RESUMO
Helicobacter pylori is one of the most common chronic bacterial infections in diabetic patients due to alteration of glucose metabolism, abnormal emptying of the stomach and autonomic neuropathy. So, this study was done to determine H. pylori infection in diabetes, to evaluate the different diagnostic methods of its infection and to estimate the efficacy of he current antimicrobial therapy to eradicate H. pylori. The study involved 40 patients with diabetes mellitus [12 with type 1 and 28 with type 2], and 20 non-diabetic patients as control group. Their sera were used for the assay of H. pylori specific lgG and IgA by enzyme immunoassay [EIA]. Biopsy specimens were tested by rapid urease test [RUT], stained by Gram's stain and cultured to isolate H. pylori. Antimicrobial susceptibility testing was performed using Epsilometer test [E-test]. Results showed that there was a significant increase in the incidence of H. pylori in diabetic patients, 77.5% by RUT, 75% by culture, 70% by lgG, 50% by IgA and 20% by direct smear. There was a significant association between age and smoking and the presence of IgG and IgA. The specificity of the direct smear and IgA was 100%, the sensitivity of RUT was 100%, positive predictive value [PPV] of direct smear and IgA was 100%, negative predictive value [NPV] of RUT was 100%. H. pylori was highly sensitive to tetracycline [93.3%] and amoxicillin [73.3%] and relatively resistant to metronidazol [70%]. We concluded that H. pylon infection is more common among diabetic patients. Culture is the method of choice in diagnosis of H. pylori as it allows testing for antimicrobial therapy. EIA for anti-H. pylori lgG could be of value in screening population and in excluding H. pylori negative infections. Anti-microbial sensitivity must be performed for better eradication of H. pylori in diabetic patients