Infección por Helicobacter pylori: mecanismos de contagio y prevención / Helicopabter pylori: infection and prevention mechanisms

H. pylori infection is a fascinating history, which combines the roles as one of the most prevalent commensal and a a pathogen responsible for severe diseases, some of them unimaginable until the end of last century, such as gastric cancer. In this review we present the available evidence that might help to identify the main mode of transmission of H. pylori and we discuss which could be the potential approaches to prevent the transmission of this bacterium in countries with high and low prevalence.

La infección por Helicobacter pylori es una historia fascinante, en donde se combinan el papel de un comensal con el de un patógeno humano que produce enfermedades graves, algunas inimaginables hasta hace menos de 30 años, como es el caso de cáncer gástrico. En esta revisión discutimos las evidencias disponibles en función de la prevalencia e incidencia de H. pylori tanto en países económicamente desarrollados como en proceso de desarrollo y tratamos de establecer cuál es el principal modo de transmisión de este organismo. Finalmente, se discuten cuáles pueden ser las mejores medidas de prevención, tanto en países con baja prevalencia como en aquellos con una alta prevalencia.

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 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.

Infección por Helicobacter pylori en pacientes atendidos en consulta de gastroenterología / Helicobacter pylori infection in patients who attended the gastroenterology office

Introducción: la infección por Helicobacter pylori constituye la infección crónica más extensamente difundida en la especie humana. Objetivo: determinar las características clínico epidemiológicas de infección por Helicobacter pylori en pacientes atendidos en consulta de Gastroenterología. Material y Método: se realizó unestudio observacional descriptivo conformado por un universo de 240 pacientes con determinaci ón de Helicobacter pylori por coloración de fucsina básica de Ziehl Neelsen y la muestra la integraron 204 pacientes positivos a dicho examen. Las variables a considerar fueron: la edad, el sexo, diagnóstico histológico, síntomas clínicos y la evolución clínica posterior al tratamiento específico para Helicobacter pylori. Se utilizó la técnica estadística de análisis de distribución de frecuencias. Resultados: la infección por Helicobacter pylori en el 85 % de los casos estudiados con predominio del sexo masculino, siendo la gastritis crónica con 63,7% la alteración gástrica que más se asoció a la infección, la epigastralgia fue el síntoma más frecuente y el 44,6 % de los casos evolucionaron de forma no satisfactoria. Conclusiones: Se obtuvo un alto por ciento de infección por Helicobacter pylori.

Introduction: helicobacter pylori infection constitutes the chronic infection most widely spread amongst the human race. Objective: to determine the clinical-epidemiological characteristics of Helicobacter pylori infection in patients who attended the Gastroenterology office. Method: a descriptive observational study was performed with a universe of 240 patients with Helicobacter pylori determined by Ziehl Neelsen basic fuchsine staining, while the sample was confirmed by 204 patients tested positive to that test. The considered variables were age, sex, histological diagnosis, clinical symptoms, and clinical history following the specific treatment of Helicobacter pylori. Frequencies distribution was used as a statistical analysis technique. Results: Helicobacter pylori infection, in the 85 % of the studies cases, with a predominance of the male sex, being chronic gastritis with 63,7% the gastric disorder more associated with the infection, while epigastric pain was the most frequent symptom and 44,6 % of the cases had a unsatisfactory evolution. Conclusions: a high percentage of Helicobacter pylori infection was obtained.

The effect of triple therapy to the levels of serum IL-10,TGF-β1 and IL-17 in eldly patients with helicobater pylori associated gastritis / 重庆医学

Objective To observe the effect of triple therapy to the levels of serum interleukin 10(IL)-10 ,transforming growth factor beta 1(TGF-β1) and IL-17 in eldly patients with helicobater pylori associated gastritis .Methods 90 eldly patients with heli-cobater pylori associated gastritis were randomly divided into observation group and control group ,45 cases in each group ,the ob-servation group was given standard triple therapy ,the control group was separately given omeprazole treatment ,after 14 days , ELISA method was used to detect the levels of serum IL-10、TGF-β1 and IL-17 .Results Compared with before treatment ,the lev-els of IL-10、TGF-β1 and IL-17 in of the two groups had significantly reduced after treatment (P<0 .05);compared with the control group after treatment ,the levels of IL-10、TGF-β1 and IL-17 in observation group after treatment had significantly reduced (P<0 .05) .Compared with helicobater pylori negative and helicobater pylori positive patients of the experimental group after treatment , the levels of IL-10、TGF-β1 and IL-17 had significantly reduced(P<0 .05) .The levels of IL-10、TGF-β1 and IL-17 in serum of pa-tients of two groups before treatment showed significantly positive correlation (P<0 .05) .Conclusion The triple therapy could sig-nificant decrease the levels of serum IL-10、TGF-β1 and IL-17 ,it has good treatment effect .

Study of 4-,5- and 7-day pantoprazole quadruple therapy regimens in the treatment of Helicobacter pylori Infection / 中国综合临床

Objective To compare the efficacy of pantoprazoh based short-term quadruple regimens in the treatment of Helicobacter pylori (H. Pylori) infection for 4 days,5 days or 7days. Methods 166 patients with H. Pylori associated severe gastritis were randomly divided into pantoprozole quadruple regimens of 4-day group (n =61) ,5-day group (n = 54) or 7-day group (n = 51). The regimen was pantoprazole 40 mg,bismuth potassium citrate 220 mg,elarithromycin 250 mg and amoxicillin 1 g twice daily. The patients received pantoprazole for 1 week, bismuth potassium citrate for 2 weeks,clarithromycin and amoxicillin for 4 days,5 days or 7 days respectively. The H. Pylori eradication and symptomatic relief was determinded by 13C-UBT at least 4 weeks after the therapy. Results The H. Pylori eradication rates of 4-day,5-day or 7-day panteprazole quadruple regimens were 73.8% (45/61) ,75.9% (41/54) and 80.4% (41/51) respectively. The pain relief rates were 82.4% (42/51) ,85.1% (40/47) and 88.9% (40/45) in 4-day,5-day and 7 day group. Conclusion The 4-day and 5- day pantoprazoh based quadrual therapy is a short- term, effective, safe and lower therapeutic- cost regimen for H. Pylori eradication.

Helicobacter pylori e linfoma gástrico de células B da zona marginal do tipo MALT / Helicobacter pylori and marginal zone B-cell gastric lymphoma of MALT type

Linfomas de células B da zona marginal do tecido linfóide associado a mucosa (linfoma MALT) são linfomas extra-nodais, compreendendo mais de 50% dos linfomas gástricos primários. É freqüente a associação entre Helicobacter pylori e alguns tumores gástricos, como adenocarcinoma e linfoma MALT. Por isso, pacientes com MALT gástrico geralmente são submetidos ao tratamento para erradicação do H. pylori. Entretanto, existem casos não responsivos à terapêutica de erradicação deste microrganismo. Em geral, o linfoma MALT gástrico de baixo grau tem evolução indolente e, quando diagnosticado em estágios precoces, há a possibilidade de cura por meio de tratamento cirúrgico. Neste trabalho, descreveu-se um caso de MALT gástrico avançado, não responsivo ao tratamento clínico para H.pylori, e foi revisado os conceitos novos e pertinentes sobre o tratamento desta associação (tumor - agente infeccioso).

Marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma) comprise up to 50% of primary gastric lymphomas. It is frequent the association between Helicobacter pylori and some gastric tumors, such as adenocarcinoma and of MALT lymphoma. Therefore, patients presenting gastric MALT lymphoma, are usually submitted to an eradication treatment of H. pylori. However, it is vital to consider some cases in which the clinical treatment for eradication of this bacterium is ineffective. Generally, the low-grade gastric MALT lymphoma has an indolent evolution, so that an accurate and timely diagnosis may offer a cure through surgical treatment. This article describes an advanced gastric MALT case, which was unresponsive to clinical treatment for H. pylori. It also reviews current concepts on pertinent treatment for this binomial (tumor-infectious agent).

Effects of Helicobater Pylori Infection on Henoch-Schonlein Purpura with Renal Impairment in Children / 实用儿科临床杂志

Objective To evaluate the relationship between Henoch-Schonlein purpura (HSP) accompanying renal impairment and helicobater pylori(Hp) infection.Methods This study consisted of 304 patients with HSP.The patients were divided into 2 groups(group A and group B) based on Hp infection or not(91 cases in group A and 213 cases in group B).Compared with the rates of accompanying renal impairment in 2 groups.And observed the recovery from renal impairment between the patients who were turned into negative(group C)and patients still were positive after the anti-Hp therapy(group D).Numeration data were analyzed by ?2 test.Results Group A which was with Hp infected,the accompanying renal impairment ratio was 65.9%.Group B which was without Hp infected,the ratio was 35.2%.There was significant difference between 2 groups(?2=24.378 P

Comparison of Selective Media for Culture of Helicobacter pylori / 대한임상미생물학회지

BACKGROUNDS: Culture of Helicobacter pylori (H. pylori) from gastric biopsy specimens is a standard method with high specificity among H. pylori diagnostic tools and is also essential for antibiotic susceptibility test. The authors compared 5 selective media for H. pylori culture and tested fresh human serum instead of fresh animal blood as a media composite. METHODS: Gastric biopsy specimens from endoscopic examination were obtained from 50 patients (gastric ulcer:33, duodenal ulcer:12, stomach cancer:5) and they were finely minced with a tissue grinder. Specimens were inoculated onto 5 media (1. Columbia agar with 5% sheep blood, 2. Columbia agar with 10% human serum, 3. Thayer-Martin agar with 5% sheep blood, 4. T-M agar with 10% human serum, 5. T-M agar with 10% hemoglobin) and cultured for 3~7 days under microaerophilic condition. Gram stain, oxidase, catalase, and urease tests, were undertaken on typical colonies for diagnosis of H. pylori. Contamination by other organisms, number and size of H. pylori colonies were compared for each media. RESULTS: Positive culture rate of H. pylori was not significantly different among 4 media except TM agar with 10% hemoglobin. However T-M agar with 10% fresh human serum was considered as the best composition for culture of H. pylori because it had the least contaminating organisms and produced the largest colony sizes. CONCLUSIONS: These findings suggest that T-M agar with 10% fresh human serum can replace columbia agar with 5% sheep blood which has been commonly used for culture of H. pylori from gastric biopsy specimens. Fresh human serum, which is easily obtained in the clinical laboratory, can replace animal bloods in making media for H. pylori.

Prevalence of Intestinal Metaplasia, Dysplasia and Helicobacter pylori Infection by Aging

BACKGROUND : The recent studies shows that Helicobacter pylori (H. pylori) related chronic gastritis leads to dysplasia, intestinal metaplasia and gastric cancer. The aim of this study was to determine the association between precancerous lesion of stomach (dysplasia, intestinal metaplasia) and H.pylori infection in the elderly. METHODS : 469 patients were enrolled this study, Patients with intestinal metaplasia or dysplasia (case, n=148) were compared with controls (without intestinal metaplasia and dysplasia, n=321) about H. pylori positive rates H. pylori positivity was confirmed by histologic determination of endoscopic biopsy specimens. Results : 1) Among study populations H. pylori positive rates were 51.8% (55.8% in male, 40.7% in female). It was significantly higher in male (p=0.001). 2) There were no significant differences in sex distribution between cases and controls, but in old age, the cases were more frequent than in young age (p<0.001). 3) Age distribution of H. pylori positive rates were not significant between cases and controls. 47.5% in intestinal metaplasia, 43.4% in dysplasia, 21.3% in dysplasia+intestinal metaplasia were H. pylori positive. H. pylori positive rates were more higher in controls than cases, followed by in decreasing order by the intestinal metaplasia group, the dysplasia group, and those having both (p=0.003). 4) Age and sex adjusted H. pylori positive rates were more higher in controls (42.7%) than in cases (25.0%)(p<0.009). CONCLUSION : The prevalence of intestinal metaplasia and dysplasia was age dependent. But we couldn't explain the carcinogenic effect of H. pylori, because H. pylori positive rates were lower in cases than in controls