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Zhang H, Xu C, Zhang J, Yin J, Yao N, Pang Q, Liu Z, Wang C, Shi Y, Shang L, Han Z. The intake of solid fat and cheese may be associated with a reduced risk of Helicobacter pylori infection status: a cross-sectional study based on NHANES 1999-2000. BMC Infect Dis 2024; 24:493. [PMID: 38745170 PMCID: PMC11092062 DOI: 10.1186/s12879-024-09392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Diet plays an important role in Helicobacter pylori (HP) infection, and our objective was to investigate potential connections between dietary patterns, specific food groups, and HP infection status in U.S. adults. METHODS The data for this study was obtained from the NHANES (National Health and Nutrition Survey) database for the year 1999-2000. This cross-sectional study involved the selection of adults aged 20 years and older who had undergone dietary surveys and HP testing. Factor analysis was employed to identify dietary patterns, and logistic regression models were utilized to assess the association between these dietary patterns and specific food groups with HP infection status. RESULT Based on the inclusion and exclusion criteria, our final analysis included 2,952 individuals. The median age of participants was 51.0 years, and 48.7% were male. In the study population, the overall prevalence of HP infection was 44.9%. Factor analysis revealed three distinct dietary patterns: High-fat and high-sugar pattern (including solid fats, refined grains, cheese, and added sugars); Vegetarian pattern (comprising fruits, juices, and whole grains); Healthy pattern (encompassing vegetables, nuts and seeds, and oils). Adjusted results showed that the high-fat and high-sugar pattern (OR = 0.689, 95% CI: 0.688-0.690), vegetarian pattern (OR = 0.802, 95% CI: 0.801-0.803), and healthy pattern (OR = 0.717, 95% CI: 0.716-0.718) were all linked to a lower likelihood of HP infection. Further analysis of the high-fat and high-sugar pattern revealed that solid fats (OR = 0.717, 95% CI: 0.716-0.718) and cheese (OR = 0.863, 95% CI: 0.862-0.864) were protective factors against HP infection, while refined grains (OR = 1.045, 95% CI: 1.044-1.046) and added sugars (OR = 1.014, 95% CI: 1.013-1.015) were identified as risk factors for HP infection. CONCLUSION Both the Vegetarian pattern and the Healthy pattern are associated with a reduced risk of HP infection. Interestingly, the High-fat and High-sugar pattern, which is initially considered a risk factor for HP infection when the score is low, becomes a protective factor as the intake increases. Within this pattern, animal foods like solid fats and cheese play a protective role, while the consumption of refined grains and added sugars increases the likelihood of HP infection.
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Affiliation(s)
- Huan Zhang
- Department of Gastroenterology, Air Force Medical Center, Fourth Military Medical University, Beijing, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi' an, 710032, China
| | - Chao Xu
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Ju Zhang
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi' an, 710032, China
| | - Jumei Yin
- Department of Gastroenterology, Air Force Medical Center, Fourth Military Medical University, Beijing, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi' an, 710032, China
| | - Nuo Yao
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi' an, 710032, China
| | - Qimeng Pang
- Postgraduate Department, Xi'an Medical University, Xi'an, Shaanxi, 710021, China
| | - Zhihua Liu
- Postgraduate Department, Xi'an Medical University, Xi'an, Shaanxi, 710021, China
| | - Chenchen Wang
- Department of Critical Care Medicine, the 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, Gansu, 730050, China
| | - Yongquan Shi
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi' an, 710032, China
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China.
| | - Zheyi Han
- Department of Gastroenterology, Air Force Medical Center, Fourth Military Medical University, Beijing, China.
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Wongsuwanlert M, Teanpaisan R, Pahumunto N, Kaewdech A, Ruangsri P, Sunpaweravong S. Prevalence and virulence factors of Helicobacter pylori isolated from oral cavity of non-disease, gastritis, and gastric cancer patients. J Dent Sci 2024; 19:1036-1043. [PMID: 38618069 PMCID: PMC11010610 DOI: 10.1016/j.jds.2023.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/23/2023] [Indexed: 11/01/2023] Open
Abstract
Background/purpose The oral cavity is considered a reservoir of Helicobacter pylori associated with gastric infection. It aimed to examine the prevalence of H. pylori strains from the oral cavity and gastric tissue of patients with different stage of gastric-diseases. Strains were further characterized for virulence genes, adhesion ability, and inflammation responses. Materials and methods 11 non-disease, 15 gastritis, and 15 gastric cancer participated in the study. After clinical examination, gastric biopsies, saliva and plaque samples were collected and H. pylori levels were examined by real-time PCR and cultivation. The cagA and vacA genes were investigated from the culture strains. Adhesion ability and pro-inflammatory responses were analyzed in comparison between the presence of virulent genes and disease status. Results Relatively poor periodontal condition was found among gastric cancer patients. Prevalence of H. pylori-positive was 84.8% and 19.5% by real-time PCR and cultivation, respectively. The cagA and vacA gene-positive strains were 52.6% and 5.3%, respectively, which were found more in gastric cancer patients. The cagA gene-positive strains were found to be higher in gastric cancer patients, and strains had significantly higher adhesion ability and pro-inflammation expressions than the cagA gene-negative strains. Conclusion Colonization by H. pylori in oral cavity was confirmed, and the cagA gene-positive strains play a crucial role in both adhesion and inflammatory responses. The presence of H. pylori and its virulence gene in oral cavity should be received attention. An eradication of such strains from oral cavity may help to prevent the transmission and recolonization to gastric organs.
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Affiliation(s)
- Mutita Wongsuwanlert
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Rawee Teanpaisan
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Nuntiya Pahumunto
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Praphansri Ruangsri
- Research Center of Excellence for Oral Health, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Thailand
| | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Wu H, Zhou Y, Huang Y. Accuracy of gastric nodule combined with rapid urease test prediction in diagnosing Helicobacter pylori infection in children. Eur J Clin Microbiol Infect Dis 2024; 43:481-487. [PMID: 38182925 DOI: 10.1007/s10096-023-04711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/09/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND The diagnosis of Helicobacter pylori (H. pylori) infection in children remains challenging with the lack of a rapid, cost-effective, and highly accurate diagnostic method. Consequently, this study aimed to investigate the accuracy of the combination of gastric nodule and rapid urease test (RUT) as a diagnostic method for H. pylori infection in children. METHODS The study included participants who underwent a thorough examination, including gastroscopy, a 13C breath test, RUT, and pathological methylene blue staining, with the gold standard for diagnosing of H. pylori infection being a positive result from both pathological methylene blue staining and 13C breath test. The sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic methods were calculated. RESULTS The accuracy of the different tests for H. pylori infection was evaluated in 2202 participants. A total of 730 (33.2%) children were diagnosed with H. pylori infection (pathological methylene blue staining and 13C breath test, both positive). Gastric nodule had a sensitivity of 87.1% and a specificity of 93.1%, whereas combining gastric nodule and RUT in parallel had the higher accuracy of 95.4%. The accuracy of gastric nodule diagnosis was higher in younger age groups and increased after excluding patients with a history of anti-H. pylori treatment. CONCLUSIONS The findings of this study suggest that gastric nodules, particularly when combined with RUT, can be a valuable predictor of H. pylori infection in children, offering a simple and feasible alternative to other invasive methods.
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Affiliation(s)
- Hailin Wu
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Ying Zhou
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
| | - Ying Huang
- Children's Hospital of Fudan University, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
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Lara Icaza JD, Tapia RL, Triana CTC, Ramírez LCR. Refractoriness to anti-Helicobacter pylori treatment attributed to phenotypic resistance patterns in patients with gastroduodenopathy in Guayaquil-Ecuador. Helicobacter 2024; 29:e13060. [PMID: 38581134 DOI: 10.1111/hel.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/13/2024] [Accepted: 02/13/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Treatment of Helicobacter pylori gastric infection is complex and associated with increased rates of therapeutic failure. This research aimed to characterize the H. pylori infection status, strain resistance to antimicrobial agents, and the predominant lesion pattern in the gastroduodenal mucosa of patients with clinical suspicion of refractoriness to first- and second-line treatment who were diagnosed and treated in a health center in Guayaquil, Ecuador. METHODS A total of 374 patients with upper gastrointestinal symptoms and H. pylori infection were preselected and prescribed one of three triple therapy regimens for primary infection, as judged by the treating physician. Subsequently, 121 patients who returned to the follow-up visit with persistent symptoms after treatment were studied. RESULTS All patients had H. pylori infection. Histopathological examination diagnosed chronic active gastritis in 91.7% of cases; premalignant lesions were observed in 15.8%. The three triple therapy schemes applied showed suboptimal efficacy (between 47.6% and 77.2%), with the best performance corresponding to the scheme consisting of a proton pump inhibitor + amoxicillin + levofloxacin. Bacterial strains showed very high phenotypic resistance to all five antimicrobials tested: clarithromycin, 82.9%; metronidazole, 69.7%; amoxicillin and levofloxacin, almost 50%; tetracycline, 38.2%. Concurrent resistance to clarithromycin-amoxicillin was 43.4%, to tetracycline-metronidazole 30.3%, to amoxicillin-levofloxacin 27.6%, and to clarithromycin-metronidazole 59.2%. CONCLUSIONS In vitro testing revealed resistance to all five antibiotics, indicating that H. pylori exhibited resistance phenotypes to these antibiotics. Consequently, the effectiveness of triple treatments may be compromised, and further studies are needed to assess refractoriness in quadruple and concomitant therapies.
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Affiliation(s)
- Javier David Lara Icaza
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
- Universidad del Zulia (LUZ), Maracaibo, Venezuela
| | - Rosalina Lara Tapia
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
| | - Cástula Tania Castro Triana
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Meliț LE, Mărginean CO, Borka Balas R. The Most Recent Insights into the Roots of Gastric Cancer. Life (Basel) 2024; 14:95. [PMID: 38255710 PMCID: PMC10817233 DOI: 10.3390/life14010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/01/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide, usually being acquired during childhood, and its persistence into adulthood represents one of the main contributors of gastric carcinogenesis. Based on these statements, it would be of great importance to know if the most early premalignant transformation occurs in children or later since, this would enable the development of effective anti-tumorigenesis strategies. The interplay between H. pylori virulence factors, the host's responses modified by this infection, and the gastric microecology are complex and eventually lead to the development of gastric cancer in susceptible individuals. Several biomarkers were identified as major contributors of this long-lasting process, such as pepsinogens, gastrin 17, lipid-, glucose- and iron-metabolism parameters, immunity players, aberrant bacterial DNA methylation, H. pylori virulence factors, and hallmarks of gastric dysbiosis. Several of these biomarkers were also identified in children with H. pylori infection, independently of the presence of premalignant lesions, which were also proven to be present in a subgroup of H. pylori-infected children, especially those carrying extremely virulent strains. Therefore, the most incipient premalignant gastric changes might indeed occur early during childhood, opening a promising research gate for further studies to delineate the border between infection and cancer.
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Affiliation(s)
| | - Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureș, Gheorghe Marinescu Street, No. 38, 540136 Târgu Mureș, Romania; (L.E.M.)
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Lo HY, Yang YJ. Seroprevalence of Helicobacter pylori infection among schoolchildren in southern Taiwan-A 20-year longitudinal follow-up. Helicobacter 2024; 29:e13049. [PMID: 38558496 DOI: 10.1111/hel.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Helicobacter pylori infection is primarily acquired in childhood and can lead to peptic ulcer diseases and gastric cancer. The prevalence of H. pylori infection varies widely in different countries. The aim of this study was to explore the change of pediatric H. pylori seroprevalence in the past two decades and to investigate the risk factors for pediatric H. pylori seropositivity in southern Taiwan. MATERIALS AND METHODS This study enrolled children aged 7-12 years in Tainan City in 2018 and compared the result with our previous data in 1998, 2005, and 2010. Parents of the participants were invited to fill out questionnaires, including information of personal history, family history of peptic ulcer diseases, annual household income, and source of drinking water. Blood samples were analyzed for anti-H. pylori IgG by enzyme-linked immunosorbent assay. RESULTS A total of 391, 629, 618, and 488 elementary school students in Tainan City were enrolled in 1998, 2005, 2010, and 2018, respectively. There was a significant decline in H. pylori seroprevalence from 9.2% in 1998, 7.8% in 2005, 6.2% in 2010 to 4.7% in 2018 (p < 0.001). Neither gender difference nor age difference was found in H. pylori seropositivity in each year of enrollment. Low household income was significantly associated with pediatric H. pylori seropositivity. CONCLUSIONS The seroprevalence of H. pylori infection among elementary schoolchildren has remarkably declined in southern Taiwan in the past two decades. Low household income was a risk factor for pediatric H. pylori seropositivity.
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Affiliation(s)
- Hsiao-Yu Lo
- Department of Pediatrics and Institutes of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Jong Yang
- Department of Pediatrics and Institutes of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Nguyen J, Kotilea K, Bontems P, Miendje Deyi VY. Helicobacter pylori Infections in Children. Antibiotics (Basel) 2023; 12:1440. [PMID: 37760736 PMCID: PMC10525885 DOI: 10.3390/antibiotics12091440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
In the context of epidemiology, host response, disease presentation, diagnosis, and treatment management, the manifestation of Helicobacter pylori (H. pylori) infection diverges between children and adults. H. pylori infection stands out as one of the most prevalent bacterial infections globally, and its prevalence in both children and adults is decreasing in many developing countries but some still struggle with a high prevalence of pediatric H. pylori infection and its consequences. The majority of infected children are asymptomatic and pediatric studies do not support the involvement of H. pylori in functional disorders such as recurrent abdominal pain. The pathophysiology of H. pylori infection relies on complex bacterial virulence mechanisms and their interaction with the host immune system and environmental factors. This interaction gives rise to diverse gastritis phenotypes, which subsequently influence the potential development of various gastroduodenal pathologies. In clinical settings, the diagnosis of this infection in childhood requires an upper gastrointestinal endoscopic exam with mucosal biopsy samples for histology and culture, or Polymerase Chain Reaction (PCR) at the very least. When warranted, eradication treatment should be given when good compliance is expected, and there should be systematic use of a treatment adapted to the antimicrobial susceptibility profile. To combat the burgeoning threat of multidrug resistance, vigilant surveillance of resistance patterns and strategic antibiotic management are paramount.
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Affiliation(s)
- Julie Nguyen
- Department of Pediatric Gastroenterology, Hopital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Kallirroi Kotilea
- Department of Pediatric Gastroenterology, Hopital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1000 Brussels, Belgium
- Belgian Helicobacter and Microbiota Study Group (BHMSG), 1000 Brussels, Belgium
| | - Patrick Bontems
- Department of Pediatric Gastroenterology, Hopital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, 1000 Brussels, Belgium
- Belgian Helicobacter and Microbiota Study Group (BHMSG), 1000 Brussels, Belgium
| | - Veronique Yvette Miendje Deyi
- Belgian Helicobacter and Microbiota Study Group (BHMSG), 1000 Brussels, Belgium
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Brussel Universitair Laboratorium (LHUB-ULB), Université Libre de Bruxelles, 1000 Brussels, Belgium
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Yang T, Zhang Y, Zhang H, Wu X, Sun J, Hua D, Pan K, Liu Q, Cui G, Chen Z. Intracellular presence and genetic relationship of Helicobacter pylori within neonates' fecal yeasts and their mothers' vaginal yeasts. Yeast 2023; 40:401-413. [PMID: 37565669 DOI: 10.1002/yea.3891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/30/2023] [Accepted: 07/18/2023] [Indexed: 08/12/2023] Open
Abstract
Helicobacter pylori are transmissible from person to person and among family members. Mother-to-child transmission is the main intrafamilial route of H. pylori transmission. However, how it transmits from mother to child is still being determined. Vaginal yeast often transmits to neonates during delivery. Therefore, H. pylori hosted in yeast might follow the same transmission route. This study aimed to detect intracellular H. pylori in vaginal and fecal yeasts isolates and explore the role of yeast in H. pylori transmission. Yeast was isolated from the mothers' vaginal discharge and neonates' feces and identified by internal transcribed spacer (ITS) sequencing. H. pylori 16S rRNA and antigen were detected in yeast isolates by polymerase chain reaction and direct immunofluorescence assay. Genetic relationships of Candida strains isolated from seven mothers and their corresponding neonates were determined by random amplified polymorphic DNA (RAPD) fingerprinting and ITS alignment. The Candida isolates from four mother-neonate pairs had identical RAPD patterns and highly homologous ITS sequences. The current study showed H. pylori could be sheltered within yeast colonizing the vagina, and fecal yeast from neonates is genetically related to the vaginal yeast from their mothers. Thus, vaginal yeast presents a potential reservoir of H. pylori and plays a vital role in the transmission from mother to neonate.
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Affiliation(s)
- Tingxiu Yang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Department of Hospital Infection and Management, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yuanyuan Zhang
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Department of Gastroenterology, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Hua Zhang
- Department of Obstetrics, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Xiaojuan Wu
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Jianchao Sun
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Dengxiong Hua
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Ke Pan
- Department of Gastroenterology, People's Hospital of Qiannan Prefecture, Guizhou, China
| | - Qi Liu
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Guzhen Cui
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zhenghong Chen
- Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou & Joint Laboratory of Helicobacter Pylori and Intestinal Microecology of Affiliated Hospital of Guizhou Medical University, Guizhou Medical University, Guiyang, China
- Key Laboratory of Endemic and Ethnic Diseases of Ministry of Education & Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
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Luo Y, Fu Y, Schwarz S, Wallach T. Comparison of Risk and Severity of Helicobacter Pylori Infection in Non-Native Versus US Native Pediatric Patients. JPGN Rep 2023; 4:e331. [PMID: 37600603 PMCID: PMC10435047 DOI: 10.1097/pg9.0000000000000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/15/2023] [Indexed: 08/22/2023]
Abstract
Introduction Helicobacter pylori (HP) infection is associated with gastritis, peptic ulcer disease (PUD) in the stomach and duodenum, and an increased risk of gastric cancer. The risk of infection, secondary symptoms, and negative outcomes is known to be increased in low- and middle-income countries and vastly less substantial in the United States and Europe. Current North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines recommend endoscopic diagnosis and susceptibility-guided therapy, which is not reflected by current adult guidelines for therapy. In this study, we complete a single-center retrospective review of HP risk by nativity status, as well as the results of the use of standard empiric therapy in HP and PUD patients. Methods We retrospectively reviewed all endoscopies with patients aged 1-21 years with a known nativity status and identified all HP diagnoses. We also completed the classification of Kyoto scores and classified patients as gastritis versus PUD. Treatment records were obtained, as well as downstream documentation of the impact of empiric therapy. HP prevalence and severity were compared between non-native and native US populations. Results In total 332 patients were identified, with 59 HP diagnoses. However, 64 patients were immigrants, and 268 were US natives. Totally 39.1% of all immigrant patients had an endoscopically identified HP infection, compared to only 12.7% of US native patients (P < 0.01, relative risk 3.07). HP severity was worse in immigrant patients (Kyoto score 1.5 versus 0.89; P = 0.008). Empiric high-dose amoxicillin triple therapy was equally effective in reducing symptoms in gastritis versus PUD patients. Conclusions Immigrant patients have a substantially higher risk and severity of HP infection than US natives. Empiric therapy remains highly effective at relieving symptoms. These findings in aggregate suggest that North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines may not adequately serve non-native pediatric patients, with an additional prospective multicenter study needed to confirm. In addition, a prospective study of treatment based on stool antigen tests, as well as a larger prospective study of empiric therapy, may suggest alterations to our approach in line with recent changes to adult Gastroenterology practice.
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Affiliation(s)
- Yan Luo
- From the Department of Pediatrics, SUNY Downstate Health Sciences University
| | - Yinan Fu
- Department of Pediatric Gastroenterology, Children’s Hospital of Los Angeles
| | - Steven Schwarz
- Division of Pediatric Gastroenterology, Department of Pediatrics, SUNY Downstate Health Sciences University
| | - Thomas Wallach
- Division of Pediatric Gastroenterology, Department of Pediatrics, SUNY Downstate Health Sciences University
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Nguyen TC, Tang NLC, Le GKN, Nguyen VT, Nguyen KHG, Che TH, Phan VTT, Nguyen NM, Truong DQ, Ngo XM, Nguyen HT, Robert A, Bontems P, Nguyen PNV. Helicobacter pylori Infection and Peptic Ulcer Disease in Symptomatic Children in Southern Vietnam: A Prospective Multicenter Study. Healthcare (Basel) 2023; 11:healthcare11111658. [PMID: 37297795 DOI: 10.3390/healthcare11111658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) remains a major cause of gastroduodenal diseases. We aimed to evaluate the burden of this infection, particularly peptic ulcer disease in Vietnamese children. METHODS We enrolled consecutive children referred for esophagogastroduodenoscopy at two tertiary children's hospitals in Ho Chi Minh City, from October 2019 to May 2021. Children treated with proton pump inhibitors during the last two weeks or antibiotics for four weeks, and those having a previous or interventional endoscopy were excluded. H. pylori infection was diagnosed with either a positive culture or positive histopathology combined with a rapid urease test, or with a polymerase chain reaction of the urease gene. The study was approved by the Ethics Committee and written informed consent/assent was obtained. RESULTS Among 336 enrolled children aged 4-16 (mean: 9.1 ± 2.4 years; 55.4% girls), H. pylori infection was positive in 80%. Peptic ulcers were detected in 65 (19%), increasing with age, and 25% with anemia. cagA+ strains were detected at a higher rate in children with ulcers. CONCLUSIONS Prevalence of H. pylori and peptic ulcers is high among symptomatic Vietnamese children. It is crucial to have a program for early detection of H. pylori to reduce ulcer risk and gastric cancer later.
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Affiliation(s)
- Tu Cam Nguyen
- Department of Gastroenterology, City Children's Hospital, Ho Chi Minh City 700000, Vietnam
- Faculty of Medicine, Université Libre de Bruxelles, 1020 Brussels, Belgium
| | - Ngoc Le Chau Tang
- Department of Gastroenterology, Children's Hospital 2, Ho Chi Minh City 700000, Vietnam
| | - Giao Kim Ngoc Le
- Department of Microbiology and Parasitology, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
| | - Vy Thuy Nguyen
- Department of Genetics, University of Science-Vietnam National University Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Khuong Hoang Gia Nguyen
- Department of Biostatistics and Informatics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
| | - Thai Hoang Che
- Department of Biostatistics and Informatics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
| | - Van Thi Tuong Phan
- Department of Gastroenterology, City Children's Hospital, Ho Chi Minh City 700000, Vietnam
| | - Ngoc Minh Nguyen
- Department of Gastroenterology, Children's Hospital 2, Ho Chi Minh City 700000, Vietnam
| | - Dinh Quang Truong
- Department of Surgery, City Children's Hospital, Ho Chi Minh City 700000, Vietnam
| | - Xuan Minh Ngo
- Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
| | - Hiep Thanh Nguyen
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
| | - Annie Robert
- Institut de Recherche Expérimentale et Clinique, Pôle d'Épidémiologie et Biostatistique, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Patrick Bontems
- Faculty of Medicine, Université Libre de Bruxelles, 1020 Brussels, Belgium
- Department of Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola, 1020 Brussels, Belgium
| | - Phuong Ngoc Van Nguyen
- Department of Biostatistics and Informatics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
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Che TH, Nguyen TC, Vu VNT, Nguyen HT, Hoang DTP, Ngo XM, Truong DQ, Bontems P, Robert A, Nguyen PNV. Factors Associated With Helicobacter Pylori Infection Among School-Aged Children From a High Prevalence Area in Vietnam. Int J Public Health 2023; 68:1605908. [PMID: 37251301 PMCID: PMC10209423 DOI: 10.3389/ijph.2023.1605908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives: The study aimed to identify prevalence of H. pylori infection and associated risk factors among pupils of Ho Chi Minh city (HCMC). Methods: A total of 1,476 pupils aged 6-15 years were enrolled in this cross-sectional study using multiple-stage sampling method. Infection status was assessed using stool antigen-test. A questionnaire was used to obtain socio-demographic, behavioral, and environmental factors. Logistic regression was performed to assess possible factors related to the infection. Results: Of the 1,409 children included in the analysis, 49.2% were male and 95.8% were of Kinh ethnicity. About 43.5% of parents completed college or university. The overall prevalence of H. pylori was 87.7%. Infrequency of handwashing with soap after toilet, the use of only water to clean after toilet, crowded living areas, larger family size, and younger age were independently contributing to an increased prevalence of H. pylori. Conclusion: H. pylori infection is highly prevalent in HCMC, and is associated with poor hygienic practices, crowded living areas, larger family size, and younger age. These findings highlight the importance of fecal-oral route and the attribution of crowded living conditions to the spreading of H. pylori in HCMC. Therefore, preventive programs should be set up with a focus on education of hygiene practices, and oriented to those living in crowded conditions.
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Affiliation(s)
- Thai Hoang Che
- Department of Biostatistics and Informatics, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Pôle Epidémiologie et Biostatistique (EPID), Institut de Recherche Expérimentale et Clinique (IREC), Faculté de Santé Publique (FSP), Université Catholique de Louvain, Brussels, Belgium
| | - Tu Cam Nguyen
- Department of Gastroenterology, City Children’s Hospital, Ho Chi Minh, Vietnam
| | - Vy Ngoc Thao Vu
- Department of Biostatistics and Informatics, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Hiep Thanh Nguyen
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Dung Thi Phuong Hoang
- Department of Microbiology, Fundamental Sciences and Basic Medical Sciences, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Xuan Minh Ngo
- Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Dinh Quang Truong
- Department of Surgery, City Children’s Hospital, Ho Chi Minh City, Vietnam
| | - Patrick Bontems
- Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Annie Robert
- Pôle Epidémiologie et Biostatistique (EPID), Institut de Recherche Expérimentale et Clinique (IREC), Faculté de Santé Publique (FSP), Université Catholique de Louvain, Brussels, Belgium
| | - Phuong Ngoc Van Nguyen
- Department of Biostatistics and Informatics, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Lupu A, Miron IC, Cernomaz AT, Gavrilovici C, Lupu VV, Starcea IM, Cianga AL, Stana B, Tarca E, Fotea S. Epidemiological Characteristics of Helicobacter pylori Infection in Children in Northeast Romania. Diagnostics (Basel) 2023; 13. [PMID: 36766513 DOI: 10.3390/diagnostics13030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/13/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Although gastritis has been associated with multiple etiologies, in pediatrics the main etiology is idiopathic. Many studies have reported mild-to-severe gastritis Helicobacter pylori (H. pylori) as an etiological factor. We evaluated the distribution of the infection with H. pylori by age, gender and place of living; (2) Methods: A retrospective study was conducted over a period of 3 years, over a cohort of 1757 patients of both sexes, aged between 1 and 18 years, admitted to a regional gastroenterology center in Iasi, Romania, with clinical signs of gastritis which underwent upper gastrointestinal endoscopy. The research was based on the analysis of data from patient observation charts and hospital discharge tickets, as well as endoscopy result registers; (3) Results: Out of the 1757 children, in 30.8% of cases the H. pylori infection was present. Out of them, 26.8% were males and 73.2% females. The average age of children with an H. pylori infection was higher (14.1 + 2.8 DS), compared with children without H. pylori (12.8 + 3.7 SD), an average difference of 1.3 years (95% confidence interval 0.96 to 1.66; p < 0.001). By place of living, children with H. pylori infection were from urban areas at 24.7% and from rural areas at 75.3%; (4) Conclusions: H. pylori infection incidence is still high in children, especially in teenagers, so extensive prevention and treatment programs are needed.
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Galoș F, Boboc C, Ieșanu MI, Anghel M, Ioan A, Iana E, Coșoreanu MT, Boboc AA. Antibiotic Resistance and Therapeutic Efficacy of Helicobacter pylori Infection in Pediatric Patients-A Tertiary Center Experience. Antibiotics (Basel) 2023; 12:antibiotics12010146. [PMID: 36671347 PMCID: PMC9854557 DOI: 10.3390/antibiotics12010146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
One of the most widespread bacterial infections worldwide, Helicobacter pylori is thought to affect almost half of the world's population. Due to rising antibiotic resistance, treatment should be tailored according to antibiotic susceptibility testing (AST). This study aims to evaluate Helicobacter pylori antibiotic resistance and its therapeutic efficacy in children. We conducted a prospective, single-center study, that evaluated 68 children referred for upper gastrointestinal endoscopy (UGE) following chronic dyspeptic syndrome. Each patient underwent multiple biopsies to perform bacterial cultures with AST and histopathological examinations for the diagnosis. Patients without antibiotic resistance or negative cultures received a 10-day sequential therapy, while the others had the antibiotic regimen tailored based on AST. Fifty-nine patients with a positive biopsy-based diagnosis (24 males) were finally included. Bacterial cultures with AST were positive for 13 patients (22.03%) and the antibiotic resistance for clarithromycin was 15.38%. Fifty-seven patients were administered sequential therapy with an eradication rate of 94.73%. Clarithromycin-resistant patients were successfully treated with 10-day triple therapy of esomeprazole, amoxicillin, and metronidazole. Although bacterial cultures had a low positivity rate, sequential therapy had a successful eradication rate. Further studies are necessary to better assess Helicobacter pylori antibiotic resistance to provide tailored treatment and identify children that need closer monitoring.
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Affiliation(s)
- Felicia Galoș
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Cătălin Boboc
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Mara-Ioana Ieșanu
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence:
| | - Mălina Anghel
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Andreea Ioan
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Elena Iana
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Maria Teodora Coșoreanu
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Anca Andreea Boboc
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
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Burgos-Santamaría D, Nyssen OP, Gasbarrini A, Vaira D, Pérez-Aisa Á, Rodrigo L, Pellicano R, Keco-Huerga A, Pabón-Carrasco M, Castro-Fernandez M, Boltin D, Barrio J, Phull P, Kupcinskas J, Jonaitis L, Ortiz-Polo I, Tepes B, Lucendo AJ, Huguet JM, Areia M, Jurecic NB, Denkovski M, Bujanda L, Ramos-San Román J, Cuadrado-Lavín A, Gomez-Camarero J, Jiménez Moreno MA, Lanas A, Martinez-Dominguez SJ, Alfaro E, Marcos-Pinto R, Milivojevic V, Rokkas T, Leja M, Smith S, Tonkić A, Buzás GM, Doulberis M, Venerito M, Lerang F, Bordin DS, Lamy V, Capelle LG, Marlicz W, Dobru D, Gridnyev O, Puig I, Mégraud F, O'Morain C, Gisbert JP. Empirical rescue treatment of Helicobacter pylori infection in third and subsequent lines: 8-year experience in 2144 patients from the European Registry on H. pylori management (Hp-EuReg). Gut 2022; 72:gutjnl-2022-328232. [PMID: 36591610 DOI: 10.1136/gutjnl-2022-328232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/06/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the use, effectiveness and safety of Helicobacter pylori empirical rescue therapy in third and subsequent treatment lines in Europe. DESIGN International, prospective, non-interventional registry of the clinical practice of European gastroenterologists. Data were collected and quality reviewed until October 2021 at Asociación Española de Gastroenterología-Research Electronic Data Capture. All cases with three or more empirical eradication attempts were assessed for effectiveness by modified intention-to-treat and per-protocol analysis. RESULTS Overall, 2144 treatments were included: 1519, 439, 145 and 41 cases from third, fourth, fifth and sixth treatment lines, respectively. Sixty different therapies were used; the 15 most frequently prescribed encompassed >90% of cases. Overall effectiveness remained <90% in all therapies. Optimised treatments achieved a higher eradication rate than non-optimised (78% vs 67%, p<0.0001). From 2017 to 2021, only 44% of treatments other than 10-day single-capsule therapy used high proton-pump inhibitor doses and lasted ≥14 days. Quadruple therapy containing metronidazole, tetracycline and bismuth achieved optimal eradication rates only when prescribed as third-line treatment, either as 10-day single-capsule therapy (87%) or as 14-day traditional therapy with tetracycline hydrochloride (95%). Triple amoxicillin-levofloxacin therapy achieved 90% effectiveness in Eastern Europe only or when optimised. The overall incidence of adverse events was 31%. CONCLUSION Empirical rescue treatment in third and subsequent lines achieved suboptimal effectiveness in most European regions. Only quadruple bismuth-metronidazole-tetracycline (10-day single-capsule or 14-day traditional scheme) and triple amoxicillin-levofloxacin therapies reached acceptable outcomes in some settings. Compliance with empirical therapy optimisation principles is still poor 5 years after clinical practice guidelines update. TRIAL REGISTRATION NUMBER NCT02328131.
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Affiliation(s)
- Diego Burgos-Santamaría
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Enfermedades Hepáticas y Digestivas, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Olga P Nyssen
- Gastroenterology Unit, Hospital Universitario de la Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Antonio Gasbarrini
- Internal Medicine, Gastroenterology and Liver Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italy
| | - Dino Vaira
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Ángeles Pérez-Aisa
- Department of Gastroenterology, Hospital Costa del Sol Marbella, Marbella, Spain
- Redes de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Marbella, Spain
| | - Luís Rodrigo
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Rinaldo Pellicano
- Outpatient Clinic, Molinette-SGAS Hospital, University of Turin, Turin, Italy
| | | | | | - Manuel Castro-Fernandez
- Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Sevilla, Spain
| | - Doron Boltin
- Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Tel Aviv University, Petach Tikva, Israel
| | - Jesus Barrio
- Department of Gastroenterology, Hospital Rio Hortega, Valladolid, Spain
| | | | - Juozas Kupcinskas
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laimas Jonaitis
- Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Inmaculada Ortiz-Polo
- Department of Gastroenterology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Bojan Tepes
- Department of Gastroenterology, AM DC Rogaska, Rogaska Slatina, Slovenia
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain
| | - José María Huguet
- Gastroenterology Unit, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Miguel Areia
- Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
| | | | | | - Luís Bujanda
- Department of Gastroenterology, Hospital Universitario de Donostia, San Sebastian, Spain
- Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastián, Spain
| | - June Ramos-San Román
- Department of Gastroenterology, Hospital Universitario de Donostia, San Sebastian, Spain
| | - Antonio Cuadrado-Lavín
- Department of Gastroenterology and Hepatology, Hospital Universitario Marques de Valdecilla, Santander, Spain
| | | | | | - Angel Lanas
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Enrique Alfaro
- Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Ricardo Marcos-Pinto
- Department of Gastroenterology, Centro Hospitalar do Porto, Porto, Portugal
- CINTESIS, University of Porto Institute of Biomedical Sciences Abel Salazar, Porto, Portugal
| | - Vladimir Milivojevic
- University Clinical Center of Serbia Clinic for Gastroenterology and Hepatology, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Theodore Rokkas
- Department of Gastroenterology, Henry Dunant Hospital Center, Athens, Greece
| | - Marcis Leja
- Digestive Disease Center GASTRO, Institute of Clinical and Preventive Medicine, Riga, Latvia
- University of Latvia Faculty of Medicine, Riga, Latvia
| | - Sinead Smith
- Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Ante Tonkić
- Department of Gastroenterology, University Hospital Center Split Križine, Split, Croatia
| | - György Miklós Buzás
- Department of Gastroenterology, Ferencváros Health Centre, Budapest, Hungary
| | - Michael Doulberis
- Division of Gastroenterology and Hepatology, Kantonsspital Aarau AG, Aarau, Switzerland
- Department of Gastroenterology and Hepatology, University of Zurich, Zurich, Switzerland
| | - Marino Venerito
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany
| | - Frode Lerang
- Department of Gastroenterololgy, Ostfold Hospital, Gralum, Norway
| | - Dmitry S Bordin
- Department of Pancreatic, Biliary and Upper Digestive Tract disorders, AS Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | | | - Lisette G Capelle
- Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Daniela Dobru
- Department of Gastroenterology, University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, Târgu Mures, Romania
| | | | - Ignasi Puig
- Department of Digestive Diseases, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
- Universitat de Vic-Universitat Central de Catalunya (UVicUCC), Manresa, Spain
| | | | - Colm O'Morain
- Department of Gastroenterology, Trinity College Dublin, Dublin, Ireland
| | - Javier P Gisbert
- Gastroenterology Unit, Hospital Universitario de la Princesa, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Che TH, Nguyen TC, Ngo DTT, Nguyen HT, Vo KT, Ngo XM, Truong DQ, Bontems P, Robert A, Nguyen PNV. High Prevalence of Helicobacter pylori Infection Among School-Aged Children in Ho Chi Minh City, VietNam. Int J Public Health 2022; 67:1605354. [PMID: 36439280 PMCID: PMC9684168 DOI: 10.3389/ijph.2022.1605354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives: There is no study on Helicobacter pylori (H. pylori) infection in pupils of Ho Chi Minh city (HCMC), the most overcrowded city in Vietnam. Therefore, the aim of this study was to estimate the prevalence of H. pylori and its geographical spread among school-aged children. Methods: A school-based cross-sectional study was conducted among 1854 pupils across 24 districts of HCMC in 2019. Multiple-stage sampling method was used to enroll pupils. We built a four-points index for geographical division based on population density and employees density to evaluate the link between H. pylori and crowded level. Stool samples were analyzed by monoclonal enzyme-immunoassay stool antigen-test to assess the infection status. Logistic regression was performed to assess possible factors related to H. pylori infection. Results: The overall prevalence of H. pylori was 87.7%. There was a linear increasing trend in the infection rate (p < 0.001) across the 4-points index of HCMC and this trend maintained within both age and gender subgroups (p = 0.02). Conclusion: Prevalence of H. pylori was high and it increased with population density or employees density. Therefore, it is crucial to plan and implement the reduction of H. pylori infection programs by targeting the highly concentrated population areas of HCMC.
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Affiliation(s)
- Thai Hoang Che
- Department of Biostatistics and Informatics, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Pôle Epidémiologie et Biostatistique (EPID), Institut de Recherche Expérimentale et Clinique (IREC), Faculté de Santé Publique (FSP), Université Catholique de Louvain, Brussels, Belgium
| | - Tu Cam Nguyen
- Department of Gastroenterology and Hepatology, City Children’s Hospital, Ho Chi Minh, Vietnam
| | - Dung Thi Thuy Ngo
- Department of Epidemiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Hiep Thanh Nguyen
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Khang Tan Vo
- Department of Physiology, Pathophysiology and Immunology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Xuan Minh Ngo
- Faculty of Medicine, University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Vietnam
| | - Dinh Quang Truong
- Department of Surgery, City Children’s Hospital, Ho Chi Minh, Vietnam
| | - Patrick Bontems
- Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
| | - Annie Robert
- Pôle Epidémiologie et Biostatistique (EPID), Institut de Recherche Expérimentale et Clinique (IREC), Faculté de Santé Publique (FSP), Université Catholique de Louvain, Brussels, Belgium
| | - Phuong Ngoc Van Nguyen
- Department of Biostatistics and Informatics, Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- *Correspondence: Phuong Ngoc Van Nguyen,
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Borka Balas R, Meliț LE, Mărginean CO. Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children. Children 2022; 9:children9091359. [PMID: 36138669 PMCID: PMC9498111 DOI: 10.3390/children9091359] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/22/2022] [Accepted: 09/03/2022] [Indexed: 01/17/2023]
Abstract
Helicobacter pylori is usually acquired during childhood. The reports from the last two decades pointed out a decrease in H. pylori prevalence across geographical areas worldwide compared to previously reported data. Most of the studies performed in America found an overall H. pylori infection prevalence of approximately 50%. The most important risk factors in America include being male, poor adherence or difficult access to treatment, and the lack of in-home water service. Despite the descending trend in prevalence worldwide, the overall prevalence in Africa remains very high (70%). Nevertheless, the prevalence of H. pylori in children without gastrointestinal who underwent screening was reported to be only 14.2%. The main risk factors in Africa are having a traditional pit or no toilet, poverty, birth order, source of drinking water, or being a farmer. Asia seems to have the widest variations in terms of H. pylori prevalence. Several risk factors were reported in Asia to be associated with this infection, such as lower income and educational level, house crowding, rural residence, ethnicity, the use of tanks as water supplies, alcohol drinking, active smoking, eating spicy food or raw uncooked vegetables, poor living conditions and sanitation. The overall prevalence of H. pylori infection in European children is almost 25%. Portugal has the highest prevalence of all European countries at 66.2% in children 13 years of age. The risk factors in European individuals consist of living in rural areas, eating unwashed fruits and vegetables, not washing hands after school, low parental education and unemployment, and short education duration. Further studies are required to identify the precise mechanisms involved in the discrepancies of H. pylori prevalence worldwide.
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KEÇELİ BAŞARAN M, ZENGİN NŞ. Can Saccharomyces boulardii treat and eradicate Helicobacter pylori among children instead of bismuth? J Health Sci Med / JHSM 2022. [DOI: 10.32322/jhsm.1084384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The objective of this study is to compare the use of Saccharomyces boulardii (S. boulardii) in eradicating Helicobacter pylori (H. pylori) in children as an alternative to bismuth, which has a limited scope of application due to its side effects.
Material and Method: Included in the study were 220 pediatric patients with symptomatic H. pylori gastritis. The patients were randomized into three treatment groups. Patients who received bismuth or S. boulardii in addition to the standard triple therapy for 14 days were compared with the control group who received only triple therapy.
Results: Analysis of the bismuth, S. boulardii, and control groups’ treatment success showed that the H. pylori eradication rate was highest among study participants who received bismuth (95.2%), followed by patients who received S. boulardii (92.4%). The most frequent side effects were observed in the patient group that received bismuth (17.5%).
Conclusion: Although bismuth continues to be successful in eradicating H. pylori, alternative treatment protocols are necessary because of its side effects and limited use in pediatric patients. S. boulardii can be administered instead when bismuth can not serve as alternative due to its side effects.
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Affiliation(s)
- Meryem KEÇELİ BAŞARAN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL GAZİOSMANPAŞA SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
| | - Nur Şeyma ZENGİN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL GAZİOSMANPAŞA SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
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Mehdipour A, Chaboki P, Rasouli Asl F, Aghaali M, Sharifinejad N, Shams S. Comparing the prevalence of Helicobacter pylori and virulence factors cagA, vacA, and dupA in supra-gingival dental plaques of children with and without dental caries: a case-control study. BMC Oral Health 2022; 22:170. [PMID: 35534888 PMCID: PMC9087938 DOI: 10.1186/s12903-022-02175-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background Helicobacter pylori infection is one of the most common infectious diseases in humans. Dental plaque is considered as a reservoir of this bacterium, which could play an important role in the development of gastrointestinal problems. Our aim was to investigate the prevalence of H. pylori and its virulence factors in dental plaques in children with and without dental caries. Methods Among children aged 6 to 12 years, a total of 72 children were enrolled in the study, including 36 cases with total DMFT/dmft > 3 (case group) and 36 participants with total DMFT/dmft < 1 (control group). After removing supra-gingival plaques from the lower first permanent molar teeth, the samples were examined using PCR method for the presence of H. pylori and some of its virulence factors. Statistical analysis was performed using chi-square, Fisher' exact test, t-tests, and logistic regression. Results Of 72 participants, 40 cases were male, and 32 cases were female. The minimum and maximum values of total DMFT/dmft indices were zero and ten, respectively, and the mean ± SD value of total DMFT/dmft was 2.78 ± 3.22. Except for vegetable consumption (p = 0.045), there was no significant difference between the two groups regarding gastrointestinal disorders, feeding methods in infancy (p = 0.058), frequency of daily brushing (p = 0.808), frequency of dental visits (p = 0.101), and history of dental scaling (p = 0.246) and professional topical fluoride therapy (p = 0.5). Out of 72 samples, 15 cases were positive for H. pylori DNA (20.8%), and there was no significant association between the presence of this bacterium in dental plaque and dental caries (p = 0.281). The frequency of virulence factors detected in 15 H. pylori cases was as follows: cagA in six cases (40.0%), vacAm1 in three cases (20.0%), and vacAs1 in one case (6.7%). There was no significant difference between the groups regarding the prevalence of virulence factors. Conclusion Our results indicate the presence of H. pylori along with some virulence factors in dental plaques as a reservoir of this bacterium in children in Iran. Although there was no significant association between this bacterium and the incidence of dental caries, dental health in children needs to be seriously taken into consideration.
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Affiliation(s)
- Aida Mehdipour
- Department of Pediatric Dentistry, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran.,Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Parisa Chaboki
- Student Research Committee, Qom University of Medical Sciences, Qom, Iran
| | - Farzaneh Rasouli Asl
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Aghaali
- Department of Epidemiology, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Negar Sharifinejad
- Student Research Committee, Qom University of Medical Sciences, Qom, Iran
| | - Saeed Shams
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran.
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Yuan C, Adeloye D, Luk TT, Huang L, He Y, Xu Y, Ye X, Yi Q, Song P, Rudan I. The global prevalence of and factors associated with Helicobacter pylori infection in children: a systematic review and meta-analysis. Lancet Child Adolesc Health 2022; 6:185-194. [PMID: 35085494 DOI: 10.1016/s2352-4642(21)00400-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Synthesised data on the prevalence of, and factors associated with, paediatric Helicobacter pylori infection at the global level remain scarce. We aimed to estimate the global prevalence of H pylori infection and its associated factors in children and adolescents. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, and Scopus for observational population-based studies published between database inception and Oct 25, 2021, without language or geographical restrictions. We included studies that reported the prevalence of H pylori infection in children aged 18 years or younger. Records were screened and data were extracted using a standardised extraction form. We estimated the worldwide prevalence of H pylori infection in children (our main outcome) using multilevel mixed-effects meta-regression and then stratified prevalence by diagnostic method (serology vs urea breath tests or stool antigen tests). We analysed the significance of associated factors using a random-effects meta-analysis. This study is registered in PROSPERO, CRD42020209717. FINDINGS We identified 3181 records, of which 198 articles with 632 data points from 152 650 children were included. The overall global prevalence of H pylori infection in children was 32·3% (95% CI 27·3-37·8), which varied by diagnostic test (28·6% [23·0-35·0] for serology vs 35·9% [29·2-43·2] for urea breath tests or stool antigen tests). Regardless of diagnostic test, the prevalence of H pylori infection was significantly higher in low-income and middle-income countries than in high-income countries (43·2% [36·5-50·2] vs 21·7% [16·9-27·4]; p<0·0001) and in older children than in younger children (41·6% [35·6-47·8] in 13-18-year-olds vs 33·9% [28·6-39·7] in 7-12-year-olds vs 26·0% [21·4-31·0] in 0-6-year-olds; p<0·0001). Paediatric H pylori infection was significantly associated with lower economic status (odds ratio [OR] 1·63 [95% CI 1·46-1·82]), more siblings or children (1·84 [1·44-2·36]), room sharing (1·89 [1·49-2·40]), no access to a sewage system (1·60 [1·22-2·10]), having a mother infected with H pylori (3·31 [2·21-4·98]), having a sibling or siblings infected with H pylori (3·33 [1·53-7·26]), drinking unboiled or non-treated water (1·52 [1·32-1·76]), and older age (OR per year 1·27 [1·15-1·40]). INTERPRETATION H pylori infection is still highly prevalent in children and adolescents globally. Our findings can help to guide further research and the development and implementation of preventive and therapeutic measures to reduce H pylori infection in children. FUNDING None.
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Affiliation(s)
- Changzheng Yuan
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Liyan Huang
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yusa He
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunhan Xu
- Department of Maternal and Child health, School of Public Health, Peking University, Beijing, China
| | - Xinxin Ye
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Rowland M. The continuing decline in the prevalence of Helicobacter pylori infection. Lancet Child Adolesc Health 2022; 6:139-140. [PMID: 35085495 DOI: 10.1016/s2352-4642(22)00026-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Marion Rowland
- School of Medicine, Catherine McAuley Research Centre, University College Dublin, Dublin D07 A8NN, Ireland.
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21
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Bai X, Jiang L, Ruan G, Liu T, Yang H. Helicobacter pylori may participate in the development of inflammatory bowel disease by modulating the intestinal microbiota. Chin Med J (Engl) 2022. [PMID: 35234697 DOI: 10.1097/CM9.0000000000002008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/04/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a non-specific inflammatory disease of the gastrointestinal (GI) tract that is generally accepted to be closely related to intestinal dysbiosis in the host. GI infections contribute a key role in the pathogenesis of IBD; however, although the results of recent clinical studies have revealed an inverse correlation between Helicobacter pylori (H. pylori) infection and IBD, the exact mechanism underlying the development of IBD remains unclear. H. pylori, as a star microorganism, has been a focus for decades, and recent preclinical and real-world studies have demonstrated that H. pylori not only affects the changes in the gastric microbiota and microenvironment but also influences the intestinal microbiota, indicating a potential correlation with IBD. Detailed analysis revealed that H. pylori infection increased the diversity of the intestinal microbiota, reduced the abundance of Bacteroidetes, augmented the abundance of Firmicutes, and produced short-chain fatty acid-producing bacteria such as Akkermansia. All these factors may decrease vulnerability to IBD. Further studies investigating the H. pylori-intestinal microbiota metabolite axis should be performed to understand the mechanism underlying the development of IBD.
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Gallardo Padilla M, León Falconi JL, Sánchez-nebreda Arias R, Gómez Santos C, Muñoz Egea MDC, Orden Izquierdo EL. Impact of the use of molecular techniques (PCR) on detection and eradication success against Helicobacter pylori. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpede.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
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Broekaert IJ, Borrelli O, Dolinsek J, Martin-de-Carpi J, Mas E, Miele E, Pienar C, Ribes-Koninckx C, Thomassen R, Thomson M, Tzivinikos C, Benninga M. An ESPGHAN Position Paper on the Use of Breath Testing in Paediatric Gastroenterology. J Pediatr Gastroenterol Nutr 2022; 74:123-137. [PMID: 34292218 DOI: 10.1097/mpg.0000000000003245] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Given a lack of a systematic approach to the use of breath testing in paediatric patients, the aim of this position paper is to provide expert guidance regarding the indications for its use and practical considerations to optimise its utility and safety. METHODS Nine clinical questions regarding methodology, interpretation, and specific indications of breath testing and treatment of carbohydrate malabsorption were addressed by members of the Gastroenterology Committee (GIC) of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN).A systematic literature search was performed from 1983 to 2020 using PubMed, the MEDLINE and Cochrane Database of Systematic Reviews. Grading of Recommendations, Assessment, Development, and Evaluation was applied to evaluate the outcomes.During a consensus meeting, all recommendations were discussed and finalised. In the absence of evidence from randomised controlled trials, recommendations reflect the expert opinion of the authors. RESULTS A total of 22 recommendations were voted on using the nominal voting technique. At first, recommendations on prerequisites and preparation for as well as on interpretation of breath tests are given. Then, recommendations on the usefulness of H2-lactose breath testing, H2-fructose breath testing as well as of breath tests for other types of carbohydrate malabsorption are provided. Furthermore, breath testing is recommended to diagnose small intestinal bacterial overgrowth (SIBO), to control for success of Helicobacter pylori eradication therapy and to diagnose and monitor therapy of exocrine pancreatic insufficiency, but not to estimate oro-caecal transit time (OCTT) or to diagnose and follow-up on celiac disease. CONCLUSIONS Breath tests are frequently used in paediatric gastroenterology mainly assessing carbohydrate malabsorption, but also in the diagnosis of small intestinal overgrowth, fat malabsorption, H. pylori infection as well as for measuring gastrointestinal transit times. Interpretation of the results can be challenging and in addition, pertinent symptoms should be considered to evaluate clinical tolerance.
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Affiliation(s)
- Ilse Julia Broekaert
- Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Osvaldo Borrelli
- Department of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK
| | - Jernej Dolinsek
- Department of Paediatrics, University Medical Centre Maribor, Maribor, Slovenia
| | - Javier Martin-de-Carpi
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Emmanuel Mas
- Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France; IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France
| | - Erasmo Miele
- Department of Translational Medical Science, Section of Paediatrics, University of Naples "Federico", Naples, Italy
| | - Corina Pienar
- Department of Paediatrics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Carmen Ribes-Koninckx
- Department of Paediatric Gastroenterology, Hepatology & Nutrition, La Fe University Hospital, Valencia, Spain
| | - Rut Thomassen
- Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Norway
| | - Mike Thomson
- Centre for Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, UK
| | - Christos Tzivinikos
- Department of Paediatric Gastroenterology, Al Jalila Children's Specialty Hospital, Dubai, UAE
| | - Marc Benninga
- Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Hung CW, Chen SCC, Ku LJE, Sheu BS, Yang YJ. A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection. Front Pediatr 2022; 10:860960. [PMID: 35592847 PMCID: PMC9110685 DOI: 10.3389/fped.2022.860960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection is a major cause of peptic ulcers and gastric cancer. This study aimed to compare the eradication rate and essential costs of culture-based and empiric therapy strategies in treating pediatric H. pylori infection. METHODS We retrospectively enrolled patients aged <18 years with a diagnosis of H. pylori infection who received esophagogastroduodenoscopy at two medical centers in southern Taiwan from 1998 to 2018. Patients with positive cultures and minimum inhibitory concentration test results were allocated to a culture-based strategy, and those with negative cultures or without culture as an empiric therapy strategy. We collected demographic data and eradication rates, and calculated the total essential costs of treating a hypothetical cohort of 1,000 pediatric patients based on the two strategies. RESULTS Ninety-six patients were enrolled, of whom 55 received a culture-based strategy and 41 received an empiric therapy strategy. The eradication rates with the first treatment were 89.1 and 75.6% in the culture-based and empiric therapy strategy, respectively. There were no significant differences in age, sex, and endoscopic diagnosis between the two strategies. For every 10% increase in those receiving a culture-based strategy, the total cost would have been reduced by US$466 in a hypothetical cohort of 1,000 patients. For every 10% increase in successful eradication rate, the total cost was reduced by US$24,058 with a culture-based strategy and by US$20,241 with an empiric therapy strategy. CONCLUSIONS A culture-based strategy was more cost effective than an empiric therapy strategy in treating pediatric H. pylori-infected patients.
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Affiliation(s)
- Chi-Wen Hung
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Pediatrics and Institute of Clinical Medicine, National Cheng Kung University Hospital, Medical College, National Cheng Kung University, Tainan, Taiwan
| | - Solomon Chih-Chen Chen
- Department of Pediatrics, Taitung Christian Hospital, Taitung, Taiwan.,Department of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Department of Pediatrics and Institute of Clinical Medicine, National Cheng Kung University Hospital, Medical College, National Cheng Kung University, Tainan, Taiwan.,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Jong Yang
- Department of Pediatrics and Institute of Clinical Medicine, National Cheng Kung University Hospital, Medical College, National Cheng Kung University, Tainan, Taiwan
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Bonilla S, Bousvaros A, Cardini J, Estrella-Pimentel L, Mitchell PD, Goldshine J, Hirsch R, Jonas M, Fox V. Lessons From a Quality Improvement Project to Standardize the Process of Gastric Biopsy Culture for Helicobacter pylori. JPGN Rep 2021; 2:e116. [PMID: 37206447 PMCID: PMC10191519 DOI: 10.1097/pg9.0000000000000116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 07/23/2021] [Indexed: 05/21/2023]
Abstract
Despite expert recommendations, clinician's adherence to pediatric societal clinical practice guidelines is variable, particularly with respect to the use of gastric biopsy culture in the initial diagnosis of Helicobacter pylori infection. In addition, the implementation of routine use of gastric biopsy culture has been challenging with several factors affecting the rate of successful primary H pylori culture. Methods We conducted a quality improvement (QI) project with the aims of increasing the rate of successful primary culture. The QI project involved educational efforts among our gastroenterologists, endoscopy suite personnel, and laboratory personnel. We compared the frequency of gastric biopsy culture sent in patients with international classification of diseases 9th revision code 041.86, and 10th revision codes B96.81 evaluated by pediatric gastroenterologists at Boston Children's Hospital during the 9 months before the QI intervention (February 1, 2019 to October 31, 2019) and 9 months after the QI intervention (November 1 2019 to July 31 2020). We also compared the rate of culture growth in patients with positive histology (culture positivity), and antimicrobial susceptibilities before and after November 1, 2019. Results We observed an increased frequency of gastric biopsy acquisition by any gastroenterologist, obtained in 39% (28 of 71) preintervention patients compared with 67% (36 of 54) intervention patients (P = 0.004). There was an increase in the percentage of culture positivity across study periods from 21% (3 of 14) preintervention to 45% (5 of 11) postintervention (P = 0.39; 95% confidence interval, 0.64-7.00). Conclusion Educational initiatives and collaborative work with staff physicians, endoscopy personnel, and hospital laboratory appear to be effective tools to increase usage of gastric biopsy culture as a diagnostic tool for H pylori infection and to increase culture positivity. Improving the surveillance of local resistance rates will improve the selection of the most effective primary treatment in specific geographic areas.
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Affiliation(s)
- Silvana Bonilla
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Athos Bousvaros
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Jeff Cardini
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | | | - Paul D. Mitchell
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Jana Goldshine
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Rebecca Hirsch
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Maureen Jonas
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
| | - Victor Fox
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA
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Yu F, Qin S, Wang S, Wang J. Regular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14548. [PMID: 34137145 DOI: 10.1111/ijcp.14548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is the most common cause of gastric cancer. Growing evidence suggests that the regular arrangement of collecting venules (RAC) can be used as an endoscopic marker to diagnose H. pylori infection. However, data on the diagnostic accuracy of RAC for H. pylori infection are conflicting. We performed a systematic review and meta-analysis of relevant studies to determine the diagnostic accuracy and clinical utility of RAC for the diagnosis of H. pylori infection. METHODS We systematically searched PubMed, Embase, Web of Science and the Cochrane Library between inception and Oct 29, 2020, for studies that assessed the diagnostic accuracy of RAC for H. pylori infection. RESULTS The literature search yielded 2921 non-duplicated screened titles, of which 58 underwent full-text review. Fifteen studies, representing a total of 6621 patients, met the inclusion criteria. The area under the summary receiver operating characteristic curve was 0.98 (95% CI 0.96-0.99). The pooled estimates for RAC were 0.98 (95% CI 0.95-0.99) for sensitivity and 0.75 (95% CI 0.54-0.88) for specificity. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 3.8 (95% CI 1.9-7.7) and 0.03 (95% CI 0.02-0.07), respectively. CONCLUSIONS RAC can be used as an endoscopic marker for exclusion of H. pylori infection. However, it cannot be recommended as a single indicator for the confirmation of H. pylori infection. The conclusion of this study should be treated with caution because significant heterogeneity exists between the evaluated studies.
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Affiliation(s)
- Fan Yu
- Department of Gastroenterology and Hepatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shaoyou Qin
- Department of Gastroenterology and Hepatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Song Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Jiangbin Wang
- Department of Gastroenterology and Hepatology, China-Japan Union Hospital of Jilin University, Changchun, China
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Szaflarska-Popławska A, Soroczyńska-Wrzyszcz A. Effect of Helicobacter Pylori Infection on Nutritional Status in Polish Teenagers. Gastroenterol Res Pract 2021; 2021:6678687. [PMID: 33859683 DOI: 10.1155/2021/6678687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/04/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Data on an association between Helicobacter pylori (H. pylori) and nutritional status in children are conflicting. We designed a large-sampled prospective community-based study to examine the differences in average body indices among Polish teenagers depending on their H. pylori status. Methods From September 2008 to June 2015, 3067 second junior high school students aged between 13 and 17 years (mean age: 14.5) from 11 randomly selected schools from Grudziadz, Poland, were recruited. For the cohort, 13C urea breath test for current H. pylori infection was performed and data on anthropometric measurements and sociodemographic characteristics were collected. Z scores of height for age (HAZ), weight for age (WAZ), and BMI for age (BMIZ) were calculated. Results The H. pylori colonisation rate was 23.6% with no gender difference. Compared to noninfected, H. pylori infected had significantly lower mean WAZ (0.0085) and BMIZ scores (p = 0.0246). Univariate linear regression models showed that living in the old town district and consumption of tap water were negative predictors of HAZ, living in the old town district, using collective catering facilities, and H. pylori infection were negative predictors of WAZ, and using collective catering facilities and H. pylori infection were negative predictors of BMIZ. In the multiple regression analyses, living in the old town district (p = 0.0039), using collective catering facilities (p < 0.0001), and H. pylori infection (p = 0.0269) were confirmed to be independently associated with lower WAZ, whereas using collective catering facilities (p < 0.0001) and H. pylori infection (p = 0.0265) were confirmed to be independently associated also with lower BMIZ. Conclusion Our finding confirms the evidence on independent negative influence of H. pylori infection on nutritional status in Polish teenagers.
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Gallardo Padilla M, León Falconi JL, Sánchez-Nebreda Arias R, Gómez Santos C, Muñoz Egea MDC, la Orden Izquierdo E. [Impact of the use of molecular techniques (PCR) on detection and eradication success against Helicobacter pylori]. An Pediatr (Barc) 2021; 96:S1695-4033(20)30502-6. [PMID: 33431330 DOI: 10.1016/j.anpedi.2020.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Helicobacter pylori (H. pylori) infection affects more than 50% of the world population. Increased antibiotic resistance is the main cause of treatment failure. The main objective was to analyze the eradication success after the application of the new ESPGHAN treatment recommendations and the introduction of PCR as a direct diagnosis technique, describe the evolution of the local pattern of antibiotic resistance, and assess the cost-effectiveness of PCR application, isolated or in conjunction with culture as a diagnostic strategy. PATIENTS AND METHODS retrospective descriptive study of all microbiological isolates of H. pylori in 2013-2019 in our center, by comparing the percentage of resistance and eradication success between the periods 2013-2016 and 2017-2019. Cost-effectiveness study of direct diagnostic tests, comparing 3 different options: culture and PCR; only culture; PCR only. RESULTS 192 patients were included, 98 were detected by culture (2013-2016) and 94 by culture and / or PCR (2017-2019). Antibiotic treatment was established in 153 patients, 90 in the first period (2011 ESPGHAN guidelines: eradication percentage 62.2%), 63 in the second (2017 ESPGHAN guidelines: eradication percentage: 73%). An increase in resistance to clarithromycin was observed, going from 16.3% (n=16) in the first period, to 53.2% (n=48) in 2017-2019 (98% detected by PCR, 60% by culture). There were no differences in the rest of antibiotic resistances. The isolated PCR application presented a cost-effectiveness analysis ratio (CEAR) of 71.91, compared to 92.16 for the culture and 96.35 for the culture and PCR combined. CONCLUSIONS the application of the ESPGHAN 2017 guidelines achieved greater eradication success, although less than that observed in previous publications, without reaching the target of at least 90%. An increase in resistance to macrolides was observed, without being able to discriminate whether it is a real increase or a greater diagnostic sensitivity of molecular techniques, with the isolated request for PCR being the most cost-effective strategy.
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Affiliation(s)
- Miguel Gallardo Padilla
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid.
| | - José Luis León Falconi
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid
| | - Rafael Sánchez-Nebreda Arias
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid
| | - Carmen Gómez Santos
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid
| | - María Del Carmen Muñoz Egea
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid
| | - Enrique la Orden Izquierdo
- Unidad de Gastroenterología Pediátrica, Servicio de Pediatría, Servicio de Microbiología, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Madrid
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Abstract
Background: Developmental disorders and high Helicobacter pylori (H. pylori) infection rates have been reported. This study aimed to examine the prevalence of H. pylori in a special needs school where all students had developmental disorders in Japan. Methods: In 2017, third-grade junior high school and second- and third-grade high school students attending a special needs school with developmental disorders were enrolled. Participants of Saga Prefecture's H. pylori test and treat project, which comprised third-grade junior high school students not from special needs school, were assigned to the control group. Results: In the control group, H. pylori positive results were 3.18% (228/7,164) students. Similarly, in developmental disorder group, H. pylori positive results were 6.80% (13/191) students. For the developmental disorder and control groups, this present examination sensitivity was 7.03% (13/185), specificity was 96.76% (6,815/7,043), positive predictive value was 5.39% (13/241), negative predictive value was 97.54% (6,815/6,987), Likelihood ratio of a positive result 2.17 and Odds ratio was 2.26 (95% confidence interval: 1.27-4.03, p = 0.005). Conclusion: The prevalence of H. pylori infection was significantly higher in adolescents with developmental disorders than in typically developing adolescents.
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Affiliation(s)
- Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, Saga, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
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Park JS, Jun JS, Seo JH, Youn HS, Rhee KH. Changing prevalence of Helicobacter pylori infection in children and adolescents. Clin Exp Pediatr 2021; 64:21-25. [PMID: 32668822 PMCID: PMC7806412 DOI: 10.3345/cep.2019.01543] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
Helicobacter pylori infection has declined over recent decades. However, its prevalence remains high, and nearly 50% of the global population has been infected. In Korea, seroprevalence has steadily decreased in adults, but the status of H. pylori infection in children is unknown. The current status or trend of H. pylori infection in children is important because it can help estimate H. pylori-related diseases including gastric cancer in later life. In this review, the authors discuss the change in H. pylori infection rate among children and adolescents based on literature reviews and our research.
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Affiliation(s)
- Ji Sook Park
- Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea
| | - Jin Su Jun
- Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea
| | - Ji-Hyun Seo
- Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea
| | - Hee-Shang Youn
- Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea
| | - Kwang-Ho Rhee
- Institute of Health Sciences, Gyeongsang National University Hospital, Jinju, Korea.,Department of Microbiology, Gyeongsang National University College of Medicine, Jinju, Korea
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31
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Lucero Y, Lagomarcino AJ, Torres JP, Roessler P, Mamani N, George S, Huerta N, Gonzalez M, O'Ryan M. Helicobacter pylori, clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage in healthy school-aged children: A case-control study. Int J Infect Dis 2021; 103:423-30. [PMID: 33278617 DOI: 10.1016/j.ijid.2020.11.202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/14/2020] [Accepted: 11/26/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Helicobacter pylori is acquired largely in early childhood, but its association with symptoms and indirect biomarkers of gastric damage in apparently healthy children remains controversial. We aimed to relate persistent H. pylori infection in apparently healthy school-aged children with clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage using a case-control design. MATERIALS AND METHODS We followed up 83 children aged 4-5 years with persistent H. pylori infection determined by stool antigen detection and/or a urea breath test and 80 noninfected matched controls from a low-income to middle-income, periurban city in Chile for at least 3 years. Monitoring included clinical visits every 4 months and annual assessment by a pediatric gastroenterologist. A blood sample was obtained to determine laboratory parameters potentially associated with gastric damage (hemogram and serum iron and ferritin levels), biomarkers of inflammation (cytokines, pepsinogens I and II, and tissue inhibitor metalloproteinase 1), and expression of cancer-related genes KLK1, BTG3, and SLC5A8. RESULTS Persistently infected children had higher frequency of epigastric pain on physical examination (40% versus 16%; P = 0.001), especially from 8 to 10 years of age. No differences in anthropometric measurements or iron-deficiency parameters were found. Persistent infection was associated with higher levels of pepsinogen II (median 12.7 ng/mL versus 9.0 ng/mL; P < 0.001); no difference was observed in other biomarkers or gene expression profiles. CONCLUSIONS H. pylori infection in apparently asymptomatic school-aged children is associated with an increase in clinical symptoms and in the level of one significant biomarker, pepsinogen II, suggesting early gastric involvement.
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Ambay TM, Schick P, Grimm M, Sager M, Schneider F, Koziolek M, Siegmund W, Schindele F, Haas R, Weitschies W. Design and Optimization of a Novel Strategy for the Local Treatment of Helicobacter pylori Infections. J Pharm Sci 2020; 110:1302-1309. [PMID: 33253724 DOI: 10.1016/j.xphs.2020.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/03/2020] [Accepted: 11/20/2020] [Indexed: 12/01/2022]
Abstract
Infections with Helicobacter pylori are a global challenge. Currently, H. pylori infections are treated systemically, but the eradication rates of the different therapy regimens are declining due to the growing number of bacterial strains resistant to major antibiotics. Here, we present a strategy for the local eradication of H. pylori by the use of Penicillin G sodium (PGS). In vitro experiments revealed that PGS shows high antibiotic activity against resistant strains of Helicobacter pylori with a minimum inhibitory concentration (MIC) of 0.125 μg/ml. In order to provide luminal concentrations above the MIC for longer periods of time, an extended release tablet was developed. Alkalizers were included to prevent acidic degradation of PGS within the tablet matrix. Out of the tested alkalizers MgO, l-Lysine, NaHCO3, and Na2CO3 NaHCO3 provided the strongest rise in pH inside the hydrated matrix when tested in simulated gastric fluid. Better PGS stability can mainly reasoned from that, addition of MgO resulted in high pH values within the matrix, causing basic degradation of PGS. This work is a first step towards the use of extended release tablets containing PGS for the local treatment of H. pylori as a safe and cost-effective alternative to common systemic treatment regimens.
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Affiliation(s)
- Taddese Mekonnen Ambay
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Philipp Schick
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Michael Grimm
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Maximilian Sager
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Felix Schneider
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Mirko Koziolek
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany
| | - Werner Siegmund
- Department of Clinical Pharmacology, Center of Drug Absorption and Transport, University Medicine, Greifswald, Germany
| | - Franziska Schindele
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Germany
| | - Rainer Haas
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Germany
| | - Werner Weitschies
- Department of Biopharmaceutics and Pharmaceutical Technology, Center of Drug Absorption and Transport, University of Greifswald, Greifswald, Germany.
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Pundak OY, Topf Olivestone C, Hofi L, Kori M. Lack of association between Helicobacter pylori infection and childhood overweight/obesity. Helicobacter 2020; 25:e12728. [PMID: 32686284 DOI: 10.1111/hel.12728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The reduction in the prevalence of Helicobacter pylori (H. pylori) infection in developed countries coincides with the increasing incidence of obesity and might be a contributing factor to the obesity epidemic. We aimed to evaluate the association between H. pylori infection and childhood overweight/ obesity in Israeli children. MATERIAL AND METHODS Patients diagnosed with H. pylori infection by endoscopy, histology, and a positive culture, between January 2013 and August 2018, were identified and compared with H. pylori-negative children, of the same age and gender, undergoing endoscopy for the same indications during the same time period. Data collected included the following: age, gender, height, weight, BMI, BMI percentile, and the indication for endoscopy. Patients with missing anthropometric data or having a disease affecting growth were excluded. RESULTS We included 146 H. pylori-positive children and 146 age- and gender-matched H. pylori-negative patients. 63.7% (186/292) were female, mean age 13.1 ± 3.7. Overweight (BMI between the 85th-95th percentile) and obesity (BMI > 95th percentile) were present in 56/292 (19.2%). Among the H. pylori-positive children, 11.6% were overweight, 7.5% obese, among the H. pylori-negative children, 10.3% were overweight, 8.9% obese, demonstrating no differences between the groups. The main indication for endoscopy was abdominal/ epigastric pain in 79.8% (233/292). The percent of children with a BMI ≥ 85% did not differ by gender age or the indication for endoscopy. CONCLUSIONS No association between H. pylori infection and childhood overweight/ obesity was demonstrated. This is in contrasts with previous pediatric studies demonstrating an inverse correlation.
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Affiliation(s)
- Oryan Y Pundak
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Lilach Hofi
- Pediatric Gastroenterology, Kaplan Medical Center, Rehovot, Israel
| | - Michal Kori
- Pediatric Gastroenterology, Kaplan Medical Center, Rehovot, Israel
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Kori M, Le Thi TG, Werkstetter K, Sustmann A, Bontems P, Lopes AI, Oleastro M, Iwanczak B, Kalach N, Misak Z, Cabral J, Homan M, Cilleruelo Pascual ML, Pehlivanoglu E, Casswall T, Urruzuno P, Martinez Gomez MJ, Papadopoulou A, Roma E, Dolinsek J, Rogalidou M, Urbonas V, Chong S, Kindermann A, Miele E, Rea F, Cseh Á, Koletzko S; Helicobacter pylori Working Group of ESPGHAN. Helicobacter pylori Infection in Pediatric Patients Living in Europe: Results of the EuroPedHP Registry 2013 to 2016. J Pediatr Gastroenterol Nutr 2020; 71:476-83. [PMID: 32541200 DOI: 10.1097/MPG.0000000000002816] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of the study was to assess clinical presentation, endoscopic findings, antibiotic susceptibility and treatment success of Helicobacter pylori (H. pylori) infected pediatric patients. METHODS Between 2013 and 2016, 23 pediatric hospitals from 17 countries prospectively submitted data on consecutive H. pylori-infected (culture positive) patients to the EuroPedHP-Registry. RESULTS Of 1333 patients recruited (55.1% girls, median age 12.6 years), 1168 (87.6%) were therapy naïve (group A) and 165 (12.4%) had failed treatment (group B). Patients resided in North/Western (29.6%), Southern (34.1%) and Eastern Europe (23.0%), or Israel/Turkey (13.4%). Main indications for endoscopy were abdominal pain or dyspepsia (81.2%, 1078/1328). Antral nodularity was reported in 77.8% (1031/1326) of patients, gastric or duodenal ulcers and erosions in 5.1% and 12.8%, respectively. Primary resistance to clarithromycin (CLA) and metronidazole (MET) occurred in 25% and 21%, respectively, and increased after failed therapy. Bacterial strains were fully susceptible in 60.5% of group A, but in only 27.4% of group B. Primary CLA resistance was higher in Southern and Eastern Europe (adjusted odds ratio [ORadj] = 3.44, 95% confidence interval [CI] 2.22-5.32, P < 0.001 and 2.62, 95% CI: 1.63-4.22, P < 0.001, respectively) compared with Northern/Western Europe. Children born outside Europe showed higher primary MET resistance (ORadj = 3.81, 95% CI: 2.25-6.45, P < 0.001). Treatment success in group A reached only 79.8% (568/712) with 7 to 14 days triple therapy tailored to antibiotic susceptibility. CONCLUSIONS Peptic ulcers are rare in dyspeptic H. pylori-infected children. Primary resistance to CLA and MET is markedly dependent on geographical regions of birth and residence. The ongoing survey will show whether implementation of the updated ESPGHAN/NASPGHAN guidelines will improve the eradication success.
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Biernat MM, Bińkowska A, Łaczmański Ł, Biernat P, Krzyżek P, Gościniak G. Phenotypic and Genotypic Analysis of Resistant Helicobacter pylori Strains Isolated from Children with Gastrointestinal Diseases. Diagnostics (Basel) 2020; 10:E759. [PMID: 32992661 PMCID: PMC7601641 DOI: 10.3390/diagnostics10100759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 12/16/2022] Open
Abstract
Antibiotic resistance of Helicobacter pylori is currently a global issue. The aim of this study was to analyze actual antibiotic resistance rates of H. pylori strains isolated from children with primary infections and to compare the incidence of mutations that determine resistance to clarithromycin (CH) and metronidazole (MET) in children with different clinical diagnoses. A total of 91 H. pylori strains were isolated from 108 children with primary infections. Drug susceptibility testing of the strains was performed using E-test method. Classical sequencing of DNA fragments was used to detect point mutations for CH and MET resistance. Resistance to CH was detected in 31% of isolated strains (28/91), while resistance to MET and CH was detected in 35% (32/91) of strains. A2143G was the most frequently detected mutation and was dominant among strains isolated from children with peptic ulcer disease (80%). Mutations in the rdxA gene were found significantly more frequently among MET-resistant strains than MET-sensitive strains (p = 0.03, Chi2 = 4.3909). In children, a higher frequency of H. pylori multiresistant strains was observed compared with the previous study in the same area. Differences were found in the occurrence of point mutations among H. pylori strains resistant to CH isolated from children with different clinical diagnoses.
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Affiliation(s)
- Monika Maria Biernat
- Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Aldona Bińkowska
- 2nd Military Field Hospital of the Polish Armed Forces, 50-984 Wroclaw, Poland;
| | - Łukasz Łaczmański
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland;
| | - Paweł Biernat
- Department of Drugs Form Technology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Paweł Krzyżek
- Department of Microbiology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Grażyna Gościniak
- Department of Microbiology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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Park JS, Jun JS, Ryu EY, Yeom JS, Park ES, Seo JH, Lim JY, Park CH, Woo HO, Baik SC, Lee WK, Cho MJ, Rhee KH, Youn HS. Changes in Seroprevalence of Helicobacter pylori Infection over 20 Years in Jinju, Korea, from Newborns to the Elderly. J Korean Med Sci 2020; 35:e259. [PMID: 32808510 PMCID: PMC7431285 DOI: 10.3346/jkms.2020.35.e259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/18/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The objective of this study was to examine changes in the prevalence of cytotoxic-associated gene A (CagA) positive Helicobacter pylori infection in Jinju, Korea, over the last 20 years. METHODS Three cross-sectional analyses were conducted concurrently. A total of 1,305 serum samples were collected from 1994-1995, 2004-2005, and 2014-2015, respectively. The presence of immunoglobulin (Ig) G, IgA, and IgM antibodies against H. pylori CagA protein was examined by western blotting. RESULTS Overall, seropositivity for anti-CagA IgG antibody was significantly decreased from 63.2% to 42.5% over the last 20 years (P < 0.001). Anti-CagA IgG seropositivities in children and young adults aged 10-29 years decreased from 1994 (60.0%-85.0%) to 2015 (12.5%-28.9%). The age when plateau of increasing IgG seropositivity was reached in each study period shifted from the 15-19 year-old group in 1994-1995 (85.0%) to the 40-49 year-old group in 2014-2015 (82.5%). Overall seropositive rates of anti-CagA IgA and IgM antibodies did not change significantly either over the last 20 years. CONCLUSION H. pylori infection rate in children and young adults declined over 20 years in Jinju, probably due to improved sanitation, housing, or economy.
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Affiliation(s)
- Ji Sook Park
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Jin Su Jun
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Eo Young Ryu
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Eun Sil Park
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Ji Hyun Seo
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Jae Young Lim
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Chan Hoo Park
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Hyang Ok Woo
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Seung Chul Baik
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Department of Microbiology, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Woo Kon Lee
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Department of Microbiology, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Myung Je Cho
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Department of Microbiology, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Kwang Ho Rhee
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Department of Microbiology, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hee Shang Youn
- Department of Pediatrics, Gyeongsang National University College of Medicine and Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.
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Waldum H, Mjønes PG. Correct Identification of Cell of Origin May Explain Many Aspects of Cancer: The Role of Neuroendocrine Cells as Exemplified from the Stomach. Int J Mol Sci 2020; 21:E5751. [PMID: 32796591 DOI: 10.3390/ijms21165751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022] Open
Abstract
Cancers are believed to originate from stem cells. Previously, the hypothesis was that tumors developed due to dedifferentiation of mature cells. We studied the regulation of gastric acid secretion and showed that gastrin through the gastrin receptor stimulates enterochromaffin-like (ECL) cell histamine release and proliferation. In animal and human studies, we and others showed that long-term hypergastrinemia results in ECL cell-derived tumor through a sequence of hyperplasia, dysplasia, neuroendocrine tumors (NETs), and possibly neuroendocrine carcinomas (NECs) and adenocarcinomas of diffuse type. Perhaps, other cancers may also have their origin in differentiated cells. Knowledge of the growth regulation of the cell of origin is important in cancer prophylaxis and treatment. Physiology plays a central role in carcinogenesis through hormones and other growth factors. Every cell division implies a small risk of mutation; thus mitogens are also mutagens. Moreover, metastasis of slow proliferating cells may also explain so-called tumor dormancy and late recurrence.
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Lin AS, McClain MS, Beckett AC, Caston RR, Harvey ML, Dixon BREA, Campbell AM, Shuman JHB, Sawhney N, Delgado AG, Loh JT, Piazuelo MB, Algood HMS, Cover TL. Temporal Control of the Helicobacter pylori Cag Type IV Secretion System in a Mongolian Gerbil Model of Gastric Carcinogenesis. mBio 2020; 11:e01296-20. [PMID: 32605987 DOI: 10.1128/mBio.01296-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The Helicobacter pylori Cag type IV secretion system (T4SS) translocates the effector protein CagA and nonprotein bacterial constituents into host cells. In this study, we infected Mongolian gerbils with an H. pylori strain in which expression of the cagUT operon (required for Cag T4SS activity) is controlled by a TetR/tetO system. Transcript levels of cagU were significantly higher in gastric tissue from H. pylori-infected animals receiving doxycycline-containing chow (to derepress Cag T4SS activity) than in tissue from infected control animals receiving drug-free chow. At 3 months postinfection, infected animals receiving doxycycline had significantly increased gastric inflammation compared to infected control animals. Dysplasia (a premalignant histologic lesion) and/or invasive gastric adenocarcinoma were detected only in infected gerbils receiving doxycycline, not in infected control animals. We then conducted experiments in which Cag T4SS activity was derepressed during defined stages of infection. Continuous Cag T4SS activity throughout a 3-month time period resulted in higher rates of dysplasia and/or gastric cancer than observed when Cag T4SS activity was limited to early or late stages of infection. Cag T4SS activity for the initial 6 weeks of infection was sufficient for the development of gastric inflammation at the 3-month time point, with gastric cancer detected in a small proportion of animals. These experimental results, together with previous studies of cag mutant strains, provide strong evidence that Cag T4SS activity contributes to gastric carcinogenesis and help to define the stages of H. pylori infection during which Cag T4SS activity causes gastric alterations relevant for cancer pathogenesis.IMPORTANCE The "hit-and-run model" of carcinogenesis proposes that an infectious agent triggers carcinogenesis during initial stages of infection and that the ongoing presence of the infectious agent is not required for development of cancer. H. pylori infection and actions of CagA (an effector protein designated a bacterial oncoprotein, secreted by the Cag T4SS) are proposed to constitute a paradigm for hit-and-run carcinogenesis. In this study, we report the development of methods for controlling H. pylori Cag T4SS activity in vivo and demonstrate that Cag T4SS activity contributes to gastric carcinogenesis. We also show that Cag T4SS activity during an early stage of infection is sufficient to initiate a cascade of cellular alterations leading to gastric inflammation and gastric cancer at later time points.
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Gao T, Zhao M, Zhang C, Wang P, Zhou W, Tan S, Zhao L. Association of Helicobacter pylori Infection with Vitamin D Deficiency in Infants and Toddlers. Am J Trop Med Hyg 2020; 102:541-546. [PMID: 31933468 DOI: 10.4269/ajtmh.19-0523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Helicobacter pylori (H. pylori), a gram-negative pathogen, has been shown to colonize multiple organs and cause various forms of extra-gastrointestinal diseases. The association of H. pylori infection with vitamin D status in apparently healthy children remained unclear; therefore, we investigated the relationship between vitamin D and H. pylori infection among apparently healthy infants and toddlers. In this large cross-sectional study, the examination data of children were collected from January 2013 to September 2017 in the Center for Children's Health Care. Among these children, 6,896 infants and toddlers were screened for our study. Helicobacter pylori infection and vitamin D status were the main indicators, and micronutrients (zinc, iron, copper, magnesium), and growth parameters (height, weight, and weight for age Z score [WAZ], height for age Z score [HAZ]) were also analyzed in this study. Among the 6,896 infants and toddlers, the detection rate of H. pylori seropositivity was 30.6%. The prevalence of vitamin D deficiency in H. pylori seropositive and seronegative groups was 20.7% and 12.1%, respectively (P < 0.001). The logistic regression analysis suggested children with H. pylori-positive antibody were 2.06 times more likely to be vitamin D deficient compared with children who had negative H. pylori antibody (odds ratio: 2.06; 95% CI: 1.77, 2.38) after controlling for confounding factors. These data suggested that there was a significant association between H. pylori seropositivity and vitamin D deficiency in children aged 6-36 months, which would make a contribution to the treatment and monitoring of vitamin D deficiency and H. pylori infection.
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Affiliation(s)
- Ting Gao
- Department of Neurology, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an Shaanxi, China.,Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Mengwen Zhao
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Chen Zhang
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Peipei Wang
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Wenjuan Zhou
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Shan Tan
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
| | - Lingling Zhao
- Department of Pediatrics, Central South University Third Xiangya Hospital, Changsha, China
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Li RJ, Dai YY, Qin C, Li XH, Qin YC, Pan Y, Huang YY, Huang ZS, Huang YQ. Treatment strategies and preventive methods for drug-resistant Helicobacter pylori infection. World J Meta-Anal 2020; 8:98-108. [DOI: 10.13105/wjma.v8.i2.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
The infection and drug resistance rates of Helicobacter pylori (H. pylori) are high and must be prevented and treated by better strategies. Based on recent research advances in this field as well as the results from our team and those on traditional Chinese medicine, we review the causes of drug resistance, and prevention and treatment strategies for drug-resistant H. pylori infection, with an aim to make suggestions for the development of new drugs, such as establishment of new target identification and screening systems, modification of existing drug structures, use of new technologies, application of natural products, and using a commercial compound library. This article may provide reference for eradication of drug-resistant H. pylori.
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Affiliation(s)
- Ru-Jia Li
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuan-Yuan Dai
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Chun Qin
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiao-Hua Li
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yan-Chun Qin
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yong Pan
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yong-Yi Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Zan-Song Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yan-Qiang Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
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Di J, Zhang J, Cao L, Huang TT, Zhang JX, Mi YN, Xiao X, Yan PP, Wu ML, Yao T, Liu DZ, Liu J, Cao YX. Hydrogen Peroxide-Mediated Oxygen Enrichment Eradicates Helicobacter pylori In Vitro and In Vivo. Antimicrob Agents Chemother 2020; 64:e02192-19. [PMID: 32071054 DOI: 10.1128/AAC.02192-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/01/2020] [Indexed: 12/19/2022] Open
Abstract
Helicobacter pylori is an important risk factor for gastric ulcers. However, antibacterial therapies increase the resistance rate and decrease the eradication rate of H. pylori Inspired by the microaerophilic characteristics of H. pylori, we aimed at effectively establishing an oxygen-enriched environment to eradicate and prevent the recurrence of H. pylori The effect and the mechanism of an oxygen-enriched environment in eradicating H. pylori and preventing the recurrence were explored in vitro and in vivo During oral administration and after drug withdrawal, H. pylori counts were evaluated by Giemsa staining in animal cohorts. An oxygen-enriched environment in which H. pylori could not survive was successfully established by adding hydrogen peroxide into several solutions and rabbit gastric juice. Hydrogen peroxide effectively killed H. pylori in Columbia blood agar and special peptone broth. Minimum inhibition concentrations and minimum bactericidal concentrations of hydrogen peroxide were both relatively stable after promotion of resistance for 30 generations, indicating that hydrogen peroxide did not easily promote resistance in H. pylori In models of Mongolian gerbils and Kunming mice, hydrogen peroxide has been shown to significantly eradicate and effectively prevent the recurrence of H. pylori without toxicity and damage to the gastric mucosa. The mechanism of hydrogen peroxide causing H. pylori death was related to the disruption of bacterial cell membranes. The oxygen-enriched environment achieved by hydrogen peroxide eradicates and prevents the recurrence of H. pylori by damaging bacterial cell membranes. Hydrogen peroxide thus provides an attractive candidate for anti-H. pylori treatment.
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Venero-Fernández S, Avila-Ochoa I, Menocal-Herredia L, Caraballo-Sánchez Y, Rosado-García F, Suárez-Medina R, Varona-Pérez P, Fogarty A. Prevalence of and factors associated with Helicobacter pylori infection in preschoolers in Havana, Cuba: A population-based study. Revista de Gastroenterología de México (English Edition) 2020. [DOI: 10.1016/j.rgmxen.2019.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Venero-Fernández SJ, Ávila-Ochoa I, Menocal-Herredia L, Caraballo-Sánchez Y, Rosado-García FM, Suárez-Medina R, Varona-Pérez P, Fogarty AW. Prevalence of and factors associated with Helicobacter pylori infection in preschoolers in Havana, Cuba: A population-based study. Rev Gastroenterol Mex (Engl Ed) 2020; 85:151-159. [PMID: 32204961 DOI: 10.1016/j.rgmx.2019.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Helicobacter pylori (H. pylori) infection is usually acquired in childhood. In Cuba, its study in pediatric ages is a little explored field. AIM To identify the prevalence of the infection and its associated risk factors in 3-year-old children in Havana. MATERIALS AND METHODS An analytic, cross-sectional, epidemiologic analysis was conducted on 1,274 children belonging to the cohort of participants in the Natural History of Wheezing in Cuba study (HINASIC for its Spanish acronym) that were 3 years of age and provided a stool sample. H. pylori infection was identified by determining the H. pylori antigen (Ag) in stool, utilizing the commercial Spinreact kit, from Spain. The data were collected through a questionnaire applied by the researchers that included sociodemographic, environmental, and lifestyle variables, as well as infection from other parasites. Prevalence and the prevalence ratio with a 95% confidence interval were calculated and the dichotomous logistic regression analysis was employed. RESULTS The prevalence of positive H. pylori Ag was 5%. Sleeping together was the risk factor found (PR:1.27; 95% CI: 1.03-1.50). Protective factors were drinking water from water delivery trucks (PR: 0.16; 95% CI: 0.04-0.72) and living in a nuclear family unit (PR: 0.94; 95% CI: 0.85-0.99). CONCLUSIONS The prevalence of H. pylori infection in early childhood places Havana in an intermediate position at the international level. To control the infection, causal studies should be conducted and opportune interventions implemented.
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Affiliation(s)
| | - I Ávila-Ochoa
- Departamento de Gastroenterología, Hospital Universitario Pediátrico Docente Centro Habana, La Habana, Cuba
| | - L Menocal-Herredia
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | - Y Caraballo-Sánchez
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | - F M Rosado-García
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | - R Suárez-Medina
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | - P Varona-Pérez
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | - A W Fogarty
- Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Reino Unido
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George S, Lucero Y, Torres JP, Lagomarcino AJ, O'Ryan M. Gastric Damage and Cancer-Associated Biomarkers in Helicobacter pylori-Infected Children. Front Microbiol 2020; 11:90. [PMID: 32117120 PMCID: PMC7029740 DOI: 10.3389/fmicb.2020.00090] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/15/2020] [Indexed: 12/11/2022] Open
Abstract
Helicobacter pylori (H. pylori) is well-known to be involved in gastric carcinogenesis, associated with deregulation of cell proliferation and epigenetic changes in cancer-related genes. H. pylori infection is largely acquired during childhood, persisting long-term in about half of infected individuals, a subset of whom will go on to develop peptic ulcer disease and eventually gastric cancer, however, the sequence of events leading to disease is not completely understood. Knowledge on carcinogenesis and gastric damage-related biomarkers is abundant in adult populations, but scarce in children. We performed an extensive literature review focusing on gastric cancer related biomarkers identified in adult populations, which have been detected in children infected with H. pylori. Biomarkers were related to expression levels (RNA or protein) and/or methylation levels (DNA) in gastric tissue or blood of infected children as compared to non-infected controls. In this review, we identified 37 biomarkers of which 24 are over expressed, three are under expressed, and ten genes are significantly hypermethylated in H. pylori-infected children compared to healthy controls in at least 1 study. Only four of these biomarkers (pepsinogen I, pepsinogen II, gastrin, and SLC5A8) have been studied in asymptomatically infected children. Importantly, 13 of these biomarkers (β-catenin, C-MYC, GATA-4, DAPK1, CXCL13, DC-SIGN, TIMP3, EGFR, GRIN2B, PIM2, SLC5A8, CDH1, and VCAM-1.) are consistently deregulated in infected children and in adults with gastric cancer. Future studies should be designed to determine the clinical significance of these changes in infection-associated biomarkers in children and their persistence over time. The effect of eradication therapy over these biomarkers in children if proven significant, could lead to modifications in treatment guidelines for younger populations, and eventually promote the development of preventive strategies, such as vaccination, in the near future.
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Affiliation(s)
- Sergio George
- Host-Pathogen Interaction Laboratory, Microbiology and Mycology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Yalda Lucero
- Host-Pathogen Interaction Laboratory, Microbiology and Mycology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Department of Pediatrics and Pediatric Surgery, Dr. Roberto del Río Hospital, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Juan Pablo Torres
- Host-Pathogen Interaction Laboratory, Microbiology and Mycology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Department of Pediatrics and Pediatric Surgery, Dr. Luis Calvo Mackenna Hospital, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Anne J Lagomarcino
- Host-Pathogen Interaction Laboratory, Microbiology and Mycology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Miguel O'Ryan
- Host-Pathogen Interaction Laboratory, Microbiology and Mycology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Millennium Institute on Immunology and Immunotherapy (IMII), Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Abstract
Helicobacter pylori is a human-specific pathogen, which leads to gastric pathologies including gastric cancer. It is a highly unique bacterium considered as a carcinogenic agent. H. pylori remains a major human health problem, responsible for ~90% of the gastric cancer cases. Approximately four billion individuals have been detected for H. pylori infection worldwide in 2015. At the turn of the twenty-first century, the prevalence of H. pylori has been declining in highly industrialized countries of the Western world, whereas prevalence has plateaued at a high level in developing and newly industrialized countries. However, the infection status remains high in immigrants coming from countries with high prevalence of H. pylori infection. H. pylori can be diagnosed both by invasive and non-invasive methods. Urea breath test and stool antigens detection are among the most commonly used non-invasive ones. Although the way H. pylori is transmitted remains still not fully clear, the level of contamination is strongly dependent on the familial and environmental context, with a drastic impact of living conditions with poor hygiene and sanitation. However, familial socioeconomic status is the main risk factor for H. pylori infection among children. In addition, food and water source have a high impact on the prevalence of H. pylori infection worldwide. This chapter highlights the latest knowledge in the epidemiology of H. pylori infection, its diagnosis and critical risk factors responsible for its high prevalence in some populations and geographic areas.
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Affiliation(s)
- Kallirroi Kotilea
- Paediatric Gastroenterology Unit, Université Libre de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgium
| | - Patrick Bontems
- Paediatric Gastroenterology Unit, Université Libre de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgium
| | - Eliette Touati
- Unit of Helicobacter Pathogenesis, Institut Pasteur, Paris, France.
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Quaglia NC, Storelli MM, Scardocchia T, Lattanzi A, Celano GV, Monno R, Dambrosio A. Helicobacter pylori: Survival in cultivable and non-cultivable form in artificially contaminated Mytilus galloprovincialis. Int J Food Microbiol 2019; 312:108363. [PMID: 31669766 DOI: 10.1016/j.ijfoodmicro.2019.108363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/02/2019] [Accepted: 09/19/2019] [Indexed: 02/06/2023]
Abstract
Several studies report the presence of Helicobacter pylori (H. pylori) in seawater either free or attached to planktonic organism. After considering the role played by plankton in the food chain of most aquatic ecosystems and the possible role that seafood products can assume in the transmission of H. pylori to humans, the aim of this study was to assess the survival of H. pylori in artificially contaminated Mytilus galloprovincialis (M. galloprovincialis). A traditional culture method and a reverse transcriptase-PCR (RT-PCR) assay were employed to detect the mRNA of known virulence factor (VacA) which can be considered use a marker of bacterial viability. The obtained results clearly show that H. pylori is able to survive in artificially contaminated mussels for 6 days (2 days in a cultivable form and 4 days in a non-cultivable form).
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Affiliation(s)
- Nicoletta C Quaglia
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinic and Animal Production, University of Bari "Aldo Moro", Strada Prov.le per Casamassima, Km 3, 70010 Valenzano, Bari, Italy.
| | - Maria M Storelli
- Department of Biosciences, Biotechnologies and Biopharmaceutical, University of Bari Aldo Moro, Strada Prov.le per Casamassima, Km 3, 70010 Valenzano, Bari, Italy
| | | | - Anna Lattanzi
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov.le per Casamassima, Km 3, 70010 Valenzano, Bari, Italy
| | - Gaetano V Celano
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov.le per Casamassima, Km 3, 70010 Valenzano, Bari, Italy
| | - Rosa Monno
- Department of Basic Medical Science, Neuroscience and Sense Organs, Section of Microbiology, University of Bari Aldo Moro, Bari, Italy
| | - Angela Dambrosio
- Department of Emergency and Organ Transplantation, Section of Veterinary Clinic and Animal Production, University of Bari "Aldo Moro", Strada Prov.le per Casamassima, Km 3, 70010 Valenzano, Bari, Italy
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Kakiuchi T, Matsuo M, Endo H, Nakayama A, Sato K, Takamori A, Sasaki K, Takasaki M, Hara M, Sakata Y, Okuda M, Kikuchi S, Eguchi Y, Takahashi H, Anzai K, Fujimoto K. A Helicobacter pylori screening and treatment program to eliminate gastric cancer among junior high school students in Saga Prefecture: a preliminary report. J Gastroenterol 2019; 54:699-707. [PMID: 30770975 DOI: 10.1007/s00535-019-01559-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/07/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND To present the strategies and preliminary findings of the first 3 years after implementing a Helicobacter pylori screening and eradication program to prevent gastric cancer in Saga Prefecture. METHODS A screening and treatment program to eradicate H. pylori from third-grade junior high students was started in Saga Prefecture in 2016, using local governmental grants. Screening was with urinary anti-H. pylori antibody tests, followed by H. pylori stool antigen tests for students who were antibody positive. Those positive on both tests underwent H. pylori eradication by triple therapy based on a potassium-competitive acid blocker. RESULTS From 2016 to 2018, the participation rate was 83.1% and the H. pylori infection rate was 3.1% (660/21,042). The participation rates were higher in 2017 (85.4%) and 2018 (85.9%) compared with 2016 (78.5%) (P < 0.0001), and the infection rate also decreased in a time-dependent manner (2016: 3.6%, 2017: 3.3%, 2018: 2.5%, P = 0.0001). In total, 501 students positive for H. pylori received eradication therapy (85.1% success) and adverse events occurred in 20 of these (4.0%). However, no serious complications occurred. CONCLUSIONS The H. pylori screening and eradication project for school students in Saga Prefecture has started successfully and we have seen both a steady increase in the participation rate and a steady decrease in the infection rate, without major safety concerns.
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Affiliation(s)
- Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan.
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, 817 Motohata-machi, Karatsu-shi, 847-0852, Japan
| | - Aiko Nakayama
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Keiko Sato
- Clinical Research Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Kazumi Sasaki
- Saga Cancer Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Mitsuhiro Takasaki
- Medical Informatics, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Megumi Hara
- Department of Prevention Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Yasuhisa Sakata
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Masumi Okuda
- Department of Pediatrics, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute-shi, 480-1195, Aichi, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute-shi, 480-1195, Aichi, Japan
| | - Yuichiro Eguchi
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Hirokazu Takahashi
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Keizo Anzai
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Kazuma Fujimoto
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
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Roldán IJ, Castaño R, Navas MC. Mutations in the Helicobacter pylori 23S rRNA gene associated with clarithromycin resistance in patients at an endoscopy unit in Medellín, Colombia. Biomedica 2019; 39:117-129. [PMID: 31529839 DOI: 10.7705/biomedica.v39i4.4377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Indexed: 06/10/2023]
Abstract
Introduction: Clarithromycin is the first-line antibiotic for the treatment of Helicobacter pylori infection. Bacterial resistance is mainly due to the presence of specific mutations in the 23S ribosomal RNA (rRNA) gene. Objective: To determine the frequency of A2143G and A2142G specific mutations in the 23S rRNA gene associated with clarithromycin resistance of H. pylori in samples from patients with dyspeptic manifestations in Medellín, northwestern Colombia. Materials and methods: DNA was extracted from gastric biopsy samples of patients with dyspeptic manifestations seen at an endoscopy unit in Medellín between 2016 and 2017. PCR was performed to amplify the bacterial s and m vacA regions, and a region in the 23S rRNA gene. The presence of the A2142G and A2143G mutations was determined using the restriction fragment length polymorphism (RFLP) technique with the BbsI and BsaI enzymes, respectively. Results: The prevalence of infection was 44.2% (175/396), according to the histopathology report. The positive samples were analyzed and the three regions of the bacterial genome were amplified in 143 of the 175 samples. The A2143G and A2142G mutations were identified in 27 samples (18.8%, 27/143). The most frequent mutation was A2143G (81.5%, 22/27). Conclusions: We found a high prevalence of H. pylori mutations associated with clarithromycin resistance in the study population. Further studies are required to determine the bacterial resistance in the Colombian population in order to define first line and rescue treatments.
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Affiliation(s)
- Ingrid Johana Roldán
- Grupo de Gastrohepatología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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Darma A, Nugroho BST, Yoanna V, Sulistyani I, Athiyyah AF, Ranuh RG, Sudarmo SM. Comparison of Helicobacter pylori stool antigen, salivary IgG, serum IgG, and serum IgM as diagnostic markers of H. pylori infection in children. Iran J Microbiol 2019; 11:206-211. [PMID: 31523403 PMCID: PMC6711868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND OBJECTIVES Various non-invasive diagnostic tests are available for the detection of Helicobacter pylori infection. The aim of this study was to compare the sensitivity and specificity of HpSA, salivary IgG, serum IgG, and serum IgM to those of endoscopic-biopsy as the gold standard for the diagnosis of H. pylori infection. MATERIALS AND METHODS This is a cross-sectional study performed among pediatric patients at Dr. Soetomo General Hospital (Surabaya, Indonesia). Fecal, blood, and saliva samples were collected from all subjects. The results of the HpSA, salivary IgG, serum IgG, and serum IgM tests were compared to the results of endoscopic-biopsy as the gold standard. RESULTS Of the 37 study participants, H. pylori infection was confirmed in 5 (13.33%) with serum IgG, 23 (63.33%) with serum IgM, 15 (40%) with HpSA, and 26 (70.97%) with salivary IgG. The salivary IgG enzyme-linked immunosorbent assay (ELISA) was the only diagnostic test with significantly different results, as compared to biopsy (p = 0.017). CONCLUSION The results of this study showed that HpSA, salivary IgG, and serum IgG and IgM were not sufficient to replace endoscopic-biopsy as the gold standard for the diagnosis of H. pylori infection.
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Affiliation(s)
- Andy Darma
- Corresponding author: Andy Darma, MD, Department of Child Health, Dr. Soetomo Hospital, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia. Tel: +6281-332333806, Fax: +6231-5022472,
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Sabbagh P, Javanian M, Koppolu V, Vasigala VR, Ebrahimpour S. Helicobacter pylori infection in children: an overview of diagnostic methods. Eur J Clin Microbiol Infect Dis 2019; 38:1035-45. [PMID: 30734129 DOI: 10.1007/s10096-019-03502-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/31/2019] [Indexed: 12/14/2022]
Abstract
Children differ from adults regarding Helicobacter pylori (H. pylori) infection in many terms. H. pylori infection represents a key factor in the pathogenesis of duodenal ulcer and chronic gastritis in children. H. pylori infection causes some extraintestinal diseases as well as gastrointestinal diseases. Although, among these illnesses in children, symptoms like recurrent abdominal pain are not specific. Moreover, the role of the pathogen in the growth faltering, iron deficiency anemia, and asthma still remains controversial. A reliable method to detect H. pylori infection is a crucial issue, sand is still a matter of active debate. The tests applied for H. pylori diagnosis are grouped as either invasive or non-invasive methods. Invasive methods consist of endoscopic evaluation, the rapid urease test (RUT), histology, and bacterial culture. Non-invasive tests include the urea breath test (UBT), stool antigen test (SAT), serology, and molecular diagnostic approaches. Use of endoscopy is a pre-requisite for all invasive methods and poses difficulties in children as it is a difficult procedure and requires patient's cooperation. For this reason, the non-invasive tests have been commonly used in children, although their accuracy is not very reliable in some cases. Invasive tests may be opted to confirm the diagnosis as and when needed. This review presents the diagnostic tests used to detect H. pylori infection in children.
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