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Tong L, Wang BB, Li FH, Lv SP, Pan FF, Dong XJ. An Updated Meta-Analysis of the Relationship Between Helicobacter pylori Infection and the Risk of Coronary Heart Disease. Front Cardiovasc Med 2022; 9:794445. [PMID: 35571162 PMCID: PMC9098821 DOI: 10.3389/fcvm.2022.794445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Coronary heart disease (CHD) is one of the leading causes of mortality in the world. Although the traditional risk factors for CHD have been identified, it seems that there are still many CHD cases without these factors. Previous studies have hypothesized that Helicobacter pylori (H. pylori) infection was associated with the risk of CHD. Objective The association between H. pylori infection and the risk of CHD was studied using a systematic evaluation and meta-analysis method. Methods In order to find relevant studies, four electronic databases were systematically searched until August 2021. According to the inclusion and exclusion criteria, studies were screened and data were extracted. Under the random-effects or the fixed-effects model, the odds ratio (OR) and 95% confidence interval (95% CI) were combined. All analyses were conducted using Review Manager software (RevMan 5.4). Results Among the included studies, 2 studies were analyzed for H. pylori stool antigen test, 2 studies were analyzed for H. pylori histological staining test, 13 studies were analyzed for the anti-CagA test, and 38 studies were analyzed for the anti-H. pylori IgG test. The pooled results revealed that positive anti-H. pylori IgG was significantly associated with an increased risk of CHD (OR, 1.58; 95% CI: 1.34–1.87). Similarly, positive anti-CagA, positive H. pylori stool antigen, and positive H. pylori histological staining were significantly associated with the development of CHD with (OR: 1.33, 95% CI: 1.16–1.53), (OR: 3.50, 95% CI: 1.60–7.66), and (OR: 1.78, 95% CI: 1.12–2.83), respectively. Conclusion This meta-analysis showed that H. pylori infection increased the risk of CHD. However, more studies are needed to further investigate whether early eradication of H. pylori may reduce the morbidity of CHD.
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Affiliation(s)
- Ling Tong
- Department of Cardiology, Shanxi Provincial People’s Hospital, Taiyuan, China
| | - Bei-Bei Wang
- Department of Cardiology, The First People’s Hospital of Jinzhong, Jinzhong, China
| | - Fei-Hong Li
- Department of Cardiology, Yantai Yeda Hospital, Yantai, China
| | - Shu-Ping Lv
- Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, China
| | - Fei-Fei Pan
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin-Jiang Dong
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan, China
- *Correspondence: Xin-Jiang Dong,
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Wang B, Yu M, Zhang R, Chen S, Xi Y, Duan G. A meta-analysis of the association between Helicobacter pylori infection and risk of atherosclerotic cardiovascular disease. Helicobacter 2020; 25:e12761. [PMID: 33026704 DOI: 10.1111/hel.12761] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Helicobacter pylori (H pylori) infection may be a risk factor for cardiovascular disease (CVD), but the reported researches have given conflicting results. AIMS To investigate the association between H pylori infection and risk of atherosclerotic CVD. MATERIALS AND METHODS The studies were retrieved in Embase, PubMed, Web of Science (published from Jan 1, 1990, to Jan 31, 2020, language restrictions: English). All studies included used data from case-control studies and cohort studies of cardiovascular adverse events. Random effect models were used to measure pooled estimates. All data were analyzed with Stata 11.2 SE (StataCorp, College Station, TX). RESULTS Helicobacter pylori infection increased the risk of adverse cardiovascular events by 51% (40 studies, n = 19 691, odd ratio [OR] = 1.51, 95% confidence interval [CI]: 1.34-1.70). The effect was greater for studies that the type of CVDs was myocardial infarction (MI) and cerebrovascular disease (MI OR = 1.80, 95% CI: 1.42-2.26, cerebrovascular disease OR = 1.54, 95% CI: 1.27-1.89). Meanwhile, CagA seropositive H pylori strains were associated with a significantly increased risk of cardiovascular adverse events based on published research data (OR = 1.73, 95% CI: 1.40-2.14). CONCLUSION In conclusion, H pylori infection enhanced the risk of atherosclerotic cardiovascular adverse events, especially in some patients with MI and cerebrovascular disease. This study will provide guidance for the targeted prevention and treatment of CVDs. But this association need to be confirmed by more prospective studies.
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Affiliation(s)
- Bin Wang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mingyang Yu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Rongguang Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China.,College of Public Health, Hainan Medical University, Haikou, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yuanlin Xi
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
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Rahmani Y, Mohammadi S, Babanejad M, Rai A, Zalei B, Shahmohammadi A. Association of Helicobacter Pylori with Presence of Myocardial Infarction in Iran: A Systematic Review and Meta-Analysis. Ethiop J Health Sci 2018; 27:433-440. [PMID: 29217946 PMCID: PMC5615033 DOI: 10.4314/ejhs.v27i4.15] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Over the past decade, cardiovascular diseases have been recognized as the leading cause of mortality worldwide. Myocardial infarction (MI) is one of the most prevalent types of cardiovascular diseases that is caused by the closure of coronary arteries and ischemic heart muscle. Numerous studies have analyzed the role of H. pylori as a possible risk factor for coronary artery diseases, in most of which the role of infection in coronary artery disease is not statistically significant. Methods These contradictory findings made us conduct a systematic review to analyze all relevant studies in Iran through a meta-analysis and report a comprehensive and integrated result. All published studies from September 2000 until September 2016 were considered. Using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, Science Direct and Persian databases like SID, Irandoc, Iran Mede and Magiran. After quality control, these studies were entered into a meta-analysis by using the random effects model. After evaluating the studies, 11 papers were finally selected and assessed. Results A total of 2517 participants had been evaluated in these studies, including 1253 cases and 1264 controls. Based on the results of meta-analysis and using random effects model, an overall estimate of OR Helicobacter Pylori with Presence of Myocardial Infarction in Iran was OR=2.53 (CI=1.37-4.67). Conclusions The results of this review study show that H. pylori are associated with the incidence of MI so that the odds ratio of MI in the patients with helicobacter pylori is twice greater than that of the people without H. pylori. Future studies are recommended to evaluate the mechanisms associated with relation of H. pylori with MI as well as its association with time.
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Affiliation(s)
- Yousef Rahmani
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
| | - Sareh Mohammadi
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehran Babanejad
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rai
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahar Zalei
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshar Shahmohammadi
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran
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Yu XJ, Yang X, Feng L, Wang LL, Dong QJ. Association between Helicobacter pylori infection and angiographically demonstrated coronary artery disease: A meta-analysis. Exp Ther Med 2017; 13:787-793. [PMID: 28352367 DOI: 10.3892/etm.2017.4028] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 11/04/2016] [Indexed: 02/06/2023] Open
Abstract
Coronary artery disease (CAD) is a leading cause of mortality globally. However, the etiology and pathogenesis of CAD are not fully understood. The aim of the present meta-analysis was to estimate the association between the risk of CAD and Helicobacter pylori (H. pylori) infection. A literature search was performed to identify eligible studies published prior to August 14, 2014. Fixed or random effect meta-analytical methods were used to pool the data and perform the subgroup analyses. The effect measures estimated were the odds ratios (OR) for dichotomous data reported with 95% confidence intervals (95% CI). Of the 109 studies identified using the search parameters, 26 cross-sectional studies were eligible involving 3,901 CAD patients and 2,751 controls. H. pylori infection was associated with an increased risk of CAD (OR: 1.96, 95% CI: 1.47-2.63, P<0.00001). When the adjusted ORs were used to conduct another meta-analysis, the OR value decreased, but the association remained significant (OR: 1.42, 95% CI: 1.09-1.86, P=0.008). The association between H. pylori infection and CAD risk was stronger in younger individuals than in older individuals (OR: 2.36, 95% CI 1.50-3.73 vs. OR: 1.59, 95% CI: 1.19-2.11). A significant association was observed in studies from Europe (OR: 2.11, 95% CI: 1.54-2.88, P=0.01) and the USA (OR: 1.43, 95% CI: 1.08-1.91, P=0.36). There is a potential association between H. pylori infection and the risk of CAD. The association may be influenced by age and ethnicity.
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Affiliation(s)
- Xin-Juan Yu
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Xuan Yang
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Lei Feng
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Li-Li Wang
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
| | - Quan-Jiang Dong
- Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China
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Altintas E, Ucbilek E, Ulu O, Sezgin O, Uzer C, Tataroglu C, Camdeviren H. Helicobacter pylori-associated atrophic gastritis and carotid intima-media thickness: is there a link? Int J Clin Pract 2007; 61:810-4. [PMID: 17343667 DOI: 10.1111/j.1742-1241.2006.01133.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Chronic infections are associated with cardiovascular diseases. Helicobacter pylori-induced chronic active gastritis results in atrophic gastritis. In this study, we attempted to determine carotid intima-media thickness in patients with and individuals without H. pylori-induced atrophic gastritis. Oesophagogastroduodenoscopy was performed on 123 patients for various reasons. Helicobacter pylori were considered positive when histological examination and rapid urease test showed H. pylori. Helicobacter pylori-positive cases were divided into two groups, namely atrophic gastritis and non-atrophic gastritis. Of 123 patients, 92 patients had H. pylori-positive non-atrophic gastritis and 31 had H. pylori-positive atrophic gastritis. There was no significant difference in carotid intima-media thickness between the two groups. Carotid intima-media thickness is not associated with H. pylori-induced atrophic gastritis.
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Affiliation(s)
- E Altintas
- Department of Gastroenterology, School of Medicine, Mersin University, Mersin, Turkey.
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Consolazio A, Borgia MC, Ferro D, Iacopini F, Paoluzi OA, Crispino P, Nardi F, Rivera M, Paoluzi P. Increased thrombin generation and circulating levels of tumour necrosis factor-alpha in patients with chronic Helicobacter pylori-positive gastritis. Aliment Pharmacol Ther 2004; 20:289-94. [PMID: 15274665 DOI: 10.1111/j.1365-2036.2004.02074.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Conflicting data have been reported concerning the relationship between Helicobacter pylori infection and coronary heart disease. AIM To evaluate clotting system activation and plasma levels of tumour necrosis factor-alpha, a procoagulant cytokine, in patients with H. pylori-positive and -negative gastritis. METHODS Three groups of patients were identified: 38 with H. pylori-positive gastritis, 18 with H. pylori-negative gastritis, and 40 H. pylori-negative controls with normal gastric mucosa. Plasma levels of prothrombin fragment 1 + 2 (F1 + 2) and tumour necrosis factor-alpha were assayed. Patients were also controlled after 2 and 6 months following standard H. pylori eradication treatment. RESULTS At baseline, fragment 1 + 2 and tumour necrosis factor-alpha levels in H. pylori-positive patients were significantly higher than those in H. pylori-negative patients with gastritis (P < 0.05 and P < 0.01, respectively). After H. pylori eradication, fragment 1 + 2 and tumour necrosis factor-alpha levels showed a significant decrease at 2 months (P = 0.03 and P = 0.02, respectively) and a further reduction at 6 months, reaching levels observed in H. pylori-negative patients and controls. CONCLUSIONS The increase thrombin generation rate and the correlation of plasma fragment 1 + 2 and tumour necrosis factor-alpha levels in H. pylori-positive patients suggest a role for inflammation in mediating the relationship between H. pylori infection and activation of the clotting system.
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Affiliation(s)
- A Consolazio
- Department of Clinical Sciences, Gastroenterology Unit, Rome, Italy.
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Stöllberger C, Finsterer J. Role of infectious and immune factors in coronary and cerebrovascular arteriosclerosis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:207-15. [PMID: 11874854 PMCID: PMC119967 DOI: 10.1128/cdli.9.2.207-215.2002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Claudia Stöllberger
- Second Medical Department, Krankenanstalt Rudolfstiftung, A-1130 Vienna, Austria.
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Abstract
An emerging pathophysiologic paradigm implicates chronic inflammation in the initiation, progression, and destabilization of atherosclerotic vascular disease. Various potential contributors to the inflammatory response in the vessel wall include atherogenic lipids, mechanical stress and injury, hypertension and angiotensin II, cigarette smoking, immune response to neoantigens, and chronic infections with viruses and or bacteria (Table 1). The potential link between chronic infection and atherosclerosis/thrombosis is under extensive investigation in several laboratories around the world. Although indirect evidence and experimental data tend to support this link, definitive proof is still lacking. If such a link is eventually proven to be causal in nature, it will provide a novel target for preventive and therapeutic strategies (anti-infective drugs, vaccines, etc.) against a common disease that is the leading killer of people in Western nations. Results of ongoing, large-scale clinical trials are eagerly awaited.
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Affiliation(s)
- Prediman K Shah
- Division of Cardiology and Atherosclerosis Research Center, Cedars Sinai Medical Center, Room 5347, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
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Stöllberger C, Mölzer G, Finsterer J. Seroprevalence of antibodies to microorganisms known to cause arterial and myocardial damage in patients with or without coronary stenosis. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:997-1002. [PMID: 11527817 PMCID: PMC96185 DOI: 10.1128/cdli.8.5.997-1002.2001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infections are assumed to play a role in coronary artery disease (CAD) and cardiomyopathies. It is unknown whether the seroprevalence of antibodies to these microorganisms is higher in patients with than without CAD. The seroprevalence of antibodies to Bartonella henselae, Borrelia burgdorferi, Chlamydia pneumoniae, Coxiella burnetii, Helicobacter pylori, human granulocytic Ehrlichia, Leptospira, Rickettsia conorii, and Treponema pallidum was assessed prospectively in patients with exertional dyspnea or anginal chest pain who underwent coronary angiography because of suspected CAD. Patients with normal angiograms (NA) were those in whom no more than 50% stenosis of any coronary artery was found. Patients with CAD were patients who underwent percutaneous transluminal coronary angioplasty. There were 50 patients with CAD (9 female) and 62 with NA (25 female), with a mean age of 62 years. All patients had antibodies to at least one microorganism: to B. henselae, 8% of CAD patients and 5% of NA patients; to B. burgdorferi IgG, 14% CAD and 6% NA; to B. burgdorferi IgM, 6% CAD and 3% NA; to C. pneumoniae lipopolysaccharide (LPS) IgA, 76% CAD and 77% NA; to C. pneumoniae LPS IgG, 80% CAD and 90% NA; to C. burnetii, 0% CAD and 5% NA; to H. pylori, 92% CAD and 68% NA; to human granulocytic Ehrlichia, 8% CAD and 3% NA; to Leptospira IgG, 4% CAD and 2% NA; to R. conorii, 10% in both groups; and to T. pallidum, 2% CAD and 0% NA. The seroprevalence of antibodies to micro-organisms known to induce arterial and myocardial damage does not differ between patients with CAD and NA.
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Affiliation(s)
- C Stöllberger
- Medizinische Abteilung der Krankenanstalt Rudolfstiftung, Steingasse 31/18, A-1030 Vienna, Austria.
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Martín de Argíla C, Boíxeda D. [Extradigestive manifestations of Helicobacter pylori infection. Science or fiction?]. Med Clin (Barc) 2000; 114:308-17. [PMID: 10774521 DOI: 10.1016/s0025-7753(00)71277-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Rosenstock SJ, Jørgensen T, Andersen LP, Bonnevie O. Association of Helicobacter pylori infection with lifestyle, chronic disease, body-indices, and age at menarche in Danish adults. Scand J Public Health 2000; 28:32-40. [PMID: 10817312 DOI: 10.1177/140349480002800107] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study examines the association between lifestyle factors, chronic disease, body-indices, and the seroprevalence of Helicobacter pylori infection in Danish adults. The relationship between age at menarche and H. pylori infection is also assessed. A random sample of 3,608 Danish adults completed a questionnaire about lifestyle factors (smoking habits, alcohol consumption, and coffee and tea intake), doctor diagnosed chronic diseases (heart conditions, diabetes, chronic bronchitis, and hypertension), menarche, and socio-demographic factors. A total of 2,913 participants were eligible for the present study. Electrocardiographs were recorded and blood pressure and serum lipid levels (HDL cholesterol, triglyceride, and cholesterol) were measured. Height and weight were determined and body mass index (BMI) calculated. Sera were analysed with an enzyme-linked immunosorbent assay for the presence of H. pylori specific IgG antibodies. The seroprevalence of H. pylori infection was associated with weekly alcohol intake > or = 6 drinks (odds ratio 0.7, 95% confidence interval 0.6-0.9) due to a low rate of H. pylori infection among wine drinkers (odds ratio 0.6, 95% confidence interval 0.5-0.7). No associations were found with smoking habits or serum lipids. People with upper quartile BMI (> or = 26.8 kg/m2) were more likely to be seropositive for antibodies to H. pylori (odds ratio 1.6, 95% confidence interval 1.1-2.4). Chronic bronchitis (odds ratio 1.6, 95% confidence interval 1.1-2.5) and unspecified heart condition (odds ratio 2.0, 95% confidence interval 1.1-3.3) was more often seen in IgG seropositive women than in uninfected women. The likelihood of being seropositive for IgG antibodies to H. pylori increased with age at menarche (odds ratio per year 1.10, 95% confidence interval 1.02-1.19). Previously reported associations with age and socioeconomic status were confirmed. We conclude that wine drinking is associated with lower rates of H. pylori infection in Danish adults. The seroprevalence of H. pylori infection is increased in people with high BMI. H. pylori infection may relate to a history of late menarche and chronic bronchitis in Danish women.
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Abstract
Overwhelming evidence implicates Helicobacter pylori as a significant causative factor in many gastroduodenal diseases. Effective multidrug antimicrobial regimens are available for cure of the infection, so investigative efforts are focusing on cost-effectiveness and treatment outcome in various populations. Potential associations between H. pylori and nongastric disorders are being examined. Recognition that infection is largely acquired during childhood has emphasized the need to study pediatric issues. Posttreatment studies confirm the importance of the bacterium in pathogenesis and relapse of peptic ulcer disease. Antimicrobial resistance has a negative impact on cure of the infection and healing of gastroduodenal lesions. Methodology to evaluate H. pylori antimicrobial susceptibility has been standardized by the National Committee for Clinical Laboratory Standards, and minimum inhibitory concentration breakpoints to standardize resistance assays are being established. Surveillance of H. pylori antimicrobial resistance is underway in a Centers for Disease Control and Prevention multisite project in the United States.
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Affiliation(s)
- M F Go
- Veterans Affairs Medical Center (111D), 2002 Holcombe Boulevard, Houston, TX 77030, USA
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