Tu1497 NATIONWIDE SURVEY OF HELICOBACTER PYLORI ANTIBIOTIC RESISTANCE IN HIGH PREVALENCE OF GASTRIC CANCER COUNTRY (BHUTAN): A LARGE-SCALE COMMUNITY-BASED STUDY

Helicobacter pylori (H. pylori) is a bacterium that resides in the human stomach, which is associated with gastroduodenal diseases. We investigate the prevalence of cagA, vacA, oipA, cagE1, cagE2 and dupA genotypes in H. pylori isolated from patients with Gastric ulcer, duodenal ulcer, and Gastric Cancer. Collected 74 samples from the Gastroenterology Unit of the Rasool Akram Hospital were included in this study. Gastric disorders were identified by endoscopy .gastric cancer was further confirmed by histopathology. H. pylori were detected by the urease test. Subsequently, DNA was extracted from gastric tissue of the subjects with the CLO-test yielded positive results. In general, 74 patients with a mean age of 53.45 years (Range 22 to 86-year-old), including 45 men and 29 women, were studied. Among 74 H. pylori-positive patients, 70 (94.5%) patients were positive for the cagA gene. About 95.8% (23/24) of the patients with gastric carcinoma were dupA positive and VacA gene (91.8%). The oipA genotype was detected in 71 (96%) of H.pylori positive samples. This gene was more common in patients with gastritis rather than cancer group. Also, 97.2% of 74 H. pylori isolates were cagE2-positive. In 25 patients with PUD, the occurrence percent of cagA+/VacA+, cagA+/Vac- , cagA- /VacA+ and cagA- /VaxA- genotypes were found 80%, 12%, 4.2% and 4.2 respectively. The results of the present study suggest that a high prevalence of virulent factors could contribute to the risk of developing gastroduodenal diseases.

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The antibiotic resistance of Helicobacter pylori to five antibiotics and influencing factors in an area of China with a high risk of gastric cancer

BMC Microbiology ◽

10.1186/s12866-019-1517-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Dan Wang ◽

Qianqian Guo ◽

Yuan Yuan ◽

Yuehua Gong

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Antibiotic Resistance ◽

High Risk ◽

Influencing Factors

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High Prevalence of Antibiotic Resistance in Iranian Helicobacter pylori Isolates: Importance of Functional and Mutational Analysis of Resistance Genes and Virulence Genotyping

Journal of Clinical Medicine ◽

10.3390/jcm8112004 ◽

2019 ◽

Vol 8 (11) ◽

pp. 2004 ◽

Cited By ~ 8

Author(s):

Nastaran Farzi ◽

Abbas Yadegar ◽

Amir Sadeghi ◽

Hamid Asadzadeh Aghdaei ◽

Sinéad Marian Smith ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Rrna Genes ◽

23S Rrna ◽

Dilution Method ◽

Agar Dilution Method ◽

Gyra Gene ◽

Therapeutic Regime ◽

High Prevalence ◽

H Pylori

The high prevalence of antibiotic resistance in Helicobacter pylori has become a great challenge in Iran. The genetic mutations that contribute to the resistance have yet to be precisely identified. This study aimed to investigate the prevalence of antibiotic resistance and virulence markers in Iranian H. pylori isolates and to analyze if there is any association between resistance and genotype. Antibiotic susceptibility patterns of 68 H. pylori isolates were investigated against metronidazole, clarithromycin, amoxicillin, rifampicin, ciprofloxacin, levofloxacin, and tetracycline by the agar dilution method. The frxA, rdxA, gyrA, gyrB, and 23S rRNA genes of the isolates were sequenced. The virulence genotypes were also determined using PCR. Metronidazole resistance was present in 82.4% of the isolates, followed by clarithromycin (33.8%), ciprofloxacin (33.8%), rifampicin (32.4%), amoxicillin (30.9%), levofloxacin (27.9%), and tetracycline (4.4%). Overall, 75% of the isolates were resistant to at least two antibiotics tested and considered as a multidrug resistance (MDR) phenotype. Most of the metronidazole-resistant isolates carried frameshift mutations in both frxA and rdxA genes, and premature termination occurred in positions Q5Stop and Q50Stop, respectively. Amino acid substitutions M191I, G208E, and V199A were predominantly found in gyrA gene of fluoroquinolone-resistant isolates. A2143G and C2195T mutations of 23S rRNA were found in four clarithromycin-resistant isolates. Interestingly, significant associations were found between resistance to metronidazole (MNZ) and cagA-, sabA-, and dupA-positive genotypes, with p = 0.0002, p = 0.0001, and p = 0.0001, respectively. Furthermore, a significant association was found between oipA “on” status and resistance to amoxicillin (AMX) (p = 0.02). The prevalence of H. pylori antibiotic resistance is high in our region, particularly that of metronidazole, clarithromycin, ciprofloxacin, and MDR. Simultaneous screening of virulence and resistance genotypes can help clinicians to choose the appropriate therapeutic regime against H. pylori infection.

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Improving Efficacy of Endoscopic Diagnosis of Early Gastric Cancer: Gaps to Overcome from the Real-World Practice in Vietnam

BioMed Research International ◽

10.1155/2020/7239075 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Duc T. Quach ◽

Quy-Dung D. Ho ◽

Khien V. Vu ◽

Khanh T. Vu ◽

Huy V. Tran ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Real World ◽

Nationwide Survey ◽

Central Type ◽

The Real ◽

Real World Evidence ◽

High Prevalence ◽

Total Proportion ◽

Annual Volume

Objective. To identify factors associated with increased proportion of early gastric cancer to total detected gastric cancer among patients undergoing diagnostic esophagogastroduodenoscopy. Methods. A nationwide survey was conducted across 6 central-type and 6 municipal-type Vietnamese hospitals. A questionnaire regarding annual esophagogastroduodenoscopy volume, esophagogastroduodenoscopy preparation, the use of image-enhanced endoscopy, and number of gastric cancer diagnosed in 2018 was sent to each hospital. Results. The total proportion of early gastric cancer was 4.0% (115/2857). Routine preparation with simethicone and the use of image-enhanced endoscopy were associated with higher proportion of early gastric cancer (OR 1.9, 95% CI: 1.1–3.2, p=0.016; OR 2.7, 95% CI: 1.8–4.0, p<0.001, respectively). Esophagogastroduodenoscopies performed at central-type hospitals were associated with higher proportion of early gastric cancer (OR 1.9, 95% CI: 1.1–3.2, p=0.017). Esophagogastroduodenoscopies performed at hospitals with an annual volume of 30.000–60.000 were associated with higher proportion of early gastric cancer than those performed at hospitals with an annual volume of 10.000-<30.000 (OR 2.7, 95% CI: 1.6–4.8, p<0.001) and with a volume of >60.000–100.000 (OR 2.7, 95% CI: 1.7–4.2, p<0.001). Only four (33.3%) hospitals reported all endoscopic types of early gastric cancer. Conclusions. The detection of early gastric cancer is still challenging even for endoscopists working in regions with relatively high prevalence. The real-world evidence showed that endoscopic detection of early gastric cancer could potentially improve with simple adjustments of esophagogastroduodenoscopy protocols.

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