Treatment of Helicobacter Pylori Infection and the Colonization of the Gastrointestinal System by Resistant Bacteria.

BACKGROUND AND AIMS: Helicobacter pylori (H. pylori) infections are widely treated with antibiotic regimens such as "Amoxicillin 1 gr 2 × 1 tablet, Clarithromycin 500 mg 2 × 1 tablet, and Lansoprazole 30 mg 2 × 1 tablet" for 14 days. We conducted a prospective observational study to explore whether this treatment protocol serves as a predisposing factor for the colonization of resistant gastrointestinal microflora, namely vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase Enterobacterales (ESBL-E), and carbapenem-resistant Enterobacterales (CRE). MATERIALS AND METHODS: Pre- and post-treatment stool samples from 75 patients diagnosed with H. pylori, without a prior treatment history, were cultured and evaluated based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Of the 75 evaluated patients, a pronounced surge in ESBL-E positivity was observed. Before initiating antibiotic treatment, 12 patients (16%) had ESBL-E-positive strains in their gastrointestinal tract. Notably, this number surged to 24 patients (32%) after the conclusion of the 14-day treatment regimen. The change was statistically significant, with a P value of less than 0.002, indicating a clear association between treatment for H. pylori and heightened ESBL-E colonization. Notably, VRE and CRE remained undetected in patients throughout the study, suggesting that the treatment regimen may specifically amplify the risk of ESBL-E colonization without affecting VRE and CRE prevalence. CONCLUSIONS: As the inaugural report from Turkey on this issue, our study suggests that antibiotic regimens for H. pylori eradication contribute to the increased risk of ESBL-positive bacterial colonization in the gastrointestinal tract.

Psychological maladjustment mediates the link between remembrances of parental rejection in childhood and loneliness in adulthood: A cross-cultural comparative study.

Drawing stimulus from interpersonal acceptance-rejection theory, this multicultural study examined relations between men's versus women's remembrances of maternal and paternal acceptance-rejection in childhood and their current level of loneliness, as mediated by adults' self-reported psychological maladjustment. Adults (N = 899) from five nations (Iraq, Italy, the Netherlands, Pakistan, and the United States) responded to the Adult version of the Parental Acceptance-Rejection Questionnaire-short form for mothers and fathers, the Adult version of the Personality Assessment Questionnaire-short form, and the Interpersonal Acceptance-Rejection Loneliness Scale. Adults' remembrances of maternal and paternal rejection in childhood significantly and independently predicted feelings of loneliness but remembered paternal rejection was more strongly related to these feelings than were remembrances of maternal rejection. Psychological maladjustment fully mediated the effect of remembered maternal rejection but only partially mediated the effect of remembered paternal rejection on loneliness. There were no significant differences in these results across the five countries or genders. Overall, the results suggest that adults' remembrances of parental rejection in childhood-along with the theoretically expected development of psychological maladjustment-are likely to be associated panculturally with the experience of loneliness in adulthood.