scholarly journals Acquisition of double mutation in gyrA caused high resistance to sitafloxacin in Helicobacter pylori after unsuccessful eradication with sitafloxacin-containing regimens

2017 ◽  
Vol 6 (3) ◽  
pp. 391-397 ◽  
Author(s):  
Hideki Mori ◽  
Hidekazu Suzuki ◽  
Juntaro Matsuzaki ◽  
Tatsuhiro Masaoka ◽  
Takanori Kanai

Background and aim Although sitafloxacin (STFX)-containing regimens are effective rescue treatments for Helicobacter pylori infection, prevalence of fluoroquinolone resistance in H. pylori has increased rapidly worldwide. The change in resistance levels and gyrA mutations, a major cause of fluoroquinolone resistance, after unsuccessful STFX-containing treatment has not been investigated. Methods We conducted a retrospective, non-randomized study to compare the minimum inhibitory concentrations (MICs) of STFX and the location of gyrA mutations in H. pylori before and after unsuccessful eradication with STFX-containing regimens at Keio University Hospital between December 2011 and March 2015. Results A total of 266 patients treated with STFX-containing regimens for third-line H. pylori eradication were evaluated. Double mutations in gyrA were acquired by 20.8% of strains that exhibited seven-fold increased STFX MICs, compared to pre-treatment MICs. The STFX MICs did not increase, however, when the location of the gyrA mutations did not change after treatment. Double mutations in gyrA developed in 60.0% of the strains in which eradication failed, which exhibited a baseline mutation at position D91, and in 11.1% of strains with baseline mutations at position N87. Conclusion Acquisition of double mutations in gyrA evoked high-level resistance to STFX in H. pylori after unsuccessful eradication with STFX-containing regimens.

2018 ◽  
Vol 7 (5) ◽  
pp. 217-224
Author(s):  
Zouaouia Chama ◽  
Khedoudj Kanoun ◽  
Fatima Zohra Elkadi ◽  
Kara Turqui Douidi ◽  
Noria Harir ◽  
...  

Helicobacter pylori infection concerns half of the world’s population, mainly in developing countries. It causes several gastrodudenal pathologies such as gastritis, ulcer and gastric adenocarcinoma. The aim of our study was to determine the prevalence of H.pylori infection and to assess the impact of different epidemiological factors as well as principal gastric diseases associ-ated to this infection. We underwent a prospective study during 18 months (month 2016-month 2017) which implicated 201 symptomatic patients for gastric fiboptic endoscopy at the level of Sidi Bel Abbes University hospital. We collected patients’ biopsies to perform a histological study and H. pylori culture. H. pylori identification was carried out based on bacteriological and biochemical analysis. The middle age of our population was (47.29 ±15.97ans) and the sex-ratio =0,8. The global prevalence of Helicobacter pylori infection is of 61.2% (123/201). This rate, after a statistic analysis, seems to be significantly related to age. It is particularly high especially for patients belonging to age range (20-30)-(51-60) years. The gender did not affect the infection prevalence that is more frequent in the gastritis case. We noticed also that HP infection prevalence was important in SBA the hospital. The range age (20-30)-(51-60) years had the highest prevalence of H. pylori and of gastritis which might be a risky ground of gastric cancer appearance. The ulcer pathology maximal rate concerned the group of 51 to 60 years. Above this age, this rate dropped whereas the number of patients suffering from gastric cancer, which presents an important rate in our study, increase for the group of 61-70 years.


2009 ◽  
Vol 58 (5) ◽  
pp. 567-576 ◽  
Author(s):  
Kuei-Hsiang Hung ◽  
Jiunn-Jong Wu ◽  
Hsiao-Bai Yang ◽  
Li-Ju Su ◽  
Bor-Shyang Sheu

Helicobacter pylori eradication can reverse gastric intestinal metaplasia (IM) in some but not all patients. H. pylori induces high levels of nuclear β-catenin staining in IM tissues, as well as overexpression of cyclooxygenase-2 (COX-2). This study investigated whether the Wnt/β-catenin pathway plays a role in IM regression following H. pylori eradication. Sixty-five H. pylori-infected patients with IM who had achieved successful H. pylori eradication provided paired gastric samples before and after eradication to analyse the persistence of IM, and to assess COX-2 and nuclear β-catenin expression. The host genotypes of single nucleotide polymorphisms (SNPs) of the COX-2, β-catenin (CTNNB1) and adenomatous polyposis coli (APC) genes were analysed. In addition, expression of β-catenin, E-cadherin and phosphorylated and unphosphorylated glycogen synthase kinase 3β (GSK-3β) in cell lines challenged with H. pylori isolates from patients with and without IM persistence was compared by immunoanalysis. After a mean 33.9-month follow-up after H. pylori eradication, 44 patients (67.7 %) with IM persistence had a higher rate of high-level nuclear β-catenin expression in IM tissue than those without IM persistence (P=0.008). The patients with IM persistence had a higher rate of AA, GG and AA APC SNP genotypes at positions 4479, 5268 and 5465, respectively, than the patients without IM persistence (P=0.022). The H. pylori isolates from the patients with IM regression after H. pylori eradication induced more phospho-GSK-3β in AGS cells than isolates from patients with IM persistence (P=0.011). It is likely that interactions with H. pylori and the patient's Wnt/β-catenin genetic predisposition determine the outcome of IM persistence following H. pylori eradication.


2021 ◽  
Author(s):  
Jinnan Chen ◽  
Yu Huang ◽  
Zhaohui Ding ◽  
Xiao Liang ◽  
Hong Lu

Abstract Background: A number of studies have shown that E-test overestimated the presence of Helicobacter pylori (H. pylori) resistance compared to agar dilution.Objective: The purpose of this study was to explore whether E-test could be an alternative for agar dilution to detect the metronidazole susceptibility of H. pylori.Method: E-test and agar dilution were used to assess susceptibility of H. pylori to metronidazole, clarithromycin and levofloxacin in 281 clinical isolates obtained from China where resistance was high. Cohen kappa analysis, McNemar test, essential and categorical agreement analysis were performed for these two methods. Results: Overall, the result of E-test showed similar prevalence of resistance rate to all antibiotics compared with agar dilution. The essential agreement (EA) of E-test method and agar dilution in the evaluation susceptibility of H. pylori to clarithromycin and levofloxacin were moderate, with 89.0% and 79.7% respectively, but only 45.9% for metronidazole. Results showed categorical agreement (CA) between E-test and agar dilution were 100% for both clarithromycin and levofloxacin. As for metronidazole, the CA was 98.7%, no major error was identified, and rate of very major error was 1.8%.Conclusion: E-test can be an alternative method to detect the metronidazole susceptibility of H. pylori in regions where high-level resistance is common.


2017 ◽  
Vol 55 (07) ◽  
pp. 653-656 ◽  
Author(s):  
Caspar Franck ◽  
Armin Hoffmann ◽  
Alexander Link ◽  
Christian Schulz ◽  
Kerstin Wuttig ◽  
...  

Abstract Background In the federal state of Saxony-Anhalt, gastric cancer (GC) incidence ranks among the highest in Germany. Helicobacter pylori prevalence is a surrogate marker for GC risk in a given population. In 2010 we reported an H. pylori seroprevalence of 44.4 % in patients at the emergency ward of the University Hospital of Magdeburg, the capital of Saxony-Anhalt. Our aim is to update these findings in a cohort of healthy blood donors from the same region. Materials and methods The sera of 516 consecutive blood donors (40.1 ± 14.1 years; 286 males and 230 females) were tested for antibodies against H. pylori and CagA. Data on demographics and previous H. pylori eradication therapy were obtained by means of a structured questionnaire. Blood donors with positive serology for H. pylori or CagA and/or history of eradication therapy were classified as H. pylori-positive. Results Overall, 28.9 % of the study cohort were H. pylori-positive. The prevalence was higher in older generations (9 % in 18 – 20 years up to 47 % in 61 – 70 years). In 44.4 % of H. pylori IgG-positive donors, CagA serology was also positive. This proportion was not age-dependent. Study participants with siblings were by trend more often H. pylori-positive (p = 0.066). Conclusion Compared to our previous study in patients at the emergency ward, we found by trend lower age-related H. pylori prevalence rates. In our cohort of healthy blood donors, we confirmed a lower H. pylori prevalence in younger generations.


2019 ◽  
Author(s):  
Hadeel Gassim Hassan ◽  
Abeer Babiker Idris ◽  
Mohamed A. Hassan ◽  
Hisham N. Altayb ◽  
Kyakonye Yasin ◽  
...  

AbstractBackgroundThere is an increase in the prevalence of Helicobacter pylori infection in Sudan, accompanied by a high incidence of upper gastrointestinal malignancy. The cytotoxin-associated gene cagA gene is a marker of a pathogenicity island (PAI) in H. pylori and plays a crucial role in determining the clinical outcome of Helicobacter infections.ObjectiveThis study aimed to determine the frequency and heterogeneity of the cagA gene of H. pylori and correlate the presence of cagA gene with clinical outcomes.Materials and methodsFifty endoscopy biopsies were collected from Fedail and Soba hospitals in Khartoum state. DNA was extracted using the Guanidine chloride method followed by PCR to amplify 16S rRNA and cagA gene of H. pylori using specific primers. DNA amplicons of cagA gene were purified and sequenced. Bioinformatics and statistical analysis were done to characterize and to test the association between cagA gene and gastric complications.ResultsCagA gene was detected in 20/37(54%) of the samples that were found positive for H. pylori. There was no association between endoscopy finding and the presence of the cagA gene (p = 0.225). Specific amino acid variations were found at seven loci related to strains from a patient with duodenitis, gastric ulcer, and gastric atrophy (R448H, T457K, S460L, IT463-464VA, D470E, A482Q, KNV490-491-492TKT) while mutations in cancerous strain were A439P, T457P, and H500Y.ConclusionDisease-specific variations of cagA of H. pylori strains, in the region of amino acid residues 428-510, were evident among Sudanese patients with different gastroduodenal diseases. A novel mutation (K458N) was detected in a patient with duodenitis, which affects the positive electrostatic surface of cagA. Phylogenetic analysis showed a high level of diversity of cagA from Sudanese H. pylori strains.


2016 ◽  
Vol 73 (11) ◽  
pp. 1044-1049 ◽  
Author(s):  
Sasa Grgov ◽  
Tomislav Tasic ◽  
Biljana Radovanovic-Dinic ◽  
Daniela Benedeto-Stojanov

Background/Aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 ? 30 mg half an hour before the meal, amoxicillin 2 ? 1.000 mg per 12 hours and clarithromycin 2 ? 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.


2017 ◽  
Vol 3 (1) ◽  
pp. 29
Author(s):  
Willy Brodus Uwan ◽  
Ari Fahrial Syam ◽  
C Rinaldi A. Lesmana ◽  
Cleopas Martin Rumende

Pendahuluan. Risiko infeksi Helicobacter pylori (H. pylori) dikaitkan dengan banyak faktor yang terkait dengan pejamuagen-lingkungan. Etnis adalah salah satu faktor dari pejamu yang banyak diteliti di luar negeri. Prevalensi infeksi H. pylori didapatkan lebih tinggi pada etnis tertentu seperti misalnya di Cina. Berdasarkan teori migrasi dan teori transmisi, diduga infeksi H. pylori akan dibawa oleh penduduk yang bermigrasi dari daerah dengan prevalensi tinggi ke tempat tujuan migrasi. Etnis Tionghoa di Kalimantan Barat berasal dari daerah Cina Selatan dengan prevalensi infeksi H.pylori tinggi. Diperkirakan ada perbedaan angka prevalensi infeksi H. pylori pada etnis Tionghoa dibandingkan pada etnis asli Kalimantan Barat, yaitu etnis Dayak. Penelitian ini dilakukan untuk mengetahui perbedaan angka prevalensi, karakteristik epidemiologis dan gambaran hasil pemeriksaan endoskopi pada subjek etnis Tionghoa dan Dayak dengan sindrom dispepsia.Metode. Penelitian ini menggunakan studi potong lintang untuk mengetahui perbedaan angka prevalensi infeksi H.pylori. Penelitian dilakukan di RSU Santo Antonius Pontianak dari bulan Desember 2014 sampai Juni 2015 dengan metode pengambilan sampel secara consecutive sampling. Angka prevalensi infeksi H. pylori disajikan dalam angka persentase, sedangkan perbedaan karakteristik epidemiologis dan perbedaan gambaran hasil pemeriksaan endoskopi pada etnis Tionghoa dan Dayak dianalisis dengan analisis bivariat menggunakan chi-square dengan tingkat kemaknaan (p)=0,05.Hasil. Dari 203 subjek yang diteliti, terdiri dari 102 subjek etnis Tionghoa dan 101 subjek etnis Dayak, didapatkan angkaprevalensi H. pylori sebesar 40,8%. Prevalensi pada etnis Tionghoa didapatkan lebih tinggi dibanding etnis Dayak,berturut-turut sebesar 48,0% dan 33,7%. Tidak ditemukan adanya perbedaan karakteristik epidemiologis dan temuan hasil pemeriksaan endoskopi yang bermakna pada kedua kelompok etnis.Simpulan. Terdapat perbedaan angka prevalensi infeksi H. pylori pada etnis Tionghoa (48,0%) dibanding etnis Dayak (33,7%). Namun, tidak ada perbedaan karakteristik epidemiologis dan gambaran hasil pemeriksaan endoskopi pada kedua kelompok etnis tersebut.Kata kunci: Dayak, etnis, Helicobacter pylori, sindrom dispepsia, Tionghoa The Difference in Prevalence of Helicobacter pylori Infection between Chinese and Dayak Ethnics with Dyspepsia SyndromeIntroduction. Helicobacter pylori (H. pylori) infection risk is associated with many factors related to host-agent-environment. Ethnicity is one of the host factors which was the most studied factor overseas. The prevalence of H. pylori infection was found higher in certain ethnic such among Chinese. Based on migration and transmission theory, it was suspected that H. pylori infection was transmitted by people migrating from areas with a high prevalence of infection to the destination area. Chinese in West Borneo are originated from South China region where the prevalence of H. pylori infection is high. It is estimated that there are differences in the prevalence of H. pylori infection among Chinese compared to the native people of West Borneo, the Dayaknese. Methods. This was a cross-sectional study to determine the differences in the prevalence of H. pylori infection. The study was conducted at St. Antonius General Hospital Pontianak from December 2014 to June 2015 with consecutive samplingmethod. H. pylori infection prevalence is presented in percentage numbers, while the epidemiological characteristics and endoscopic finding differences among Chinese and Dayaknese were analyzed by bivariate analysis using the chi-square with significance value (p) = 0.05.Results. From a total of 203 subjects in this study, consisted of 102 Chinese subjects and 101 Dayaknese subjects, the prevalence of H. pylori infection was 40.8%. The prevalence among Chinese is higher than Dayaknese, which is 48.0% and 33.7%, respectively. There is no difference in the epidemiological characteristics and endoscopic findings in both ethnic groups.Conclusions. The prevalence of H. pylori infection among the Chinese (48.0%) is higher than among Dayaknese (33.7%). There is no difference in the epidemiological characteristics and endoscopic findings among both ethnic groups.Keywords: Chinese, Dayak, Dyspeptic syndrome, Ethnic, Helicobacter pylori


2009 ◽  
Vol 46 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Abadia Gilda Buso ◽  
Haroldo Luis Oliva Gomes Rocha ◽  
Débora Miranda Diogo ◽  
Priscila Miranda Diogo ◽  
Augusto Diogo-Filho

CONTEXT: The association between Helicobacter pylori infection and colon neoplasia has been the subject of recent investigations which have produced controversial results. OBJECTIVE: To evaluate the prevalence of H. pylori infection in patients with colonic adenomas and also in patients whose colonoscopy exams were normal. METHODS: After colonoscopy, the individuals were distributed into two groups: patients with colon adenomas (cases) and patients whose colons were normal (controls). The groups were similar regarding age and gender. The individuals of both groups were subjected to a dosage of IgG antibody against H. pylori. The dosage was applied according to the solid phase, chemiluminescent immunometric assay. The chi-square test was used to analyze the data. RESULTS: There were 30 men and 64 women in each group (94 cases and 94 controls). The mean age of the cases was 59.79 ± 12.25 years and that of the controls was 58.98 ± 11.55 years. The H. pylori serology was positive for 66 (70.21%) of the cases and for 51 (54.25%) of the controls. There was a significant difference (P = 0.024). The odds ratio was 1.98 (CI 95%, 0.82-3.15). The prevalence of H. pylori in cases and controls according to gender, histological type and location of the colon lesions showed a significant difference only among women (P = 0.03), among patients with tubular adenomas (P = 0.03), and in those with distal adenomas (P = 0.038). CONCLUSION: There is a positive association between H. pylori infection and colonic adenomas. This association is more evident in women, especially for tubular adenomas and distal colonic location.


2019 ◽  
Vol 9 (2) ◽  
pp. 321-324 ◽  
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Mohammad Hosein Somi ◽  
Mohammad Asghari Jafarabadi ◽  
Alireza Ostadrahimi ◽  
Seyed-Yaghob Moaddab ◽  
...  

Purpose: The present study aimed to assess the effect of ginger (Zingiber officinale) powder supplementation on Helicobacter pylori eradication and improvement of dyspeptic symptoms in patients with H. pylori positive functional dyspepsia (FD). Methods: During this pilot study 15 patients with H. pylori positive FD received 3 g/d ginger powder as three 1-g tablets for 4-weeks. Dyspepsia symptoms were asked before and after the intervention using a questionnaire based on the Rome III criteria. H. pylori eradication was also assessed by a non-invasive stool antigen (HpSAg) test. Results: Ginger consumption accompanied by significant H. pylori eradication rate of 53.3% (P = 0.019) and the odds ratio (95% CI) was 8 (1.07 to 357.14). Moreover, our results showed significant changes in most of the dyspepsia symptoms after ginger supplementation. Conclusion: According to our findings, Z. officinale can be considered as a useful complementary therapy for FD. However, due to the small number of clinical trials in this area, further welldesigned clinical trials are needed to explicitly talk about its effectiveness especially about the eradication of H. pylori.


2017 ◽  
Vol 54 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Arezu JUDAKI ◽  
Asghar RAHMANI ◽  
Jalil FEIZI ◽  
Khairollah ASADOLLAHI ◽  
Mohammad Reza HAFEZI AHMADI

ABSTRACT BACKGROUND Helicobacter pylori (H. pylori) gastric infection is a main cause of inflammatory changes and gastric cancers. OBJECTIVE The aim of this study was finding the effects of curcumin on oxidative stress and histological changes in chronic gastritis associated with H. pylori. METHODS In a randomized clinical trial, patients were divided into two groups: a standard triple therapy group and triple therapy with curcumin group. Endoscopic and histological examinations were measured for all patients before and after 8 weeks. RESULTS Triple therapy with curcumin treatment group significantly decreased malondialdehyde markers, glutathione peroxides and increased total antioxidant capacity of the gastric mucosa at the end of study compared to baseline and triple regimen groups. In addition, the oxidative damage to DNA was significantly decreased in triple therapy with curcumin group at the end of study compared to baseline and compared to triple therapy (P<0.05 for both). Triple therapy group in combination with Curcumin significantly decreased all active, chronic and endoscopic inflammation scores of patients compared to the baseline and triple therapy group (P<0.05 for both). The eradication rate by triple therapy + curcumin was significantly increased compared to triple therapy alone (P<0.05). CONCLUSION Curcumin can be a useful supplement to improve chronic inflammation and prevention of carcinogenic changes in patients with chronic gastritis associated by H. pylori.


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