ABSTRACT
OBJECTIVE: The increasing resistance of Helicobacter pylori to clarithromycin led to developing new eradication treatment regimens. The objective of our observational study was to determine the proportion of H. pylori strains resistant to clarithromycin in infected patients in Reunion Island and to suggest a first-line treatment in agreement with the local ecology. PATIENTS AND METHODS: We included 200 patients who underwent esophagogastroduodenoscopy at the University Hospital of Saint-Pierre from February to July 2014. H. pylori was isolated from 73 patients. RESULTS: A wild-type susceptibility profile to clarithromycin was observed in 64 isolates (87.7%) and nine isolates (12.3%) had a resistant mutation profile. CONCLUSION: With a proportion of resistant strains below the critical threshold of 15%, physicians in Reunion Island may continue to prescribe the usual treatment regimen as a first-line option (clarithromycin, amoxicillin, and proton pump inhibitor for 14 days).
Subject(s)
Anti-Bacterial Agents/therapeutic use , Clarithromycin/pharmacology , Dyspepsia/epidemiology , Gastritis, Atrophic/microbiology , Helicobacter Infections/microbiology , Helicobacter pylori/drug effects , Adenocarcinoma/epidemiology , Adenocarcinoma/microbiology , Amoxicillin/therapeutic use , DNA, Bacterial/genetics , Drug Resistance, Microbial/genetics , Drug Therapy, Combination , Dyspepsia/etiology , Gastric Fundus/microbiology , Gastritis, Atrophic/drug therapy , Gastritis, Atrophic/epidemiology , Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Helicobacter pylori/genetics , Helicobacter pylori/isolation & purification , Humans , Metaplasia , Mutation , Proton Pump Inhibitors/therapeutic use , Pyloric Antrum/microbiology , Reunion/epidemiology , Stomach Neoplasms/epidemiology , Stomach Neoplasms/microbiologyABSTRACT
Basal cell carcinoma is one of the most common neoplasmatic diseases of the skin. Oral leukoplakia is precancerous stage. Early diagnosis of both diseases gives very good treatment results. Fluorescence spectroscopy is a new modality of diagnostics using excitation of absorbed PPIX in tumor. Spectroscopy is an objective method showing concentration and emission spectrum of protoporphyrin IX. In fluorescence spectroscopy with PPIX we used diode light 405 nm to induce fluorescence and observed significant emission peak at 630 nm. Fluorescence spectroscopy is based on searching of emission peaks of photosensitizer in areas of BCC and oral leukoplakia. In our study we used spectral camera measuring spectrum from pictures taken in different wavelengths between 570 nm and 650 nm. The pictures taken with this camera were compared with the pictures captured with Xillix Onco Life system. 20 patients with histopathologically confirmed BCC and 10 with oral leukoplakia were examinated with spectral camera and with Xillix Onco Life system 8h after local instillation of delta aminolevulinic acid. Our spectral camera made pictures with different filters for wavelength between 570 nm and 650 nm showing highest fluorescence intensity in 630 nm. Captured spectral lines were compared with NCV (numerical color value) from Xillix Onco Life. All of spectral lines taken from neoplasmatic tissues were compared with spectral lines taken from healthy tissues in symmetrical areas of body. Results were statistically processed. All of spectral lines taken from neoplasmatic tissues showed significant peak at 630 nm in the area of BCC and oral leukoplakia in all of the examinated patients. Spectral lines taken from healthy tissues were significantly different. There was no peak in 630 nm and fluorescence intensity was decreasing from 570 nm to 630 nm. Intensity of fluorescence in 630 nm was in high correlation with NCV from Xillix Onco Life.
