Manejo de la infección por Helicobacter pylori: apreciación crítica de la literatura / Treatment of the Helicobacter pylori Infection: A Critical Appraisal of the Literature

Introducción: la infección por Helicobacter pylori es un problema de salud pública, dada su relación con cáncer gástrico. El incremento de la resistencia bacteriana limita la erradicación efectiva, a pesar del empleo de diferentes esquemas de tratamiento. Métodos: revisión de la literatura en la base de datos Pubmed/Medline entre el 1 de enero de 2015 y el 31 de diciembre de 2016 sobre el manejo del Helicobacter pylori. Resultados: se incluyeron 26 artículos. La terapia secuencial sobresale como opción de tratamiento de primera línea para escenarios como Colombia. La implementación de coadyuvantes puede influir en las tasas de erradicación. Los estudios de epidemiología local y costo-efectividad son escasos. Conclusiones: el uso y conocimiento adecuado de los esquemas de manejo puede disminuir los costos para el sistema, la resistencia antimicrobiana y favorecer la erradicación de patógenos. Se requieren estudios para generar recomendaciones locales.

Introduction: Helicobacter pylori (H. pylori) infection is a public health problem due to its relationship with gastric cáncer The escalation of antibiotic resistance hampers an effective eradication, despite the availability of treatment options. Methods: A review of the literature was performed in the database PubMed between 01/01/2015 and 31/31/2016. Results: Twenty six articles were included. Sequential therapy stands out as a first line therapy for scenarios such as Colombia. The implementation of adjuvants may have a positive impact on eradication rates. Local epidemiólogo- and cost-effectiveness studies are scarce. The results were analized by erradication therapies, coadyuvant treatment, guidelines and outcomes non mentioned in the guidelines. Conclusions: The correct use and knowledge of the different treatment options could reduce the costs for the health systems, the antibiotics resistance and could favor pathogen eradication. Further studies are required for establishing local recommendations.

Helicobacter pylori with East Asian-type cagPAI genes is more virulent than strains with Western-type in some cagPAI genes

Abstract The severity of Helicobacter pylori-related disease is correlated with the presence and integrity of a cag pathogenicity island (cagPAI). cagPAI genotype may have a modifying effect on the pathogenic potential of the infecting strain. After analyzing the sequences of cagPAI genes, some strains with the East Asian-type cagPAI genes were selected for further analysis to examine the association between the diversity of the cagPAI genes and the virulence of H. pylori. The results showed that gastric mucosal inflammatory cell infiltration was significantly higher in patients with East Asian-type cagPAI genes H. pylori strain compared with mosaicism cagPAI genes H. pylori strain (p < 0.05). H. pylori strains with the East Asian-type cagPAI genes were closely associated with IL-8 secretion in vitro and in vivo compared with H. pylori strains with the mosaicism cagPAI genes (p < 0.01). H. pylori strains with East Asian-type cagPAI genes are able to strongly translocate CagA to host cells. These results suggest that H. pylori strains with East Asian-type cagPAI genes are more virulent than the strains of cagPAI gene/genes that are Western type.

Prevalence of Helicobacter pylori in children in eastern Turkey and molecular typing of isolates

The objectives of the present study were to determine Helicobacter pylori via culture, polymerase chain reaction and histopathological diagnosis in 101 children ranging in age from 4 to 18 years, to identify the association among restriction fragment length polymorphism types and clinical disease and to investigate the relationships among different isolates of H. pylori in different age groups. We observed a high prevalence of H. pylori infections in children between the ages of 13 and 18 (75.8%), while children aged 4 to 6 years had the lowest prevalence of infection (40%). H. pylori was detected in 30.7% (31 of 101), 66.3% (67 of 101) and 63.2% (60 of 95) of children as determined by culture methods, PCR and histological examination, respectively. H. pylori isolates with RFLP types I and III were the most common among children with antral nodularity, whereas RFLP types II and IV were the least detected types. Interestingly, all isolates from peptic ulcer patients were type III. Although our results show a high prevalence of H. pylori infections in the pediatric population in eastern Turkey, no association was identified between H. pylori infection with antral nodularity and recurring abdominal pain. In addition, we found low genetic variation among H. pylori isolates from children and no association between RFLP types and antral nodularity (p > 0.05). Additionally, we found that H. pylori isolates with specific RFLP types were predominant in different age groups.

Determinación de mutaciones de un solo nucleótido en el gen 23S rRNA de Helicobacter pylori relacionadas con resistencia a claritromicina en una población del departamento del Cauca, Colombia / Determination of single nucleotide mutations in the 23S rRNA gene of Helicobacter pylori related to clarithromycin resistance in a population from Cauca, Colombia

Introducción. La terapia antibiótica combinada para la erradicación de Helicobacter pylori debería basarse en los patrones locales de resistencia. Objetivo. Determinar la resistencia de H. pylori a claritromicina en una población del departamento del Cauca mediante la identificación de mutaciones en el gen 23S r RNA en ADN obtenido de biopsias gástricas. Materiales y métodos. Se incluyeron en el estudio 162 pacientes con dispepsia funcional. El gen 23S rRNA se amplificó por PCR y el patrón de mutaciones se identificó por secuenciación directa. Resultados. La frecuencia de resistencia a claritromicina fue de 4 %. La mutación A2143G del gen se encontró en cuatro pacientes (2,46 %) y la mutación A2142G, en tres pacientes (1,85 %). Conclusiones. El estudio encontró que el genotipo más frecuente en los especímenes positivos para H. pylori fue 2143G, seguido por A2142G. La prevalencia observada de resistencia de H. pylori fue baja; por lo tanto, se considera que el tratamiento con claritromicina es una opción válida para la erradicación de H. pylori en la población objeto de estudio.

Introduction: Antibiotic combination therapy for the eradication of Helicobacter pylori should be based on local resistance patterns. Objective: To d etermine the resistance of H. pylori to clarithromycin in a population from Cauca province, through the identification of mutations in the 23S rRNA gene in DNA from gastric biopsies. Materials and methods: A total of 162 patients with functional dyspepsia were included in the study. The 23S rRNA gene and the DNA from 162 gastric specimens were amplified by PCR, and the mutation pattern was identified by direct sequencing. Results: The frequency of clarithromycin resistance was 4%. A2143G mutation was found in four patients (2.46%) and A2142G mutation was found in three patients (1.85%). Conclusions: Our study shows that the most frequent genotype in H. pylori -positive specimens was A2143G, followed by A2142G. The observed resistance prevalence of H. pylori was low; thus, we consider that clarithromycin treatment is a valid option for H. pylori eradication in the study population.

Estado actual de la resistencia de Helicobacter pylori a tetraciclina:revisión sistemática de la literatura / Current status of Helicobacter pylori resistance to tetracycline: a systematic review of the literature / Estado atual da resistência do Helicobacter pylori à tetraciclina: uma revisão sistemática da literatura

Determinar la prevalencia de resistencia de Helicobacter pylori a tetraciclina y las posibles mutaciones que generan estaresistencia mundialmente. Materiales y método. Se realizó una búsqueda sistemática de literatura en las bases de datos: Medline,Science Direct (Elsevier), Ovid, Pubmed, Lilacs y MEDICLATINA, con el uso de palabras clave relevantes. La extracción de losdatos fue independiente y se realizaron listas de verificación para evaluar la calidad metodológica de los estudios. El análisis de lainformación fue realizado en el programa RevMan 5®. Resultados. Se evidenció resistencia a tetraciclina por Helicobacter pyloricon prevalencias de 1% para Norte América, 8% para Centro y Sur América; 5% para Asia y 2% para Europa . La alta resistencia sedebe a la triple mutación AGA(926-928)-->TTC, en el gen 16S rDNA. Conclusiones. La resistencia antibiótica es una de las causasque más se asocia a falla terapéutica en la erradicación de Helicobacter pylori, así como la poca adherencia al tratamiento y el usoindiscriminado de antibióticos. Se evidenció que la tasa de resistencia a tetraciclina aumenta después de un primer tratamiento con esteantibiótico, sin embargo la prevalencia de la resistencia global a tetraciclina es baja sin aún alcanzar límites que impidan su utilizaciónen los esquemas de tratamiento...

To determinethe prevalence of Helicobacter pylori resistance to and the possible mutations that generate this worldwide resistance. Materials andmethods. A systematic search for literature was performed in the databases Medline, Science Direct (Elsevier), Ovid, PubMed, Lilacsand MedicLatina using relevant key words. Data extraction was independent and checklists were prepared to assess the methodologicalquality of the studies. Analysis of information was done with RevMan 5®. Results. We found Helicobacter pylori resistance prevalencerates of 1% for North America, 8% for Central and South America, 5% for Asia, and 2% for Europe. The mutation associated to thisresistance is in the 16S rDNA gene at nucleotide position 967TTC to AGA965 responsible of high resistance to tetracycline. Conclusions.Antibiotic resistance is one of the causes most associated to treatment failure in the eradication of Helicobacter pylori, as well as pooradherence to treatment and indiscriminate use of antibiotics. We also evidenced that the rate of tetracycline resistance is higher whenit is used in a second treatment scheme. The distribution of resistance is variable in different areas and it is important to know theseresistances to avoid treatment failures...

Determinara prevalência da resistência do Helicobacter pylori à tetraciclina e possíveis mutações que geram esta resistência a nível mundial.Materiais e métodos. Foi realizada uma procura sistemática da literatura nas bases de dados Medline, Science Direct (Elsevier), Ovid,Pubmed, Lilacs e MEDICLATINA, usando palavras-chave relevantes. A extração dos dados foi independente e realizaram-se listas deverificação para avaliar a qualidade metodológica dos estudos. A análise dos dados foi realizada em REVMAN 5®. Resultados. Foievidenciada a resistência de Helicobacter pylori com taxas de prevalência de 1% para a América do Norte, 8% para América Central eAmérica do Sul; 5% para Ásia e 2% para Europa. A mutação associada a estas resistências no gen 16S rDNA nos nucleótidos da posiçãoAGA965 a 967TTC é responsável da alta resistência à tetraciclina. Conclusões. A resistência aos antibióticos é uma das razões maisassociadas à falha do tratamento na erradicação de Helicobacter pylori, assim como a pouca adesão ao tratamento e uso indiscriminadode antibióticos; também foi evidente que a taxa de resistência à tetraciclina é maior quando utilizado em regime de segundo tratamento;a distribuição da resistência varia em diferentes áreas e é importante saber estas resistências a fim de evitar falhas terapêuticas...

Polimorfismos genéticos de interleucinas IL-1B-511, IL-1RN, IL-10, factor de necrosis tumoral alfa-308 e infección por Helicobacter pylori CagA positivo en cáncer gástrico y úlcera duodenal en diferentes poblaciones en Colombia / Genetic polymorphisms of IL-1B-511, IL-1RN, IL-10 interleukins, tumor necrosis alfa-308 and Positive Helicobacter pylori CagA infection in gastric cancer and duodenal ulcer in different populations in Colombia

Objetivo: Determinar la asociación entre los polimorfismos IL-1B-511, IL-1RN, TNF-α-308, IL-10-819 e IL-101082 y la infección por Helicobacter pylori CagA positivo en un grupo de pacientes con cáncer gástrico y úlcera duodenal en diferentes poblaciones en Colombia. Métodos: Estudio de casos y controles con 341 pacientes: con gastritis no atrófica, 194; con cáncer gástrico, 58; úlcera duodenal con lesiones preneoplásicas, 54; y con úlcera duodenal, 35. La genotipificación de los polimorfismos se hizo por discriminación alélica usando PCR en tiempo real, y la del IL-1RN, por PCR convencional y electroforesis en agarosa. La infección por Helicobacter pylori CagA se determinó mediante ELISA. Se utilizó la regresión logística en el análisis estadístico. Resultados: Ser portador del genotipo IL-1B-511TT (OR=4,69; IC 95% 1,22-18,09) y tener una infección por Helicobacter pylori CagA positivo (OR=4,43; IC 95% 1,72-11,4) se asociaron a cáncer gástrico. Tener una infección por Helicobacter pylori CagA positivo (OR=4,39; IC95% 1,82-10,59) se asoció a la presencia de úlcera duodenal con lesiones preneoplásicas, y ser portador del genotipo IL-1B-511CT se asoció a úlcera duodenal (OR=0,30; IC 95% 0,10-0,91). Conclusión: Los resultados sugieren que la respuesta pro-inflamatoria y la genética virulenta de la bacteria son factores relacionados con los diferentes desenlaces ocasionados por la infección por Helicobacter pylori en la población estudiada; así, el polimorfismo IL-1B-511 es un factor relacionado con cáncer gástrico y úlcera duodenal, y la infección por Helicobacter pylori CagA positivo es un factor asociado a cáncer gástrico y úlcera duodenal con lesiones preneoplásicas.

Objective: To determine the association between the IL-1B-511, IL-1RN, TNF-α-308, IL-10-819 and IL-101082 polymorphisms and positive Heliocobacter pylori CagA infection in a group of patients with gastric cancer and duodenal ulcer in different populations in Colombia. Methods: A case-control study was performed on 341 patients: those with non-atrophic gastritis, 194; with gastric cancer, 58; duodenal ulcer with preneoplastic lesion, 54; and with duodenal ulcer, 35. The genotyping of polymorphisms was done with allelic discrimination using PCR in real time, and that for IL-1RN with conventional PCR and agarose electrophoresis. Helicobacter pylori CagA infection was ascertained with ELISA. Logistic regression was used in statistical analysis. Results: Being a carrier of genotype IL-1B-511TT (OR=4.69; CI 95% 1.22-18.09) and being positive for Helicobacter pylori CagA infection (OR=4.43; CI 95% 1.72-11.4) are associated with gastric cancer. Positive Helicobacter pylori CagA infection (OR=4.39; CI 95% 1.82-10.59) is associated with the presence of duodenal ulcer with preneoplastic lesions, being a carrier of genotype IL-1B-511CT is associated with duodenal ulcer (OR=0.30; CI 95% 0.10-0.91). Conclusion: The results suggest that pro-inflammatory response and virulent bacterial genetics are factors related to the different outcomes brought about by Helicobacter pylori infection in the population studied; that is, the IL-1B-511 polymorphism is a factor related to gastric cancer and duodenal ulcer, and positive Helicobacter pylori CagA infection is a factor associated with gastric cancer and duodenal ulcer with preneoplastic lesions.

Nucleótidos y carotenoides naturales / Nucleotides and carotenoids

El concepto de los nucleótidos no es nuevo; máxime que son elementos que hacen parte de los componentes naturales de la leche materna. Casi todos los estudios señalan que el consumo de carotenoides, previenen el desarrollo de enfermedades crónicas en la edad adulta, posiblemente por su efecto antioxidante que disminuye el estrés oxidativo, mejorando enfermedades degenerativas y malignas.

The concept of nucleotides is not new, especially since they are elements that are part of the natural components of human milk. Most studies indicate that the consumption of carotenoids, prevent the development of chronic diseases in adulthood, possibly by its antioxidant effect that reduces oxidative stress, improving degenerative diseases and malignancies.

Características clínicas y epidemiológicas del cáncer gástrico en cuatros hospitales de Managua, en el período 2000- 2006 / Clinical and epidemiological characteristics of gastric cancer in four hospitals in Managua, during the period 2000 - 2006

Objetivo: se realizó un estudio con el objetivo de analizar las características clínicas y epidemiológicas del cáncer gástrico en cuatro hospitales de Managua. Material y método: es un estudio de tipo descriptivo, retrospectivo,observacional, en pacientes con diagnóstico de Cáncer gástrico en cuatro hospitales de Managua, periodo 2000- 2006; se revisaron en el Hospital Roberto Calderón Gutiérrez una población de 61 pacientes con Cáncer Gástrico, en el Hospital Antonio Lenin FOnseca 90 pacientes, Hospital Alemán Nicaragüense20 pacientes y Hospital Militar Alejandro Dávila Bolaños 19 pacientes, para un total de 190 pacientes. Resultados: el promedio de edad de los pacientes fue de 71 años, del sexo masculino en un 62.1 por ciento, procedían de zonas urbanas en un 74.7 por ciento, el 70.5 por ciento fue nivel acádemico primaria con ocupación ama de casa. Los principales signos y síntomas de presentación fueron; pédida de peso, náuseas y/o vómitos, dolor abdominal con un período de presentación de los síntomas menor de seís meses...

Helicobacter pylori cagA, vacA and iceA genotypes in western Indian population of Maharashtra with varied gastroduodenal diseases.

Scarce reports relying on rapid urease test, serology and histopathology are currently known for H. pylori from Western India, Maharashtra. We investigated H. pylori genotypes at molecular level in gastro-duodenal disease population during the years 2002-2005. H. pylori presence was scored by polymerase chain reaction in the infected biopsies (n = 95) in various gastric diseases. H. pylori specific 16S rDNA gene amplification based preliminary identification coupled with protein coding gene amplification scores were assessed for the incidence. H. pylori 16S rDNA and 7 housekeeping genes were detected in all biopsies, whereas 71.18% and 28% found to be cagA positive and negative respectively. The vacA toxigenic alleles (vacA s1) and middle region subunit vac m1a were found in 54%, and 59% patients. However, the iceA1 was present in 40.06%; the iceA2 was less i.e. in 13.5% patients. The most common allelic combinations in different age groups irrespective of disease types were 13-30, 31-45, 46-60 and 61-73 were cagA-vac m1a-vacA s1-iceA1. In our analysis, PCR was found to be 100% accurate in detecting H. pylori in gastric biopsies. Among West Indian population H. pylori was found to be present, irrespective of any correlation with the genotype and gender of patients with the clinical outcome. However, the genotype incidences were related to age of the patients, wherein the age group ranging from 46 to 60 years was found be susceptible for H. pylori infection.

Infección por Helicobacter pylori en niños / Helicobacter pylori infection in children

La población infantil está expuesta a múltiples gérmenes bacterianos, uno de éstos es el Helicobacter pylori. Esta bacteria gram negativa microaerofílicaes responsable de la presencia de gastritis primaria, duodenitis, úlceras gástricas y sangrado digestivo alto en niños.

Utilización de la reacción en cadena de la polimerasa para le detección y genotificación de Helicobacter pylori gástricas incluidas en parafina: un estudio retrospectivo / Utilization of polymerase chain reaction for detection and genotyping of Helicobacter pylori in gastric biopsy using paraffin: a retrospective study

BACKGROUND: Helicobacter pylori infection is presumed to be the major causal agent of chronic active gastritis in humans. The persistent infection with this pathogen would be an important factor in the pathogenesis of peptic ulcer and also gastric cancer. METHODS: We investigated relationship between H. pylori characteristics in 42 patients with normal mucosa or gastritis with minor changes and 40 patients with mild and severe gastritis. Detection and typing of vacA and cagA genes were performed using a polymerase chain reaction method. RESULTS: The analysis of vacA prevalence and the type (S1 or S2) showed non-significant differences between the two groups studied (p > 0.05). However, cagA analysis showed highly significant differences between the groups classified as normal tissue-weak gastritis and mild-severe gastritis (p < 0.0001; OR = 8.4; CI = 3.1-22.8). CONCLUSIONS: cagA status is associated to the grade of gastritis, finding higher frequencies of H. pylori cagA+ in the moderate-severe gastritis group. These highly significant differences could make cagA status a genetic marker for disease progress.

Electron Microscopic Evaluation of Adhesion of Helicobacter pylori to the Gastric Epithelial Cells in Chronic Gastritis

BACKGROUND: The adhesion of H. pylori to the gastric epithelial cells may be an essential step for the pathophysiology of various H. pylori-induced gastrointestinal diseases. The purpose of this study was to investigate the ultrastructural relation of H. pylori and gastric epithelial cells in their adhesion. METHODS: Endoscopic biopsy of gastric antrum and body was performed from 15 patients (9 men, 6 women) with chronic gastritis and H. pylori infection. The specimens were processed for electron microscopy and observed with a transmission electron microscope (Hitachi H-600). RESULTS: On the basis of morphological appearances, the adhesions of H. pylori to the gastric epithelial cells were categorized into three types; filamentous connection, adhesion pedestals and membrane fusion. Coccoid and undetermined forms adhered mainly by the filamentous connection, whereas the bacillary forms adhered primarily by the adhesion pedestals and membrane fusion. CONCLUSION: Various types of adhesion were associated with H. pylori and gastric epithelium. Further studies are needed to evaluate the influence of different types of adhesion to the pathophysiology of H. pylori.

Genotyping cagA, vacA subtype, iceA1, and babA of Helicobacter pylori isolates from Korean patients, and their association with gastroduodenal diseases

The genetic status of cagA, vacA subtype, iceA1, and babA, and the relationship to gastroduodenal diseases were assessed in Helicobacter pylori isolates in Korea. Seventy-six strains of H. pylori were isolated from the antrum and the corpus of 41 adult patients (22 with peptic ulcer and 19 with gastritis). The cagA, iceA1, and babA genes were assessed by polymerase chain reaction and the vacA subtypes were determined by reverse hybridization-line probe assay. The positive rates of 349-bp cagA, 208-bp cagA, iceA1, and babA genes were 97.4%, 96.1%, 84.2%, and 36.1%, respectively. The vacA s1a, s1b, s1c, and s2 variants were detected in 11.8%, 3.9%, 80.4%, and 1.3%, respectively. m1 (78.9%) is more prevalent than m2 (5.3%). The most common vacA genotype was s1c/m1 (61.9%), and 14 isolates (18.4%) contained mixed vacA genotypes from a single biopsy specimen. Twenty-one (60%) of 35 patients were infected with more than two strains of different cagA, iceA1, babA, and vacA genotypes. None of cagA, iceA1, babA, and vacA s1/m1 were associated with peptic ulcer. In conclusion, most H. pylori isolates in Korea carry cagA, iceA1, and vacA s1c/m1 genes, and reside with multiple strains. These genes do not correlate with the peptic ulcer in the Korean patients.

Enzyme biotypes of Helicobacter pylori isolated from Penang, Peninsular Malaysia.

A total of 52 clinical strains of Helicobacter pylori were characterized on the basis of preformed enzyme production with API ZYM kits. Using the biotyping schemes as defined by Reina and Alomar (1989), Kung et al (1989) and Matsumoto et al (1996), 15.3% (8/52), 13.5% (7/52) and 11.5% (6/52) of the isolates were not biotypable, respectively. Two enzymes, valine arylamidase and cystine arylamidase could be additionally used to differentiate between isolates. Our isolates were either negative or positive for both the enzymes or positive only for cystine arylamidase. We propose the incorporation of these two enzymes into the Matsumoto et al (1996) biotyping scheme to biotype strains into additional enzyme biotypes.

Pruebas diagnósticas para Helicobacter pylori

La enfermedad ácido-péptica es altamente prevalente en el mundo y está ligada al Helicobacter pylori (Hp), gérmen que ha sido relacionado en el 80 por ciento con gastritis y en el 100 por ciento con úlcera duodenal, como uno de los factores más determinantes en la patogenia, a tal punto que el comportamiento epidemiológico de la enfermdad, es similar al de la bacteria. La epidemiología también lo liga, a largo plazo, con la malignización de las lesiones inflamatorias del estómago sin que se pueda afirmar que su tratamiento en la niñez, evitará la aparición gástrico en el adulto, lo que en la práctica implicaría un manejo diferente de acuerdo a la edad. El diagnóstico de la enfermedad ácido péptica es endoscópico-histológico y por su estrecha relación, debe investigarse habitualmente la presencia de Hp, teniendo en cuenta su variabilidad epidemiológica y el tipo de lesiones que ocasiona, para establecer su papel en la enfermedad, orientar el manejo y administrar un tratamiento antibiótico racional, fundamentado en la evidencia científica. En nuestro medio poco se ha estudiado la prevalencia de colonización en niños y no existe un estudio clínico que valide los métodos para su diagnóstico. Al respecto, hemos hecho un corte preliminar de un estudio que estamos desarrollando en nuestro Hospital, en el que se ha encontrado una prevalencia de colonización del 53 por ciento y revisamos los diferentes métodos disponibles para el diagnóstico del Hp; los invasivos, que requieren una endoscopia: Prueba rápida de ureasa o CLO-test, cultivo, histología y reacción en cadena de polimerasa (PCR) con una alta sensibilidad y especificidad y los no invasivos: serología con IgG y test de la urea espirada, marcada con carbono (13)C

Crecimiento y evolución del Helicobacter pylori / Growth and evolution of Helicobacter pylori

El género Helicobacter tiene una historia relativamente reciente. Su protagonismo data del año 1982, fecha en la que el Helicobacter Pylori se aisló por primera vez de paciente humanos. Esta bacteria, inicialmente, se incluyó en el género Campylobacter y se la denominó Campylobacter Pylori o Piloridis. Posteriormente en el año 1989, se separo de este género y se creó uno nuevo el género Helycobacter, al que actualmente pertenecen varias especies. Los expertos en microbiología le asignaron este término por su forma de hélice in vivo y sus caracteres de bacteria in vitro, ya que encontraron que la denominación Campylobacter era errónea en vista del contenido de ácidos grasos de su pared y por el análisis del ADN se dieron cuenta que la bacteria no pertenecía a los Campylobacter.

Evaluación de la prueba rapida de ureasa en la infección por helicobacter pylori / Rapid test of ureasa in the helicobacter pylory infection

El propósito de este estudio es comparar una prueba rápida de ureasa (PRUtest) elaborada en el servicio de gastroenterología del Hospital Universitario de Maracaibo, con CLOtest. Usando como Gold Standard para el diagnóstico de infección por H.pylori, histología con Giemsa. Se incluyeron 60 pacientes a quienes se le practicó endoscopia digestiva superior con toma de 4 biopsias a nivel de curvatura mayor de antro, cerca del píloro. Dos biopsias antrales fueron destinadas para estudio histológico con Giemsa y Hematoxilina & Eosina, una para CLOtest y una para PRUtest. A través de histología se identifico 33 (55 por ciento) especímenes positivos para H.pylori y 27 (45 por ciento) fueron negativas. Con PRUtest se obtuvo una sensibilidad de 93,93 por ciento y especificidad de 92,59 por ciento sin diferencia estadísticamente significativa con el CLOtest. Se concluye que el PRUtest es un método seguro para el diagnóstico de infección por H.pylori