion in rdxA were detected in samples from some patients with recurrence after treatment with amoxicillin, levofloxacin, and metronidazole, respectively. The present study describes the epidemiological features of H. pylori infection in the area outside the capital in Bangladesh, revealing the spread of AMR-associated mutations.
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Affiliation(s)
- Syeda Jannatul Ferdaus
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | | | - Syeda Anjuman Nasreen
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Mohammad Sadekuzzaman
- Department of Livestock Services, Central Disease Investigation Laboratory (CDIL), 48, KaziAlauddin Road, Dhaka 1000, Bangladesh;
| | - Mohammad Reazul Karim
- Department of Gastroenterology, Mymensingh Medical College, Mymensingh 2200, Bangladesh;
| | - Syed Mahmudul Islam
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh;
| | - Abdullah Al Mamun
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Fardousi Akter Sathi
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Proma Basak
- Shaheed Syed Nazrul Islam Medical College, Kishoreganj 2300, Bangladesh;
| | - Rifat Binte Nahid
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh; (S.J.F.); (S.A.N.); (N.H.); (A.A.M.); (F.A.S.); (R.B.N.)
| | - Suraiya Aktar
- Department of Microbiology, Dhaka Central International Medical College and Hospital, 2/1 Ring Road, Shyamoli, Dhaka 1207, Bangladesh;
| | - Nobumichi Kobayashi
- Department of Hygiene, School of Medicine, Sapporo Medical University, S-1 W-17, Chuo-ku, Sapporo 060-8556, Japan
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Kismat S, Tanni NN, Akhtar R, Roy CK, Rahman MM, Molla MMA, Anwar S, Ahmed S. Diagnosis and Comparison of Three Invasive Detection Methods for Helicobacter pylori Infection. Microbiol Insights 2022; 15:11786361221133947. [PMID: 36325107 PMCID: PMC9619850 DOI: 10.1177/11786361221133947] [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: 04/21/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare different invasive methods for Helicobacter pylori (H. pylori) detection, namely PCR for H. pylori specific ureC gene, Rapid urease test (RUT), and histopathological examination by modified Giemsa staining. METHODOLOGY Endoscopic gastroduodenal biopsy materials were collected from dyspeptic patients who underwent endoscopic examination upon fulfilling the inclusion criteria. Three to four samples were collected from each patient after taking informed consent and proper clinical history. A rapid urease test (RUT) was done on spot with in-house RUT media from 1 specimen. One to two specimens were preserved in 10% formaldehyde for histopathology and PCR for ureC gene was done from 1 specimen. Collected biopsy specimens from gastric and duodenal mucosa of 142 patients were categorized as H. pylori-positive cases and H. pylori-negative cases based on the case definition used in the study upon positivity of 3 diagnostic tests. RESULTS Among 142 biopsy specimens, 34.5% were categorized as H. pylori-positive cases, 35.2% as H. pylori-negative cases, and finally 30.2% as doubtful or indeterminate cases. Rapid urease test was the most sensitive method, closely followed by ureC gene PCR and histopathology, with a sensitivity of 94.2%, 83.0%, and 76.5%, respectively. Whereas histology was the most specific, having 98.0% specificity followed by 83.0% in PCR. RUT was the least specific, with 55.5% specificity. CONCLUSION While histopathology could detect H. pylori infection with the highest specificity, for definitive diagnosis combination of any 2 methods should be used, if available.
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Affiliation(s)
- Saifa Kismat
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh,Saifa Kismat, Department of Microbiology
and Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
| | - Nusrat Nur Tanni
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rokshana Akhtar
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Chandan Kumar Roy
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Md. Maruf Ahmed Molla
- Department of Virology, National
Institute of Laboratory Medicine and Referral Center, Dhaka, Bangladesh
| | - Shaheda Anwar
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sharmeen Ahmed
- Department of Microbiology and
Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Hossain MS, Das S, Begum SMKN, Rahman MM, Mazumder RN, Gazi MA, Fahim SM, Mahfuz M, Haque R, Petri WA, Sarker SA, Ahmed T. Asymptomatic Duodenitis and Helicobacter pylori associated Dyspepsia in 2-Year-Old Chronic Malnourished Bangladeshi Slum-Dwelling Children: A Cross-Sectional Study. J Trop Pediatr 2020; 67:5939797. [PMID: 33099650 PMCID: PMC7948384 DOI: 10.1093/tropej/fmaa079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM There is insufficient knowledge on the * duodenal histology and Helicobacter pylori infection in malnourished Bangladeshi children. Therefore, we attempted to explore the prevalence of H. pylori infection and duodenal histopathology in 2-year-old chronic malnourished Bangladeshi slum-dwelling children and investigate their association with dyspeptic symptoms. METHODS This cross-sectional study was conducted using the data of the Bangladesh Environmental Enteric Dysfunction study in an urban slum of Dhaka, Bangladesh. With a view to address the association of environmental enteric dysfunction (EED) with stunting, upper gastrointestinal endoscopy was performed on 54 chronic malnourished children {31 stunted [length-for-age Z-scores (LAZ) <-2] and 23 at risk of stunting (LAZ <-1 to -2)} aged between 12-24 months and the mucosal biopsies were subjected to histopathological examination after obtaining proper clinical history. Stool antigen for H. pylori (HpSA) was assessed to determine H. pylori status. RESULTS In all, 83.3% (45/54) of the children had histopathological evidence of duodenitis. Chronic mild duodenitis was found to be the most prevalent form of duodenitis (53.7%) in the children. Only 8.9% (4/45) of the children with duodenitis had dyspepsia (p < 0.05). The 14.8% (8/54) of the children were found positive for H. pylori infection. Logistic regression analysis revealed children positive for HpSA had significant association with dyspepsia (OR 9.34; 95% CI 1.54-56.80). CONCLUSIONS The number of chronic malnourished children suffering from duodenitis was found to be very high. Majority of these children was asymptomatic. Children positive for HpSA had significant association with dyspeptic symptoms.
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Affiliation(s)
- Md Shabab Hossain
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh,Correspondence: Md. Shabab Hossain, Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka 1212, Bangladesh. E-mail <>
| | - Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | | | - M Masudur Rahman
- Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh
| | - Ramendra Nath Mazumder
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Md Amran Gazi
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Rashidul Haque
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA 22908, USA
| | - Shafiqul Alam Sarker
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
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Rahman MM, Sarker MAK, Hossain MM, Alam MS, Islam MM, Shirin L, Sultana R, Sultana GNN. Association of p53 Gene Mutation With Helicobacter pylori Infection in Gastric Cancer Patients and Its Correlation With Clinicopathological and Environmental Factors. World J Oncol 2019; 10:46-54. [PMID: 30834051 PMCID: PMC6396778 DOI: 10.14740/wjon1087] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 02/11/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Gastric cancer is also a leading cancer in Bangladesh like that of the global incidences. It is speculated that environmental, bacterial infection and molecular factors might have been carrying the key role of rising trend of the disease. This study was aimed to investigate the association of mutated p53 gene with of Helicobacter pylori (H. pylori) infection, clinicopathological and some environmental factors of the gastric cancer patients. METHODS This cross-sectional study was carried out from January 2015 to December 2016 in a specialized cancer hospital of Bangladesh. Patients were selected randomly who were admitted for surgical intervention after diagnosis as adenocarcinoma of the stomach and physically fit for surgery. After admission proper evaluation of the patients was done. Tissue sample from the gastrectomy specimen along with the blood sample was sent to the related laboratories. After DNA extraction for p53, exons 5 and 6, they were adjusted for proper primer designing. Appropriate sequencing analysis of the result was done. Status of p53 was investigated to see their association with the result of the H. pylori, age and sex, tumor status, smoking and extra salt intake of the patients. Result of the study was calculated and analyzed by Chi-square and binomial logistic regression to find the association amongst them. RESULTS Among the 71 patients, mean age was 52.96 years old, male: female ratio were 48:23, age group above 41 years were 53 (74.6%), proliferative and ulceroproliferative group of the tumor dominated (87.3%). There were 52 cases with (73.2%) p53 mutation. Among the 51 H. pylori positive cases, 41 (80%) had p53 mutation (P = 0.033). Tumor size and lymph node status were found to be associated with the gene mutation (P = 0.05). Age also had strong correlation with the mutation (P = 0.015). Gene mutation was found mostly among the younger (≤ 40 years) group of patients (94.4%). Patient with extra salt intake was also found related with the mutation (P = 0.03). CONCLUSIONS Environmental and genetic factors seem to be risk factors for gastric cancer in Bangladesh. Nationwide anti H. pylori drive and further molecular research could elicit the other risk factors which might help to reduce the gastric cancer incidences in the country after taking appropriate measures.
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Affiliation(s)
- M. Mizanur Rahman
- Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
| | | | | | - Mohd. Sahajadul Alam
- National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
| | - Md. Monzurul Islam
- National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
| | - Laila Shirin
- National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
| | - Rokeya Sultana
- Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, Bangladesh
| | - Gazi Nurun Nahar Sultana
- Genetic Engineering and Biotechnology Research Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, Bangladesh
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H. pylori infection and gastric cancer in Bangladesh: a case-control study. INTERNATIONAL JOURNAL OF SURGERY-ONCOLOGY 2017; 2:e44. [PMID: 29177209 PMCID: PMC5680990 DOI: 10.1097/ij9.0000000000000044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 12/13/2022]
Abstract
Background: Like that of other Asian countries gastric cancer (GC) is also a leading cancer in Bangladesh and also a cause for cancer-related mortality. Infection with Helicobacter pylori (H. pylori) is the strongest recognized risk factor for gastric adenocarcinoma. The infection is also prevalent in common people. This case-control study was carried out to find an association between GC and H. pylori infection in the community. Materials and Methods: To evaluate association of H. pylori and carcinoma of stomach this study was conducted at National Institute of Cancer Research & Hospital, Dhaka from January 2013 to December 2014. H. pylori status was determined serologically by using H. pylori kit in the department of Biochemistry laboratory of Bangabandhu Sheikh Mujib Medical University. In total, 114 patients with GC and 520 patients not having GC were studied as controls. Logistic regression method was used to calculate the odds ratio. Results: Significantly more patients in the case group (86.8%) were found to be seropositive for H. pylori antigen in contrast to the control group (67.5%). All of the cases in the present study were in advanced stage. No significant association between H. pylori seropositivity and tumor location was found. It was noted that undifferentiated gastric carcinoma had slightly more association with H. pylori infection. Younger H. pylori–infected patients had been found to be at higher relative risk for GC than older patients. Conclusion: As there is a strong association found between GC and H. pylori infection special emphasis to eradicate H. pylori infection might reduce the incidence of this dreadly disease.
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