1447Gastric histopathology by Helicobacter pylori cagA status in Arctic Canada

Abstract Background Our community-driven projects address concerns of Canadian Arctic Indigenous communities about Helicobacter pylori (Hp) infection, responsible for elevated gastric cancer mortality in the region. Community research partners wished to learn whether bacterial characteristics determine severity of Hp-related disease in their communities. We aimed to describe gastric histopathology by cagA genotype of Hp isolated from residents of 7 Indigenous communities in the Northwest Territories and Yukon. Methods Participants underwent gastroscopy with 5-6 biopsies taken for histopathological assessment and 2 biopsies taken for tissue culture during 2008-2017. We used multiple PCR reactions and DNA sequence analysis to classify Hp genotypes as cagA+ or cagA-. A single pathologist used the updated Sydney classification system to grade severity of 5 gastric pathology outcomes: Hp density; chronic gastritis; active gastritis; atrophy; and intestinal metaplasia. We estimated prevalence of each outcome with 95% confidence intervals (CI) by gastric subsite and cagA status. Results Of 262 Hp isolates assessed, 142 (54%) were cagA+. Prevalence of moderate-high Hp density, severe chronic gastritis, moderate-severe active gastritis, atrophy, and metaplasia were (%[CI]): respectively, 78[70-85], 44[36-53], 65[56-72], 55[46-63], 25[18-33] in cagA+ participants and 61[52-70], 35[27-44], 31[23-40], 32[23-41], 8[4-15] in cagA- participants. cagA+ participants had higher prevalence of all outcomes in antrum and corpus. Conclusion Hp-infected Indigenous residents of Arctic Canada who harbored cagA-positive strains had higher prevalence of more severe gastric pathology than those with cagA-negative strains. Key messages Community-driven research answers questions posed by those who bear the disease burden.

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1445Antibiotic susceptibility of Helicobacter pylori in Arctic Canadian Indigenous communities

International Journal of Epidemiology ◽

10.1093/ije/dyab168.392 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Lauren Lindsey ◽

Doug Quilty ◽

Taylor Cromarty ◽

Ali Assi ◽

Sander Veldhuyzen van Zanten ◽

...

Keyword(s):

Helicobacter Pylori ◽

Disease Burden ◽

Gastrointestinal Endoscopy ◽

Indigenous Communities ◽

Upper Gastrointestinal Endoscopy ◽

Antibiotic Resistant ◽

Resistance Patterns ◽

Gastric Biopsies ◽

Antibiotic Resistance Patterns ◽

Upper Gastrointestinal

Abstract Background Our community-driven projects address concerns of Canadian Arctic Indigenous communities about Helicobacter pylori (Hp) infection, responsible for elevated gastric cancer mortality in the region. A key concern is poor effectiveness of anti-Hp treatment. We aimed to describe antibiotic resistance patterns in Hp isolated from project participants. Methods Participants in 7 communities underwent upper gastrointestinal endoscopy with 2 gastric biopsies taken for tissue culture during 2008-2017. We tested Hp isolates for resistance to 7 antibiotics by Etest and assessed 4 outcomes: resistance to metronidazole, clarithromycin, 1+ antibiotics, and 2+ antibiotics. We tabulated proportion positive among isolates tested with 95% confidence intervals (CI) and used logistic regression to assess the relation of age and sex to resistance outcomes. Results Of 259 Hp isolates tested, resistance to metronidazole, clarithromycin, 1+ antibiotics, and 2+ antibiotics were (% [CI]): respectively, 35 [29-41], 19 [15-25], 44 [38-50], and 12 [8-17] overall; 38 [30-47], 24 [17-32], 49 [41-58], and 16 [11-23] in 146 isolates from women; and 30 [22-39], 13 [8-21], 36 [27-46], and 6 [3-12] in 113 isolates from men. Odds of resistance to clarithromycin, 1+ antibiotics, 2+ antibiotics, and, to a lesser degree metronidazole, were elevated in women relative to men after age adjustment and increased with age in women but not men. Conclusion In Arctic Indigenous communities in Canada, women were more likely than men to harbor antibiotic-resistant Hp, and their frequency of resistant Hp infection increased with age. Key messages Community-driven research answers questions posed by those who bear the disease burden.

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Influence of genetic characteristics of Helicobacter pylori on pathomorphology of gastric mucosa in young persons with chronic gastritis

Perm Medical Journal ◽

10.17816/pmj37642-47 ◽

2021 ◽

Vol 37 (6) ◽

pp. 42-47

Author(s):

E. M. Spivak ◽

O. M. Manyakina ◽

I. S. Akkuratova-Maksimova

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Intestinal Metaplasia ◽

Chronic Gastritis ◽

Young Patients ◽

Chain Reaction ◽

Highly Pathogenic ◽

Genetic Characteristics ◽

Polymerase Chain ◽

Caga Status

Objective. To evaluate the effect of the genetic characteristics of Helicobacter pylori on the nature of pathomorphological disorders in the gastric mucosa in chronic Hp-associated gastritis in young people. Material and methods. Forty-two adults (25 men and 17 women) aged 19 to 40 years with Hp-associated chronic gastritis were examined. The severity and activity of inflammation, as well as the presence of atrophy and intestinal metaplasia were determined in gastrobioptates. Genetic typing of Hp was performed for 16 pathogenicity factors of infect: CagA, CagM, CagT, CagH, CagC, CagF, CagE, VacAs1 and As2, IceA, Baba; HpaA; OipA, AlpB; UreB and UreI using polymerase chain reaction. Results. Pathogenic Hp strains were detected in 59.5 % of patients. Factors of adhesion HpaA (83.3 %), OipA (81 %), and AlpB (83.3 %) were identified with the highest frequency. In 57.1 % of cases, cytotoxin of the Cag group was detected, and 54.8 % of patients had a positive CagA-status. The VacA S1 allele was registered in 73.8 %, VacA S2 in 4.8 %, IceA in 38.1 %, and BabA in 45.2 % of cases. The presence of Hp strains in the gastric mucosa, which have three or more pathogenicity island genes, significantly increases the severity and activity of the inflammatory process, revealing signs of moderate atrophy of the digestive tract and intestinal metaplasia. Conclusions. Colonization of the gastric mucosa in young patients with Hp-associated chronic gastritis by highly pathogenic Hp strains leads to severe violations of its morphology.

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Gastric atrophy is correlated to the activity of Helicobacter pylori-induced chronic gastritis

Gastroenterology ◽

10.1016/s0016-5085(01)83264-9 ◽

2001 ◽

Vol 120 (5) ◽

pp. A656-A656

Author(s):

M CAVICCHI ◽

J AUROUX ◽

J NHIEU ◽

J DELCHIER ◽

D LAMARQUE

Keyword(s):

Helicobacter Pylori ◽

Chronic Gastritis ◽

Gastric Atrophy

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HISTOLOGICAL PROFILE OF HELICOBACTER PYLORI-INDUCED CHRONIC GASTRITIS: ABOUT 227 CASES

10.1055/s-0039-1681930 ◽

2019 ◽

Author(s):

M Kadi ◽

M Eljihad ◽

M Tahiri Joutei-Hassani ◽

W Badre ◽

W Hliwa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Chronic Gastritis

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EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.2.5 ◽

2019 ◽

pp. 28-32

Author(s):

Van Huy Tran

Keyword(s):

Helicobacter Pylori ◽

Adverse Effects ◽

Chronic Gastritis ◽

Eradication Rate ◽

High Rate ◽

First Line ◽

Helicobacter Pylori Eradication ◽

Quadruple Therapy ◽

First Line Therapy ◽

Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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