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Ribaldone DG, Pellicano R, Fagoonee S, Actis GC. Modulation of the gut microbiota: opportunities and regulatory aspects. Minerva Gastroenterol (Torino) 2023; 69:128-140. [PMID: 35179341 DOI: 10.23736/s2724-5985.22.03152-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The human gut is an intensively colonized organ containing microorganisms that can be health-promoting or pathogenic. This feature led to the development of functional foods aiming to fortify the former category at the expense of the latter. Since long, cultured products, including probiotics fortification, have been used for humans as live microbial feed additions. This review presents some of the microbes used as probiotics and discusses how supplementation with probiotics may help initiate and/or restore eubiotic composition of gut microbiota. Additionally, it considers safety and regulatory aspects of probiotics.
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Affiliation(s)
| | | | - Sharmila Fagoonee
- Institute of Biostructures and Bioimaging (CNR) c/o Molecular Biotechnology Center, Turin, Italy
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2
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Wang X, Shu X, Li Q, Li Y, Chen Z, Wang Y, Pu K, Zheng Y, Ye Y, Liu M, Ma L, Zhang Z, Wu Z, Zhang F, Guo Q, Ji R, Zhou Y. Prevalence and risk factors of Helicobacter pylori infection in Wuwei, a high-risk area for gastric cancer in northwest China: An all-ages population-based cross-sectional study. Helicobacter 2021; 26:e12810. [PMID: 33904635 DOI: 10.1111/hel.12810] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/02/2021] [Accepted: 03/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence and risk factors of Helicobacter pylori infection across all age groups in Wuwei City, a high-risk area for gastric cancer in Northwest China. METHODS We conducted this study from 2016 to 2017 in an urban and a rural community in Wuwei City. Stool antigen tests targeted individuals aged 0 to 3 years old, and 13 C-urea breath tests targeted individuals aged above 3 years. We selected participants based on hierarchical cluster sampling. We assessed the association between variables and H. pylori infection based on logistic regression models. RESULTS Ultimately, the results of 2,163 participants (age: 0 to 77 years old) were included (1,238 minors and 925 adults) in the analysis. The overall prevalence of H. pylori infection was 35.6%. It increased with age, reaching the peak in the 30 to 39 age group, and then began to decline. In multivariate analysis, age was positively associated with prevalence of H. pylori infection, and factors negatively associated with the prevalence were drinking running water, the frequency of yoghurt consumption, and an annual household income of Renminbi (¥) 30,000-100,000 or 100,000 above. In the subgroup analyses, however, the same variables associated differently in different age groups. Additionally, we interestingly noticed that boarding, eating at school cafeterias over six times per week, and frequently drinking untreated water were independent predictors of H. pylori infection in junior and senior high school students. CONCLUSION The prevalence of H. pylori infection is moderate and closely associated with the socioeconomic conditions of Wuwei City, as well as the sanitary situations and dietary habits of the participants in the city. Boarding, eating at school, and drinking untreated water are the main factors explaining the rising infection rate in junior-senior high school students.
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Affiliation(s)
- Xiaofeng Wang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xiaochuang Shu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Qiang Li
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | | | - Zhaofeng Chen
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ke Pu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yuwei Ye
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Min Liu
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Lijun Ma
- Department of Medical Administration, The First Hospital of Lanzhou University, Lanzhou, China
| | | | - Zhengqi Wu
- Gansu Wuwei Tumour Hospital, Wuwei, China
| | - Fuhua Zhang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Gansu Second Provincial People's Hospital, Lanzhou, China
| | - Qinghong Guo
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yongning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
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Curado MP, de Oliveira MM, de Araújo Fagundes M. Prevalence of Helicobacter pylori infection in Latin America and the Caribbean populations: A systematic review and meta-analysis. Cancer Epidemiol 2019; 60:141-148. [PMID: 31009922 DOI: 10.1016/j.canep.2019.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/03/2019] [Accepted: 04/08/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe the prevalence of Helicobacter pylori (H. pylori) infection in Latin Americaand the Caribbean (LAC), through systematic review and meta-analysis by age groups and gender. METHODS Systematic review and meta-analysis of the population-based observational epidemiological studies carried out in LAC, focused on the prevalence of H. pylori and published until March, 2018. The databases utilized in the search were MEDLINE, SCIELO andPUBMED. The prevalence described in the meta-analysis and 95% confidence intervals were estimated by the random effects model, and weighted by the size of the study. RESULTS The 22 selected studies were carried out in 14 countries of LAC, and included 24,178 individuals. The studies were conducted between 1987 and 2012, and all were representative of at least one city. The prevalence of H. pylori infection was 57.57% (CI95%:50.43;64.72) for all ages; in children and adolescents the prevalence was 48.36% (CI95%:38.03;58.70) and in adults 69.26%(CI95%:64.54;76.99). No differences were observed regarding sex. CONCLUSION Prevalence of H. pylori infection in LAC is high for all age groups. These data reinforce the necessity of actions towards the prevention and treatment of H. pylori infection for all age groups. Treating H pylori infection in young ages probably will reduce gastric cancer incidence in the future.
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Affiliation(s)
- Maria Paula Curado
- Epidemiology and Statistics Group, Research Center, A.C Camargo Cancer Center, São Paulo, Brazil.
| | - Max Moura de Oliveira
- Epidemiology and Statistics Group, Research Center, A.C Camargo Cancer Center, São Paulo, Brazil
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Kheyre H, Morais S, Ferro A, Costa AR, Norton P, Lunet N, Peleteiro B. The occupational risk of Helicobacter pylori infection: a systematic review. Int Arch Occup Environ Health 2018; 91:657-674. [DOI: 10.1007/s00420-018-1315-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022]
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Zaidi SF, Ahmed K, Saeed SA, Khan U, Sugiyama T. Can Diet Modulate Helicobacter pylori-associated Gastric Pathogenesis? An Evidence-Based Analysis. Nutr Cancer 2017; 69:979-989. [PMID: 28937799 DOI: 10.1080/01635581.2017.1359310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Helicobacter pylori is involved in the pathogenesis of gastritis, peptic ulcer, and gastric cancer. The infection is prevalent in more than half of the world's population. Although the infection may lead to detrimental consequences, still the majority of the infected individuals only develop mild gastritis. Several factors are behind this paradoxical outcome including virulence of the infecting H. pylori strains, genetic background of the host, and factors related to lifestyle such as dietary habits. Among these, lifestyle including dietary factors was not in the limelight, until recently, as one of the important factors that could modulate H. pylori-linked gastric diseases. This review is directed to gather and elucidate the role of dietary components in augmenting or attenuating pathological processes initiated by H. pylori. Available evidence strongly supports the notion that the diet may play a critical role in defining the final outcome of H. pylori infection particularly if certain dietary components are taken on a regular basis for a long time. Despite a recent surge in research related to the role of dietary ingredients, further studies involving large-scale clinical trials are required to gain a better understanding of the precise role played by the dietary ingredients in H. pylori-associated pathogenesis.
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Affiliation(s)
- Syed Faisal Zaidi
- a Department of Basic Medical Sciences, College of Medicine , King Saud bin Abdulaziz University of Health Sciences , Jeddah , Kingdom of Saudi Arabia
| | - Kanwal Ahmed
- a Department of Basic Medical Sciences, College of Medicine , King Saud bin Abdulaziz University of Health Sciences , Jeddah , Kingdom of Saudi Arabia
| | - Sheikh Abdul Saeed
- a Department of Basic Medical Sciences, College of Medicine , King Saud bin Abdulaziz University of Health Sciences , Jeddah , Kingdom of Saudi Arabia
| | - Usmanghani Khan
- b Faculty of Pharmacy , Jinnah University for Women , Karachi , Pakistan
| | - Toshiro Sugiyama
- c Department of Gastroenterology, Faculty of Medicine , University of Toyama , Toyama , Japan
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Influence of Dietary Factors on Helicobacter pylori and CagA Seroprevalence in Bulgaria. Gastroenterol Res Pract 2017; 2017:9212143. [PMID: 28659975 PMCID: PMC5474270 DOI: 10.1155/2017/9212143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/24/2017] [Accepted: 05/15/2017] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to assess the association between some dietary factors and prevalence of H. pylori infection or strain virulence in 294 adult asymptomatic blood donors. Methods. Seroprevalence was evaluated using ELISA. Logistic regression was used. Results. Anti-H. pylori IgG prevalence was 72.4%, and CagA IgG seroprevalence was 49.3%. In the multivariate analyses, the frequent (>5 days per week) honey consumption was associated with both reduced H. pylori seroprevalence OR, 0.68 with 95% confidence interval (CI), 0.473-0.967 and reduced CagA IgG seroprevalence OR, 0.65 with 95% CI, 0.486-0859. Frequent (>5 days per week) yoghurt consumption also was associated with lower H. pylori virulence of the strains (CagA IgG OR, 0.56 with 95% CI, 0.341-0.921). Smoking and consumption of the other dietary factors resulted in no significant differences in the prevalence of H. pylori IgG and CagA IgG within the subject groups. Conclusion. To the best of our knowledge, this is the first report revealing reverse associations between honey or yoghurt consumption and CagA IgG prevalence as well as between frequent honey consumption and lower prevalence of the H. pylori infection. Regular honey and yoghurt consumption can be of value as a supplement in the control of H. pylori therapy.
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Nair MRB, Chouhan D, Sen Gupta S, Chattopadhyay S. Fermented Foods: Are They Tasty Medicines for Helicobacter pylori Associated Peptic Ulcer and Gastric Cancer? Front Microbiol 2016; 7:1148. [PMID: 27504109 PMCID: PMC4958626 DOI: 10.3389/fmicb.2016.01148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/11/2016] [Indexed: 12/21/2022] Open
Abstract
More than a million people die every year due to gastric cancer and peptic ulcer. Helicobacter pylori infection in stomach is the most important reason for these diseases. Interestingly, only 10-20% of the H. pylori infected individuals suffer from these gastric diseases and rest of the infected individuals remain asymptomatic. The genotypes of H. pylori, host genetic background, lifestyle including smoking and diet may determine clinical outcomes. People from different geographical regions have different food habits, which also include several unique fermented products of plant and animal origins. When consumed raw, the fermented foods bring in fresh inocula of microbes to gastrointestinal tract and several strains of these microbes, like Lactobacillus and Saccharomyces are known probiotics. In vitro and in vivo experiments as well as clinical trials suggest that several probiotics have anti-H. pylori effects. Here we discuss the possibility of using natural probiotics present in traditional fermented food and beverages to obtain protection against H. pylori induced gastric diseases.
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Affiliation(s)
| | | | | | - Santanu Chattopadhyay
- Microbiome Research Facility, Microbiome Biology, Rajiv Gandhi Centre for BiotechnologyTrivandrum, India
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Glanville JM, Brown S, Shamir R, Szajewska H, Eales JF. The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review. Front Pharmacol 2015; 6:246. [PMID: 26578956 PMCID: PMC4626633 DOI: 10.3389/fphar.2015.00246] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 10/12/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt. OBJECTIVE The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt. METHODS The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol. RESULTS 213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies), weight management and nutrition related health outcomes (81 studies), metabolic health (6 studies); cardiovascular health (57 studies); gastrointestinal health (24 studies); cancer (39 studies); diabetes (13 studies), Parkinson's disease risk (3 studies), all-cause mortality (3 studies), skin complaints (3 studies), respiratory complaints (3 studies), joint pain/function (2 studies); the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews. CONCLUSIONS This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of conventional yogurt consumption.
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Affiliation(s)
| | - Sam Brown
- York Health Economics Consortium, University of YorkYork, UK
| | - Raanan Shamir
- Sackler Faculty of Medicine, Schneider Children's Medical Center, Institute of Gastroenterology, Nutrition and Liver Diseases, Tel-Aviv UniversityTel-Aviv, Israel
| | - Hania Szajewska
- Department of Paediatrics, The Medical University of WarsawWarsaw, Poland
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Boyanova L, Ilieva J, Gergova G, Vladimirov B, Nikolov R, Mitov I. Honey and green/black tea consumption may reduce the risk of Helicobacter pylori infection. Diagn Microbiol Infect Dis 2015; 82:85-6. [PMID: 25779680 DOI: 10.1016/j.diagmicrobio.2015.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 02/25/2015] [Accepted: 03/01/2015] [Indexed: 12/24/2022]
Abstract
The aim of the study was to evaluate the influence of dietary and demographic factors and some habits on the prevalence of Helicobacter pylori infection in 150 dyspeptic patients examined endoscopically and by the urea breath test. Positivity rate was lower (50.6%) in patients consuming honey ≥1 day weekly compared with the remainder (70.8%) and in those consuming green/black tea ≥1 day weekly (45.2%) compared with the other patients (64.8%). Logistic regression confirmed that the factors associated with significantly lower H. pylori positivity rate were the consumption of honey (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.19-0.78) and green/black tea (OR, 0.45; 95% CI, 0.21-0.95). In conclusion, honey and green/black tea intake is associated with reduced prevalence of H. pylori infection.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Zdrave street 2, 1431 Sofia, Bulgaria.
| | - Juliana Ilieva
- Department of Social Medicine Healthcare Management, Medical University of Sofia, Sofia, Bulgaria
| | - Galina Gergova
- Department of Medical Microbiology, Medical University of Sofia, Zdrave street 2, 1431 Sofia, Bulgaria
| | - Borislav Vladimirov
- Gastroenterology Clinic, University Center of Gastroenterology, University Hospital "Queen Ioanna", Sofia, Bulgaria
| | - Rossen Nikolov
- Department of Gastroenterology, University Hospital St. Ivan Rilski, Sofia, Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology, Medical University of Sofia, Zdrave street 2, 1431 Sofia, Bulgaria
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10
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Denova-Gutiérrez E, Hernández-Ramírez RU, López-Carrillo L. Dietary Patterns and Gastric Cancer Risk in Mexico. Nutr Cancer 2014; 66:369-76. [DOI: 10.1080/01635581.2014.884237] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Sachdeva A, Rawat S, Nagpal J. Efficacy of fermented milk and whey proteins in Helicobacter pylori eradication: A review. World J Gastroenterol 2014; 20:724-737. [PMID: 24574746 PMCID: PMC3921482 DOI: 10.3748/wjg.v20.i3.724] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 10/12/2013] [Accepted: 12/06/2013] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) eradication is considered a necessary step in the management of peptic ulcer disease, chronic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Standard triple therapy eradication regimens are inconvenient and achieve unpredictable and often poor results. Eradication rates are decreasing over time with increase in antibiotic resistance. Fermented milk and several of its component whey proteins have emerged as candidates for complementary therapy. In this context the current review seeks to summarize the current evidence available on their role in H. pylori eradication. Pertinent narrative/systematic reviews, clinical trials and laboratory studies on individual components including fermented milk, yogurt, whey proteins, lactoferrin, α-lactalbumin (α-LA), glycomacropeptide and immunoglobulin were comprehensively searched and retrieved from Medline, Embase, Scopus, Cochrane Controlled Trials Register and abstracts/proceedings of conferences up to May 2013. A preponderance of the evidence available on fermented milk-based probiotic preparations and bovine lactoferrin suggests a beneficial effect in Helicobacter eradication. Evidence for α-LA and immunoglobulins is promising while that for glycomacropeptide is preliminary and requires substantiation. The magnitude of the potential benefit documented so far is small and the precise clinical settings are ill defined. This restricts the potential use of this group as a complementary therapy in a nutraceutical setting hinging on better patient acceptability/compliance. Further work is necessary to identify the optimal substrate, fermentation process, dose and the ideal clinical setting (prevention/treatment, first line therapy/recurrence, symptomatic/asymptomatic, gastritis/ulcer diseases etc.). The potential of this group in high antibiotic resistance or treatment failure settings presents interesting possibilities and deserves further exploration.
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Boyanova L, Ilieva J, Gergova G, Davidkov L, Spassova Z, Kamburov V, Katsarov N, Mitov I. Numerous risk factors for Helicobacter pylori antibiotic resistance revealed by extended anamnesis: a Bulgarian study. J Med Microbiol 2011; 61:85-93. [PMID: 21873378 DOI: 10.1099/jmm.0.035568-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to assess risk factors for primary Helicobacter pylori antibiotic resistance by an extended anamnesis. In total, 519 H. pylori strains from untreated symptomatic adults who answered a questionnaire were evaluated. Strain susceptibility was assessed by a breakpoint susceptibility test. Primary resistance rates were 29.5 % for metronidazole, 17.9 % for clarithromycin, 7.3 % for metronidazole+clarithromycin, 4.0 % for tetracycline and 10.8 % for ciprofloxacin. On multivariate analysis, younger (≤65 years) age was an independent predictor for metronidazole resistance. To our knowledge, for the first time, being a member of the health-care profession was revealed as a risk factor for H. pylori resistance to metronidazole and both metronidazole and clarithromycin. Respiratory and urinary tract infections were independent predictors of clarithromycin and ciprofloxacin resistance, respectively. The presence of co-infections was an independent risk factor for clarithromycin, metronidazole and ciprofloxacin resistance. Surprisingly, female sex was the only predictor for tetracycline resistance. The antibiotic resistance rates were not associated with disease type, place of residence, birthplace, educational level, non-steroidal anti-inflammatory drug or proton pump inhibitor use, smoking or dietary factors, such as consumption of coffee, yogurt, green tea, raw garlic, raw onion, honey or meat. There was a trend for higher metronidazole resistance in strains from diabetic patients. In conclusion, the extended anamnesis of H. pylori-positive patients should include data on patient age, sex, whether they are in the health-care profession, co-infections and possibly diabetes to improve the choice of empiric therapy. Tailored treatment based on the extended anamnesis is suggested, and susceptibility testing of the strains is recommended for patients at risk for antibiotic resistance, especially to clarithromycin, fluoroquinolones or both metronidazole and clarithromycin.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
| | - Juliana Ilieva
- University Department of Social Medicine and Healthcare Management, Medical University of Sofia, Sofia, Bulgaria
| | - Galina Gergova
- Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
| | - Lubomir Davidkov
- Departments of Gastroenterology and General Surgery, University Hospital St Ekaterina, Sofia, Bulgaria
| | - Zoya Spassova
- Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria
| | - Victor Kamburov
- Urgent Endoscopy Unit, Emergency Hospital Pirogov, Sofia, Bulgaria
| | - Nikolai Katsarov
- Second Surgery Department, University Alexander Hospital, Sofia, Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria
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Bekar O, Yilmaz Y, Gulten M. Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. J Med Food 2010; 14:344-7. [PMID: 21186984 DOI: 10.1089/jmf.2010.0099] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Preliminary evidence has suggested that probiotics may improve eradication rates in patients infected with Helicobacter pylori treated by triple therapy. This study examined the effect of combining triple therapy with kefir, a fermented milk drink containing probiotics. A randomized, double-blind study was carried out on 82 consecutive patients with symptoms of dyspepsia and H. pylori infection confirmed by the urea breath test. Patients were given a two times a day, 14-day course of lansoprazole (30 mg), amoxicillin (1,000 mg), and clarithromycin (500 mg) with either 250 mL of kefir twice daily (triple therapy + kefir, n = 46) or 250 mL of milk containing placebo (triple therapy + placebo, n = 36). Side effects were determined using a standard questionnaire form at 15 days after beginning treatment. Patients returned for urea breath tests 45 days after beginning treatment. Significantly more triple therapy + kefir patients achieved eradication (36 of 46 [78.2%]) compared with triple therapy + placebo patients (18 of 36 [50.0%]) (P = .026, χ(2) test). Side effects were significantly less frequent and less severe in triple therapy + kefir patients than in triple therapy + placebo patients. We conclude that a 14-day regimen of triple therapy with kefir is more effective in achieving H. pylori eradication than is triple therapy alone.
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Affiliation(s)
- Onder Bekar
- Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey
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Vale FF, Vítor JMB. Transmission pathway of Helicobacter pylori: does food play a role in rural and urban areas? Int J Food Microbiol 2010; 138:1-12. [PMID: 20122750 DOI: 10.1016/j.ijfoodmicro.2010.01.016] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Revised: 01/13/2010] [Accepted: 01/14/2010] [Indexed: 01/03/2023]
Abstract
Helicobacter pylori is a Gram-negative microaerophilic bacterium that has colonized the human gastric mucosa. This infection is very common and affects more than half of the human population. The prevalence is however unbalanced between rural developing areas (more than 80%) and urban developed areas (less than 40%). H. pylori is responsible for several pathologies, such as gastritis, peptic ulcer and gastric cancer but its transmission pathway is still not clear. The risk factors for H. pylori infection include poor social and economic development; poor hygienic practices; absence of hygienic drinking water; and unsanitary prepared food. There is evidence supporting a gastro-oral, oral-oral and faecal-oral transmission, but no predominant mechanism of transmission has been yet identified. Transmission may occur in a vertical mode (e.g. from parents to child) or in a horizontal mode (across individuals or from environmental contamination). In either case, the involvement of water and food cannot be excluded as vehicles or sources of infection. Indirect evidence of presence of H. pylori in water and food, namely the detection of its DNA and survival studies after artificial contamination of food and water has been described. This paper reviews data both favourable and against the role of water and food in the transmission of H. pylori, exploring their role as a potential transmission vehicle for person-to-person and food-chain transmission. The likelihood of the transmission pathway in developing rural and developed urban areas appears to be different. In developed areas, person-to-person transmission within families appears to be dominant, while in the rural developing areas the transmission pathway appears to be more complex. In this later case, the transmission by contaminated food, water, or via intensive contact between infants and non-parental caretakers may have a greater influence than within-family transmission.
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Affiliation(s)
- F F Vale
- Faculty of Engineering Catholic University of Portugal, Estrada Octávio Pato, Rio de Mouro, Portugal.
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Abstract
Gut flora and probiotics have potential to affect health and disease far beyond the gut. There is increasing evidence that probiotics have beneficial effects in preventing a wide range of conditions and improving health. Randomized, double-blind studies have provided evidence of the effectiveness of probiotics for preventing various diarrheal illnesses as well as allergic disorders. Evidence for their efficacy for use in the prevention and treatment of bacterial vaginosis and urinary tract infections is also mounting. In addition, probiotics may be useful for preventing respiratory infections, dental caries, necrotizing enterocolitis, and certain aspects of inflammatory bowel disease. Data also suggest that probiotics may promote good health in day care and work settings, and may enhance growth in healthy as well as ill and malnourished children. Results from meta-analyses and systematic reviews that combine results of studies from different types of probiotics to examine the effects in any disease state should be interpreted with caution. Specific strains are effective in specific disease states. No 2 probiotics are exactly alike; we should not expect reproducible results from studies that employ different species or strains, variable formulations, and diverse dosing schedules.
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Affiliation(s)
- Anil Minocha
- VA Medical Center, Medical Service, 510 E. Stoner Ave, Shreveport, LA 71101, USA.
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Abstract
The different invasive and noninvasive diagnostic tests for Helicobacter pylori have been applied mainly in emerging countries. Molecular methods have been developed, especially a test for detection of H. pylori and its clarithromycin resistance directly from stools. The long-term effects of eradication on histologic lesions have been studied in a meta-analysis and the prognostic value of post-treatment in gastric mucosa-associated lymphoid tissue lymphoma has been assessed. An operating link for gastritis assessment (the OLGA staging) has also been published. Attempts to simplify the urea breath test protocol have been made, and new stool antigen tests have been proposed and compared to those previously available.
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Affiliation(s)
- Marta Granstrom
- Clinical Microbiology, Karolinska Hospital, SE171 76 Stockholm, Sweden
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