Prevalence of Helicobacter pylori infection among asymptomatic children in southeastern Brazil: a cross-sectional study

ABSTRACT BACKGROUND: The prevalence of Helico bacter pylori (H. pylori) infection is decreasing worldwide, but is still high in developing countries. We previously observed an H. pylori infection rate of 52% among children and adolescents with chronic non-ulcer dyspepsia. OBJECTIVE: To investigate the prevalence of H. pylori infection among asymptomatic children living in a single region and to evaluate the risk factors for this infection. DESIGN AND SETTING: Cross-sectional study in which 161 children aged 5-13 years (mean age 7.8 years), at a public school in Botucatu, state of São Paulo, southeastern Brazil, were assessed. METHOD: The children's H. pylori infection status was determined through the urea breath test and the risk factors for acquisition of the infection were determined based on a sociodemographic questionnaire. RESULTS: The overall prevalence of H. pylori infection was 20.5%: 18.7% among females and 22.2% among males. The results from the sociodemographic survey did not differ between children with and without H. pylori infection. 30.9% of the children had previous records of upper gastrointestinal symptoms, which consisted of H. pylori infection in only 26.5% of these cases. Family histories of gastritis and peptic ulcer disease were found in relation to 50% and 32.3% of the children with H. pylori infection respectively. CONCLUSION: The prevalence of H. pylori infection among asymptomatic children in southeastern Brazil is lower than that recorded among symptomatic children in the same region and similar to the prevalence of H. pylori infection observed in developed countries.

Influencing factors of 13C-urea breath test in the diagnosis of Helicobacter pylori infection in children / 中华实用儿科临床杂志

The 13C-urea breath test is the most widely applied non-invasive test to diagnose Helicobacter pylori (Hp) infection in children.The fasting time, dose and formulation of labeled urea, type of test meal, time of breath collection, device to detect breath samples, cut-off value of exhaled 13CO 2/ 12CO 2 breath delta value and the interpretation of results have been modified to improve the accuracy.The 13C-urea breath test possesses a good perfor-mance in diagnosing Hp infection and evaluating the eradication of infection after treatment in children.However, the high false-positive results in young children are caused by oral flora, endogenous CO 2 and fixed dose of labeled urea.In addition, taking proton pump inhibitors, antibiotics and bismuth before test, low bacterial density and peptic ulcer bleeding will lead to false negative results.This study aims to review the influencing factors of 13C-urea breath test in the diagnosis of Hp infection in children.

Status and related factors of helicobacter pylori infection in Nantong Area / 公共卫生与预防医学

Objective To investigate status of helicobacter pylori (Hp) infection in Nantong Area and its related factors. Methods A cluster of 1 680 people who underwent a physical examination at a hospital in the Nantong area from June 2020 to February 2021 were selected as the subjects of this survey. All subjects were tested for Hp infection through the 14C-urea breath test and the Hp infection status analyzed. At the same time, the self-filled and interrogative questionnaires made by our hospital were used to collect general data of the research subjects, and then single-factor and multi-factor logistic regression was used to analyze the related factors affecting Hp infection in the physical examination population in Nantong area. Results Among the 1 680 medical examiners investigated in this study, 980 were positive for Hp infection, and the overall positive rate of infection was 58.33%. The results of univariate analysis found that Hp infection was related to the age, drinking, hotness, frequent eating of pickled food, family history of gastric cancer, and chronic gastritis in the physical examination population in Nantong area (P60 years old (OR=3.46, 95%CI: 1.35-8.84), drinking (OR=5.22, 95%CI: 2.79-9.77), addiction to spicy food (OR=5.47, 95%CI: 2.45-9.30), regular consumption of pickled foods (OR=5.28, 95%CI: 3.48-7.92), family history of gastric cancer (OR=4.29, 95%CI: 2.86-76.45), chronic gastritis (OR=5.07, 95%CI: 2.79-9.22) were all related factors affecting Hp infection(P<0.05). Conclusion Positive rate of HP infection in physical examination population in Nantong area is high, and it is related to age, drinking alcohol, spicy food, eating pickled food frequently, family history of gastric cancer, chronic gastritis and other factors. To strengthen the publicity and education of HP infection, establish good eating habits and reduce the risk factors to prevent HP infection in physical examination population in Nantong area.

Adaptación a la realidad de Latinoamérica de la Guía Clínica NASPGHAN/ESPGHAN 2016 sobre Diagnóstico, Prevención y Tratamiento de Infección por Helicobacter pylori en Pediatría / Adaptation to the reality of Latin America of the NASPGHAN/ESPGHAN 2016 Guidelines on the Diagnosis, Prevention and Treatment of Helicobacter pylori Infection in Pediatrics

Resumen: Introducción: Las últimas guías clínicas conjuntas de NASPGHAN y ESPGHAN en relación a la infección por H. pylori publicadas el año 2016, contienen 20 afirmaciones que han sido cuestionadas en la práctica respecto a su aplicabilidad en Latinoamérica (LA); en particular en relación a la preven ción del cáncer gástrico. Métodos: Se realizó un análisis crítico de la literatura, con especial énfasis en datos de LA y se estableció el nivel de evidencia y nivel de recomendación de las afirmaciones mas controversiales de las Guías Conjuntas. Se realizaron 2 rondas de votación de acuerdo a la técnica Delfi de consenso y se utilizó escala de Likert (de 0 a 4) para establecer el "grado de acuerdo" entre un grupo de expertos de SLAGHNP. Resultados: Existen pocos estudios en relación a diagnóstico, efectividad de tratamiento y susceptibilidad a antibióticos de H. pylori en pacientes pediátricos de LA. En base a estos estudios, extrapolaciones de estudios de adultos y la experiencia clínica del panel de expertos participantes, se realizan las siguientes recomendaciones. Recomendamos la toma de biopsias para test rápido de ureasa e histología (y muestras para cultivo o técnicas moleculares, cuando estén disponibles) durante la endoscopia digestiva alta sólo si en caso de confirmar la infección por H. pylori, se indicará tratamiento de erradicación. Recomendamos que centros regionales seleccio nados realicen estudios de sensibilidad/resistencia antimicrobiana para H. pylori y así actúen como centros de referencia para toda LA. En caso de falla de erradicación de H. pylori con tratamiento de primera línea, recomendamos tratamiento empírico con terapia cuádruple con inhibidor de bomba de protones, amoxicilina, metronidazol y bismuto por 14 días. En caso de falla de erradicación con el esquema de segunda línea, se recomienda indicar un tratamiento individualizado considerando la edad del paciente, el esquema indicado previamente y la sensibilidad antibiótica de la cepa, lo que implica realizar una nueva endoscopía con extracción de muestra para cultivo y antibiograma o es tudio molecular de resistencia. En niños sintomáticos referidos a endoscopía que tengan antecedente de familiar de primer o segundo grado con cáncer gástrico, se recomienda considerar la búsqueda de H. pylori mediante técnica directa durante la endoscopia (y erradicarlo cuando es detectado). Con clusiones: La evidencia apoya mayoritariamente los conceptos generales de las Guías NASPGHAN/ ESPGHAN 2016, pero es necesario adaptarlas a la realidad de LA, con énfasis en el desarrollo de centros regionales para el estudio de sensibilidad a antibióticos y mejorar la correcta selección del tratamiento de erradicación. En niños sintomáticos con antecedente familiar de primer o segundo grado de cáncer gástrico, se debe considerar la búsqueda y erradicación de H. pylori.

Abstract: Introduction: The latest joint H. pylori NASPGHAN and ESPGHAN clinical guidelines published in 2016, contain 20 statements that have been questioned in practice regarding their applicability in Latin America (LA); in particular in relation to gastric cancer prevention. Methods: We conduc ted a critical analysis of the literature, with special emphasis on LA data and established the level of evidence and level of recommendation of the most controversial claims in the Joint Guidelines. Two rounds of voting were conducted according to the Delphi consensus technique and a Likert scale (from 0 to 4) was used to establish the "degree of agreement" among a panel of SLAGHNP ex perts. Results: There are few studies regarding diagnosis, treatment effectiveness and susceptibility to antibiotics of H. pylori in pediatric patients of LA. Based on these studies, extrapolations from adult studies, and the clinical experience of the participating expert panel, the following recom mendations are made. We recommend taking biopsies for rapid urease and histology testing (and samples for culture or molecular techniques, when available) during upper endoscopy only if in case of confirmed H. pylori infection, eradication treatment will be indicated. We recommend that selected regional centers conduct antimicrobial sensitivity/resistance studies for H. pylori and thus act as reference centers for all LA. In case of failure to eradicate H. pylori with first-line treatment, we recommend empirical treatment with quadruple therapy with proton pump inhibitor, amoxi cillin, metronidazole, and bismuth for 14 days. In case of eradication failure with the second line scheme, it is recommended to indicate an individualized treatment considering the age of the pa tient, the previously indicated scheme and the antibiotic sensitivity of the strain, which implies performing a new endoscopy with sample extraction for culture and antibiogram or molecular resistance study. In symptomatic children referred to endoscopy who have a history of first or se cond degree family members with gastric cancer, it is recommended to consider the search for H. pylori by direct technique during endoscopy (and eradicate it when detected). Conclusions: The evidence supports most of the general concepts of the NASPGHAN/ESPGHAN 2016 Guidelines, but it is necessary to adapt them to the reality of LA, with emphasis on the development of regional centers for the study of antibiotic sensitivity and to improve the correct selection of the eradication treatment. In symptomatic children with a family history of first or second degree gastric cancer, the search for and eradication of H. pylori should be considered.

Standardizing Diagnosis of Helicobacter pylori Infection to Improve Diagnostic Accuracy / 胃肠病学

Eradication of Helicobacter pylori (Hp) is important for the prevention and treatment of chronic gastritis, peptic ulcer and gastric cancer. The Chinese consensus on the management of Hp infection has taken "confirmed Hp infection" as an indication for eradication. The World Gastroenterology Organisation global guideline states the "test-and-treat strategy" for Hp infection. Accurate diagnosis of Hp infection is a prerequisite for standardized eradication. There are many methods to diagnose Hp infection. Each has its advantages and disadvantages. Different methods are suitable for different diseases and patients, and each method has strict requirements for reagents, equipment, testers and patients. Therefore, increasing the awareness of physicians and testers about the standardized diagnosis of Hp infection is essential to improve the diagnostic accuracy.

Comparison of immunohistochemical stain and 14C urea breath test in the diagnosis of helicobacter pylori associated gastritis / 临床与实验病理学杂志

Purpose To evaluate the value of immunohistochemical stain (IHC) in the diagnosis of helicobacter pylori (HP) -associated gastritis with gastric biopsy tissue. Method239 cases of gastric biopsy were selected. All patients had14 C urea breath test (UBT) at the time of gastric biopsy. IHC for HP was performed with the biopsy tissues. The results were compared with gold standard results. Gold standard was established according to the Chinese Fourth National Consensus report on HP infection with modification. It was considered positive if two or more of the three test results were positive, including IHC, UBT, and HE. Results 239 gastric biopsy specimens fit the criteria. Compared with the gold standard, the sensitivity and specificity value of IHC stains were 97.3％ and 100.0％ respectively, higher than 91.1％, 81.9％ of 14 C UBT, and 80.4％, 92.9％ of HE stain respectively. The14 C UBT showed 9.6％ false positive rate, and 4.2％ false negative rate. Conclusion IHC is a valuable test in the diagnosis of HP-associated gastritis, and it should be recommended for routine histopathologic diagnostic workup if HP gastritis is clinically suspected or chronic active gastritis is identified in the biopsy tissue.

Performance of the 13C-urea breath test for the diagnosis of H. pylori infection using a substrate synthesized in Brazil: A preliminary study

OBJECTIVE: The 13C-urea breath test is the main non-invasive test for the diagnosis of Helicobacter pylori infection. The availability of this test throughout the country is limited, mainly due to the difficulty in obtaining the labeled isotope from abroad. Recently, researchers from the Nuclear Energy Center in Agriculture at the University of São Paulo (CENA/USP) succeeded in synthesizing 13C-enriched urea for Helicobacter pylori diagnosis. The aim of the study was to compare the performance of the 13C-urea breath test using 13C-urea acquired abroad with that of a test using 13C-urea synthesized in Brazil. METHOD: Sixty-four dyspeptic patients participated in the study (24 men and 40 women). Initially, the patients performed the 13C-urea breath test using the imported substrate (Euriso-Top, France). Seven to fourteen days later, all the patients repeated the test using the Brazilian substrate. The samples from both examinations were processed in an infrared isotope analyzer (IRIS, Wagner Analisen Technik, Germany), and all delta over baseline (DOB) [%] values above four were considered positive results. RESULTS: Twenty-seven patients (42%) exhibited negative results for Helicobacter pylori infection, and thirty-seven patients (58%) exhibited positive results when tested using the foreign substrate (gold standard). There was a 100% concordance regarding the presence or absence of infection when the gold standard results were compared with those obtained using the Brazilian substrate. CONCLUSIONS: Similar performance in the diagnosis of Helicobacter pylori infection was demonstrated when using the 13C-urea breath test with the Brazilian 13C-urea substrate and the test with the substrate produced abroad. This validation represents an important step toward increasing the availability of the 13C-urea breath test throughout the country, which will have a positive influence on the management of Helicobacter pylori infection.

Evaluation of the potential inhibitory activity of a combination of L. acidophilus, L. rhamnosus and L. sporogenes on Helicobacter pylori: A randomized double-blind placebo-controlled clinical trial / 中国结合医学杂志

<p><b>OBJECTIVES</b>To investigate whether three strains of probiotics, L. acidophilus, L. rhamnosus, and L. sporogenes, had signifificant inhibitive effects on Helicobacter pylori (H. pylori).</p><p><b>METHODS</b>This is a 4-week, randomly assigned, parallel-group, doubled-blind, and placebo-controlled study. Fifty patients with a positive H. pylori infection urea breath test (△UBT) result > 10% and without ulcer symptoms were randomized into a treatment group and a placebo group by a computer generated allocation sheet with 1:1. These subjects took one capsule of probiotics or placebo twice daily. The primary measurement was the change in △UBT values.</p><p><b>RESULTS</b>The △UBT values during the 4-week treatment period and the 2-week follow-up period were not signifificantly different between the treatment group and the placebo group, indicating that the inhibitive effects on H. pylori were comparable between both groups. The monocyte count (%) was 5.77±1.11 in the treatment group versus 5.09±1.12 in the placebo group (P=0.044), and the basophile count was 0.55±0.32 in the treatment group versus 0.36±0.23 in the placebo group (P=0.024) at week 2 of the treatment period, both of which reached statistical signifificance. The monocyte count was 5.75±1.26 in the treatment group and 4.72±0.99 in the placebo group at the end of the follow-up period (P=0.003).</p><p><b>CONCLUSION</b>There was no signifificant inhibitive effects of the three probiotic strains (L. acidophilus, L. rhamnosus, and L. sporogenes) on H. pylori. Probiotics can not play the same role as antibiotics in the eradication of H. pylori, the role of probiotics is likely to be important as adjuvant to the triple or quadruple therapy for H. pylori, especially in resistance cases.</p>

Analysis of the current infection status and risk factors of Helicobacter pylori among people taken physical examination in Miyun area of Beijing / 中国综合临床

Objective To analyze the infection status and possible risk factors of Helicobacter pylori among people taken physical examination in Miyun area of Beijing,so as to establish effective intervention measures scientifically.Methods From January 2012 to December 2016,eleven thousand physical examinees in Beijing MIyun Hospital were enrolled in this study,13C-urea breath test was used to detect Helicobacter pylori infection and a face to face questionnaire survey was applied.The data colleted was analyzed based on sex,age, living habits.Results The overall infection rate of Hp was 46.72%(5139/11000),the rate of male infection was higher than that of female(49.74%(2826/5682)vs.43.49%(2313/5318)),and the difference was statistically significant(χ2=43.000,P<0.000).The physical examinees were divided into 4 groups by 20 years for age.The infection rates of Hp in the<20 years old group,20—39 years old group,40-59 years old group,>60 years old group were 36.17%,47.28%,48.04%,43.59%,respectively.The infection rate before the age of 60 was on the rise,and the infection rate was the highest in the 40-59 year group,the lowest in the<20 years old group.There was significant difference among the 4 groups(χ2=23.694,P=0.000).The Hp infection rate in people who smoked,had a large number of family members and preferred a hot diet,a dinner party and no hand washing habits was significantly higher than those without related habits,the differences were statistically significant(P<0.05).Conclusion The infection rate of Hp infection in the MIyun area is lower than that of the national average.The infection distribution is closely related with sex,age and living habits.Health education should be strengthened and the occurrence of food-borne disease should be prevented to reduce the Hp infection rate.

Analysis of Helicobacter pylori infection in patients with oral lichen planus / 口腔疾病防治

Objective @#To explore the correlation between oral mucosal lichen planus and Helicobacter pylori infection by analyzing the infection status of Helicobacter pylori in patients with oral mucosal lichen planus.@*Methods@#14C- urea breath test was done in 69 patients with oral lichen planus and 28 patients with chronic inflammation of oral mucosa. Detection of serum anti Helicobacter pylori antibody was done in 32 patients (23 with oral lichen planus and 9 with chronic inflammation of oral mucosa) at the same time. @*Results @#The positive rate of 14C-urea breath test was 68.12% in patients with oral lichen planus and 46.43% in chronic inflammation of oral mucosa. There was significant difference between the 2 groups (χ2=3.970, P=0.046). The positive rate of anti Helicobacter pylori antibody was 52.17% in patients with oral lichen planus and 22.22% in chronic inflammation of oral mucosa, and there was no significant difference between the 2 groups (χ2=2.358, P=0.125). @*Conclusion @#The prevalence of Helicobacter pylori infection in patients with oral lichen planus is higher, and there is a relevance between oral lichen planus and Helicobacter pylori infection.

Analysis of the current infection status and risk factors of Helicobacter pylori among people taken physical examination in Miyun area of Beijing / 中国综合临床

Objective To analyze the infection status and possible risk factors of Helicobacter pylori among people taken physical examination in Miyun area of Beijing,so as to establish effective intervention measures scientifically.Methods From January 2012 to December 2016,eleven thousand physical examinees in Beijing MIyun Hospital were enrolled in this study,13C-urea breath test was used to detect Helicobacter pylori infection and a face to face questionnaire survey was applied.The data colleted was analyzed based on sex,age, living habits.Results The overall infection rate of Hp was 46.72%(5139/11000),the rate of male infection was higher than that of female(49.74%(2826/5682)vs.43.49%(2313/5318)),and the difference was statistically significant(χ2=43.000,P<0.000).The physical examinees were divided into 4 groups by 20 years for age.The infection rates of Hp in the<20 years old group,20—39 years old group,40-59 years old group,>60 years old group were 36.17%,47.28%,48.04%,43.59%,respectively.The infection rate before the age of 60 was on the rise,and the infection rate was the highest in the 40-59 year group,the lowest in the<20 years old group.There was significant difference among the 4 groups(χ2=23.694,P=0.000).The Hp infection rate in people who smoked,had a large number of family members and preferred a hot diet,a dinner party and no hand washing habits was significantly higher than those without related habits,the differences were statistically significant(P<0.05).Conclusion The infection rate of Hp infection in the MIyun area is lower than that of the national average.The infection distribution is closely related with sex,age and living habits.Health education should be strengthened and the occurrence of food-borne disease should be prevented to reduce the Hp infection rate.

Updates on the Diagnosis of Helicobacter pylori Infection in Children: What Are the Differences between Adults and Children? / 대한소아소화기영양학회지

Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the ¹³C-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection.

Comparison between rapid urease test and carbon 14 urea breath test in the diagnosis of Helicobacter pylori infection.

Background: The most common human infection of upper gastrointestinal region is Helicobacter pylori. Most individuals remain asymptomatic due to misuse of antibiotic and proton pump inhibitors. Methods: 50 patients admitted or on outpatient department basis were selected based on the upper gastrointestinal symptoms and whether they were 18 years and above. Results: The Rapid Urease Test (RUT) had 84% sensitivity and 91% specificity, with an overall accuracy of 88%. The results of the Urea breath Test (UBT) showed 88% sensitivity and 83% specificity, and an overall accuracy of 85%. Conclusions: The invasive procedure OGD scopy need not be done in patients for the sole purpose of diagnosing HP infection as the diagnostic efficacies of RUT & UBT tests are similar.

Sociodemographic profile of Helicobacter pylori positive functional dyspepsia patients in central India.

Background: Dyspepsia is one of the common complaints in all sectors of the Indian population. It is diagnosed in the presence of symptoms thought to originate from gastroduodenal region and if there is no organic cause to explain dyspeptic symptoms on upper gastrointestinal endoscopy, the patient is labeled as functional dyspepsia (FD). Helicobacter pylori, a Gram-negative bacilli harboring in the acidic gastric environment has been said to be the causative agent, but this association has not been proved in Indian population. Hence, this study was conducted to find out the prevalence of H. pylori in FD. Methods: After the approval from Institutional Ethics Committee, patients presenting with symptoms of dyspepsia of both sex, within age group of 18-60 years and any dietary habit were enrolled in the study. After a detailed history and complete general and systemic examination, patients were subjected to gastroduodenoscopy. On endoscopy, if no lesion was observed, then the patient was labeled as FD. The severity of dyspepsia symptoms was assessed by seven-point global overall symptom (GOS) scale. Patients were then screened for H. pylori infection by both invasive (rapid urease, Gram staining, and culture) and non-invasive tests (C-14 urea breath test). Results: The prevalence of H. pylori in FD was found to be 63.38%. Among 90 H. pylori positive FD patients, 56% were male, 58.89% were below the age of 40 years, and 53.33% belonged to middle income group. The average GOS score for dyspepsia symptoms was 6.01±0.64. Epigastric pain and mild gastritis were the most common presenting symptom and endoscopic finding, respectively. Conclusion: Our results suggest that H. pylori is an important causative factor for dyspeptic symptoms in patients of FD. Hence, all the FD patients must be investigated for H. pylori and treated promptly.

Effectiveness of Triple Therapy Regimens in the Eradication of Helicobacter Pylori in Patients with Uninvestigated Dyspepsia in Ekiti State, Nigeria.

Aim and Objective: The term dyspepsia has been used inconsistently by healthcare professionals to describe different patterns of upper gastrointestinal symptoms. It denotes a symptom and does not itself represent a disease. In this study, we seek to determine the effectiveness of common triple therapy regimens in use in the eradication of H. pylori in this environment and to compare it what is obtained worldwide. Materials and Methods: One hundred and four Consecutive adult patients, aged 18 to 50 years presenting newly with uninvestigated dyspepsia and without alarm symptoms at General Outpatient Clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti and the Federal Medical Centre, Ido-Ekiti, Nigeria were randomized into five treatment groups in the study. Approval was obtained from Ethical Committees of the two study centres. Treatment outcome was computed using frequency table. Results: The mean age of the studied population was 37.8±12.98 years. 32.7% were males while 67.3% were females. Most prevalent symptom for uninvestigated dyspepsia was abdominal discomfort 100 (96.2%), this was followed by early satiety, abdominal fullness and vomiting with 32 (30.8%), 26 (25%) and 13 (12.5%) of the participants respectively. 76.0% were positive for H. pylori infection by Urea Breath Test Heliprobe® System with highest prevalence of H. Pylori infection within age group 31-45 years (36.7%). Rabeprazole-Clarithromycin-Metronidazole group (RCM) had the highest eradication rate per protocol [77.8%], followed in descending order by Rabeprazole-Amoxil- Levofloxacin group (RAL) [53.3%], Omeprazole-Tinidazole-Clarithromycin “ulcer kit” (OTC) [44.4%], Rabeprazole-Amoxil- Metronidazole group (RAM) [44.4%] and Rabeprazole-Amoxil-Clarithromycin (RAC) [30.0%]. Conclusion: This study showed there is difference in eradication rates of popularly known triple therapy regimens. This may be due to geographical differences in antibiotics resistant pattern to H. pylori. Further study is suggested to find out the national sensitivity pattern to the commonly used triple therapy regimens in Nigeria.

Investigation on Causes of False-negative 14 C-Urea Breath Test / 胃肠病学

Background:14 C-urea breath test(14 C-UBT)is widely used for diagnosis of Helicobacter pylori(Hp)infection owing to its noninvasiveness and high sensitivity and specificity. Nevertheless,the presence of false-negative result can influence the diagnostic accuracy. Aims:To investigate the possible causes of false-negative 14 C-UBT for improving the accuracy of diagnosis. Methods:Eight-two cases with confirmed false-negative 14 C-UBT and 813 controls with true-positive 14 C-UBT at the People’s Hospital of Xinjiang Uygur Autonomous Region from Jan. 2014 to Aug. 2014 were enrolled. Patients in both groups were diagnosed as positive for Hp infection by Warthin-Starry silver staining combined with Hp stool antigen test. Univariate and multivariate analysis were performed to screen the factors related with false-negative 14 C-UBT. Results:In univariate analysis,5 variables were significantly different between case group and control group(P ﹤ 0. 05),and were taken into the multivariate analysis. Logistic stepwise regression analysis revealed that bile reflux( OR = 3. 961,P ﹤0. 001),post subtotal gastrectomy(OR = 9. 734,P ﹤ 0. 001),type Ⅱ Hp infection(OR = 1. 892,P = 0. 012)and upper gastrointestinal bleeding( OR = 4. 979,P ﹤ 0. 001 ) were the independent risk factors for false-negative 14 C-UBT. Conclusions:Bile reflux,upper gastrointestinal bleeding,post subtotal gastrectomy and type Ⅱ Hp infection might be the influential factors for false-negative 14 C-UBT. Combined tests for Hp infection should be suggested in patients with negative 14 C-UBT who had undergone subtotal gastrectomy or complicated with bile reflux or upper gastrointestinal bleeding.

The role of 14C-labelled urea breath test in the diagnosis of Helicobacter pylori infection

Helicobacter pylori infection is the most common infection causing gastritis, peptic ulcer disease, non-ulcer dyspepsia and gastric carcinoma. Diagnostic methods used to determine infection include blood antibody test, stool antigen test, urea breath test and endoscopy. Endoscopy with biopsy is the most reliable procedure, but is associated with several major adverse events including perforation, bleeding and infection.OBJECTIVE: This study aimed to determine the value of 14C-labelled urea breath test in the diagnosis of H. pylori infection, and to determine its sensitivity, specificity, positive and negative predictive values, and accuracy.METHODS: From January to December 2007, 34 subjects were recruited from a tertiary hospital in Metro Manila. All of them underwent both urea breath test and endoscopy. Statistical analysis was performed using endoscopy as the gold standard.RESULTS:The sensitivity and specificity of urea breath test were 90% and 91 %, respectively. Endoscopy with biopsy, histopathologic analysis and rapid urease test is still the gold standard, but it should not be the first procedure to be requested because of the complications associated with this invasive procedure.CONCLUSION: 14C-labelled urea breath test is the safest, fastest, the most non-invasive and therefore the best screening test in the diagnosis of Helicobacter pylori infection.

Anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract in mice and humans / 한국실험동물학회지

Helicobacter pylori-eliminating effects of FEMY-R7, composed of fucoidan and evening primrose extract, were investigated in mice and humans. Male C57BL/6 mice were infected with the bacteria by intragastric inoculation (1x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10 or 100 mg/kg FEMY-R7 for 2 weeks. In Campylobcter-like organism-detection test, FEMY-R7 markedly reduced the urease-positive reactivity. In a clinical sudy, human subjects, confirmed to be infected with Helicobacter pylori, were orally administered twice a day with a capsule containing 150 mg FEMY-R7 for 8 weeks. FEMY-R7 significantly decreased both the Delta over baseline-value in urea breath test and the serum pepsinogens I and II levels. The results indicate that FEMY-R7 not only eliminates H. pylori from gastric mucosa of animals and humans, but also improves gastric function.

Relationship of Helicobacter pylori infection and carotid plaques in patients with coronary heart disease / 中国医师进修杂志

Objective To explore the relationship of Helicobacter pylori (Hp) infection and carotid plaques in patients with coronary heart disease and analyze the related factors of carotid plaques.Methods This study enrolled 209 patients.13C-urea breath test (13C-UBT) was used to assess Hp infection.Based on the results of 13C-UBT,patients were divided into infection-positive group (101 patients) and infection-negative group (108 patients).The incidence of carotid plaques was detected by color Doppler,and plasma homocysteine (Hcy),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),fibrinogen (Fbg),high sensitivity C reactive protein (hs-CRP) were measured and compared.Results The incidence of carotid plaques in infection-positive group(69.31％,70/101) was higher than that in infection-negative group (55.56％,60/108),and there was significant difference (P =0.040).There was significant difference in hs-CRP between infection-positive group and infection-negative group [(3.91 ± 1.91) mg/L vs.(2.65 ± 1.15)mg/L] (P =0.041).There were no significant difference in Hcy,TC,LDL-C,Fbg between infection-positive group and infection-negative group (P ＞ 0.05).Logistic regression analysis showed that Hp infection was correlated with carotid plaques in patients with coronary heart disease.The severity of Hp infection had no significant effect on the incidence of carotid plaques.Conclusions Hp infection-positive patients with coronary heart disease may have a higher incidence of carotid plaque,regardless of Hcy,LDL-C,Fbg and TC level.This study shows that Hp is correlated with carotid plaque.The severity of Hp infection has no significant effect on the incidence of carotid plaque.

Clinical value of three kinds of helicobacter pylori detection methods / 重庆医学

Objective To discuss the clinical value of three kinds of helicobacter pylori (HP) detection methods and find out the appropriate method for clinical application of the HP detection .Methods A total of 109 patients received gastroscopy ,the efficacy of RUT ,13C-urea breath test(13C-UBT) and the immunoCard STAT helicobacter pylori stool antigen (HpSA) for detection of HP were compared .Results RUT positive rate of the two pieces of gastric mucosa (the gastric antrum and the gastric body) was 34 .86% ,higher than that of single piece of gastric mucosa (gastric antrum or stomach body ) and two pieces of gastric mucosa (stomach) ,the difference was statistically significant (P0 .05) .The diagnosis of HP infection was based on 13C-UBT ,the immunoCard STAT HpSA sensi-tivity ,specificity and accuracy were 86 .49% ,95 .83% ,92 .66% ,respectively ,which were higher than RUT .Conclusion Two pieces of gastric mucosa (the gastric antrum and the gastric body) materials is appropriate for clinical promotion RUT based solution . RUT ,13C-UBT and hpsas immune quick check card are all clinical detection of HP and reliable methods ,but hpsas immune quick check card is more suitable for clinical promotion .