Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study

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.

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European Registry on the management of Helicobacter pylori infection: features of diagnosis and treatment in Kazan

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.08.000758 ◽

2020 ◽

Vol 92 (8) ◽

pp. 52-59

Author(s):

S. R. Abdulkhakov ◽

D. S. Bordin ◽

R. A. Abdulkhakov ◽

D. D. Safina ◽

A. R. Gizdatullina ◽

...

Keyword(s):

Helicobacter Pylori ◽

Proton Pump Inhibitor ◽

Triple Therapy ◽

Proton Pump ◽

Eradication Therapy ◽

Helicobacter Pylori Infection ◽

Rapid Urease Test ◽

Standard Triple Therapy ◽

Urease Test ◽

H Pylori

Background. As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens.

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CHRONIC HELICOBACTER PYLORI GASTRITIS: THE ERADICATION EFFICACY&NBSP;OF THE&NBSP;BISMUTH-CONTAINING QUADRUPLE REGIMEN (EBMT)

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.2.21 ◽

2016 ◽

pp. 149-158

Author(s):

Ngoc Quy Hue Dang ◽

Van Huy Tran ◽

Thanh Hai Nguyen

Keyword(s):

Helicobacter Pylori ◽

Side Effects ◽

Chronic Gastritis ◽

Medication Compliance ◽

Compliance Rate ◽

Eradication Therapy ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

Helicobacter Pylori Gastritis

Background: there has not been yet any research on the effectiveness of H. pylori eradication of bismuth-containing quadruple regimen on chronic gastritis patients in our country. Objective: to evaluate H. pylori eradication rate of bismuth-containing quadruple regimen according to intention to treat (ITT), per protocol (PP) analysis, the rate of side effects and medication compliance. Subjects and Methods: from March 2014 to January 2016 we used bismuth-containing quadruple regimen (EBMT) 10 days for H. pylori eradication therapy for 166 chronic gastritis patients diagnosed based on clinical, endoscopic, rapid urease test, histology and culture. Patients were evaluated side effects and medication compliance at the end of treatment (day 11-14). To assess the eradication, repeating endoscopy with both rapid urease test and histological examination were performed at 4 to 8 weeks after stopping treatment course. Results: H. pylori eradication rates on ITT and PP analysis overall, for naïve patients, after one and more two eradication failures were respectively: 80.72-89.33%, 79.51-90.65%, 91.67-91.67% and 75.00-78.95%. Medication adherence rate was 96.99%. The rates of patients experiencing moderate, severe and very severe side effects were: 19.88%, 0.60% and 1.81%. Conclusion: the EBMT 10-day regimen attained high eradication rates in chronic gastritis patients with rare serious side effects and the high compliance rate. We should apply bismuth-containing quadruple regimen in H. pylori eradication therapy for naïve patients or after one eradication failure. Key words: bismuth-containing quadruple regimen, EBMT, eradication, chronic Helicobacter pylori gastritis

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Association of cagA, cagC, virB2, and vacA Subtypes of Helicobacter pylori with Adenocarcinoma Development in Iranian Patients

Jundishapur Journal of Microbiology ◽

10.5812/jjm.101275 ◽

2020 ◽

Vol 13 (7) ◽

Author(s):

Pouya Khodadadi ◽

Mohammad Kargar ◽

Mahdi Bijanzadeh ◽

Abbas Doosti ◽

Shapoor Aghaei

Keyword(s):

Helicobacter Pylori ◽

Gastric Ulcers ◽

Rapid Urease Test ◽

Genotype Distribution ◽

Caga Gene ◽

Group I ◽

Two Samples ◽

Urease Test ◽

H Pylori ◽

Iranian Patients

Background: Gastric cancer has been introduced as the second cause of cancer death worldwide. Helicobacter pylori infection is considered one of the main risk factors for this type of cancer, so that it has been classified as group I carcinogens. Objectives: The present research intended to examine the prevalence of cagA, cagC, virB2, vacA, and genotype distribution in H. pylori-infected biopsies and adenocarcinoma cases. Methods: Thirty-four H. pylori gastric biopsies taken from Western Iranian patients that were diagnosed as gastritis, gastric ulcers, and adenocarcinoma were used in this study. Two samples were taken from each patient. These samples were selected based on endoscopic observations and histological examinations. The presence of H. pylori was confirmed by the Rapid Urease test (RUT) and the ureC gene by the polymerase chain reaction (PCR) technique. Then, specific primers for vacA and cagPAI were used for genotyping H. pylori by PCR-typing. Results: The obtained results showed that 86.8% of the samples were H. pylori-positive. Moreover, the cagA gene prevalence was 51.50% in the samples. In addition, the adenocarcinoma outcome was significantly related to all selected genes. Likewise, some gastric diseases such as gastric ulcers, duodenal ulcer (DU), gastritis, lymphoid, and gastroesophageal reflux disease (GERD) were observed in adenocarcinoma cases. It was also found that the vacAs1m1i1 genotype plays an important role in gastric malignancies. The most frequent vacA genotype in the H. pylori-infected isolates was s1m1i1, and the observed frequency of vacA and cagA genes in adenocarcinoma was statistically significant. Conclusions: The findings showed that H. pylori vacA and cagA gene virulence factors are associated with adenocarcinoma in Western Iranian patients.

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Evidence of mother-child transmission of Helicobacter pylori infection

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032004000400008 ◽

2004 ◽

Vol 41 (4) ◽

pp. 239-244 ◽

Cited By ~ 16

Author(s):

Mario Luis Escobar ◽

Elisabete Kawakami

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Family Members ◽

Control Group ◽

Common Source ◽

Rapid Urease Test ◽

Source Of Infection ◽

Group I ◽

Urease Test ◽

H Pylori

BACKGROUND: Low socioeconomical status is a major risk factor for natural acquisition of Helicobacter pylori (H. pylori) infection in developing countries. Its transmission route is unknown but studies suggest person-to-person transmission. AIM: To evaluate seropositivity of anti-H. pylori antibodies in family members of infected symptomatic index patients as compared to family members of symptomatic uninfected index patients. PATIENTS AND METHODS: One hundred and twelve family members of 38 patients who underwent endoscopy to exclude peptic disease were studied. Patients were deemed H. pylori infected or not infected when rapid urease test and histology were both positive or both negative. The family members underwent ELISA serology using the Cobas Core II Kit (Roche) and were classified into three groups: I - 29 family members of 10 H. pylori (+) duodenal ulcer index patients; II - 57 family members of 17 H. pylori (+) index patients without duodenal ulcer; III - 26 family members of 11 H. pylori (-) index patients. RESULTS: Seropositivity of group I and II (infected patients) was higher than the control group, 83% vs 38%, specially in mothers, 81% vs 18%, and in siblings 76% vs 20%. Differences between fathers' seropositivity was not statistically significant in the three groups: 100% vs 86% vs 70%. Seropositivity of all family members (mother, father and siblings) between infected group (I vs II) was similar. CONCLUSION: Prevalence of H. pylori infection was higher in family members of infected patients, but was similar among family members of infected patients with and without duodenal ulcer. H. pylori infection is more frequent in mothers and siblings of infected index children. A common source of infection cannot be excluded, but facts suggest that person-to-person transmission occurs, specially from mother to child.

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Evropeyskiy registr Helicobacter pylori (Hp-EuReg): analiz dannykh 2360 bol'nykh, poluchavshikh terapiyu pervoy linii v Rossii

Terapevticheskii arkhiv ◽

10.26442/terarkh201890235-42 ◽

2018 ◽

Vol 90 (2) ◽

pp. 35-42 ◽

Cited By ~ 4

Author(s):

D S Bordin ◽

Yu V Embutnieks ◽

L G Vologzhanina ◽

T A Il'chishina ◽

I N Voinovan ◽

...

Keyword(s):

Helicobacter Pylori ◽

Clinical Practice ◽

Triple Therapy ◽

Day Treatment ◽

Eradication Therapy ◽

Primary Diagnosis ◽

Rapid Urease Test ◽

Urease Test ◽

Multicenter Prospective Observational Study ◽

H Pylori

On behalf of the scientific Committee and researchers Hp-EuReg European Registry on the management of Helicobacter pylori infection («Hp-EuReg») - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. Materials and methods. The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg» in 2013-2017, who were underwent 1st line eradication therapy. Results. The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effectiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clarithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Еradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. Conclusion. Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.

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European registry Helicobacter pylori (Hp-EuReg): how has clinical practice changed in Russia from 2013 to 2018 years

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.02.000156 ◽

2019 ◽

Vol 91 (2) ◽

pp. 16-24 ◽

Cited By ~ 5

Author(s):

D S Bordin ◽

Yu V Embutnieks ◽

L G Vologzhanina ◽

T A Ilchishina ◽

I N Voynovan ◽

...

Keyword(s):

Helicobacter Pylori ◽

Clinical Practice ◽

Serological Test ◽

Eradication Therapy ◽

Diagnostic Methods ◽

Helicobacter Pylori Infection ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

European Registry

The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: “Hp-EuReg”) allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. Materials and methods. A comparative analysis of the data entered in the register by the Russian research centers “Hp-EuReg”, in the period from 2013 to 2018, was conducted. Results and discussion. Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. Conclusion. In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.

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Early Development of Refl ux Esophagitis after Successful Helicobacter Pylori Eradication in Superfi cial Gastritis

Journal of Nepal Medical Association ◽

10.31729/jnma.23 ◽

2011 ◽

Vol 51 (184) ◽

Author(s):

H H Jeon ◽

HH Jeon

Keyword(s):

Helicobacter Pylori ◽

Los Angeles ◽

De Novo ◽

Eradication Therapy ◽

Rapid Urease Test ◽

Stomach Body ◽

Short Period ◽

Urease Test ◽

H Pylori

The relationship between gastroesophageal refl ux disease (GERD) and Helicobacter pylori (H. pylori) eradication is still debated. Recently, we had a patient of GERD who had developed it shortly after H. pylori eradication therapy. A 72-year-old man was diagnosed by endoscopy as suffering from severe superfi cial gastritis in the stomach body. A rapid urease test showed H. pylori infection. He was then started on proton pump inhibitor (PPI) based therapy for two weeks eradicating H.pylori. After completion of H. pylori eradication, he complained of a heart-burn sensation. Follow-up endoscopy showed refl ux esophagitis, of grade B according to the Los Angeles classifi cation. Since the patient had developed GERD after completion of the triple therapy, their suggests that H. pylori eradication must have triggered the development of de novo GERD after a short period of time. Keywords: GERD, Helicobacter pylori, PPI.

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Influence of H. Pylori and Sex on Leukocyte Differentials

10.21203/rs.3.rs-208716/v1 ◽

2021 ◽

Author(s):

Yuri Fukui ◽

Hiroyuki Yamanaka ◽

Noboru Kitamura ◽

Masami Takei ◽

Maho Iwamoto ◽

...

Keyword(s):

Helicobacter Pylori ◽

Medical Information ◽

University Hospital ◽

Rapid Urease Test ◽

Igg Antibody ◽

Urease Test ◽

The Difference ◽

H Pylori ◽

Negative Controls ◽

Eosinophil Counts

Abstract Background: Influence of Helicobacter pylori infection and sex difference on leukocyte differentials was insufficiently understood. We therefore conducted the current study to evaluate influence of H. pylori and sex on peripheral leukocyte differentials as well as influence of Helicobacter pylori eradication. Methods: Dyspeptic patients and persons asked to examine gastroduodenal lesions at medical check were included. Total leukocytes, differentials, and anti-H.pylori IgG antibody were measured. Those change after eradication was also measured. H. pylori infection was assessed by anti-H. pylori IgG antibody, rapid urease test, and pathologic findings. H. pylori-uninfected patients and non-dyspeptic/seronegative persons were regarded as negative controls. Results: Totally 374 patients and 299 controls were evaluated, and 167 patients were successfully eradicated. Peripheral counts of neutrophil and monocyte elevated with H. pylori infection: 3221.7+/-1108.7 vs. 2911.9+/-1027.3/μL and 307.5+/-130.5 vs. 281.5+/-106.4/μL, (p=.0002 and .0054). Compared to females, males manifested elevated counts of every leukocyte, but the difference was insignificant in basophil (p=.0089, 0.0316, <.0001, and .0384 for neutrophil, lymphocyte, monocyte, and eosinophil, respectively). After eradication, counts of neutrophil, lymphocyte, and monocyte declined: 3111.0+/-966.8 to 2785.1+/997.2/μL, 1905.9+/-603.2 to 1831.6+/-613.5/μL, and 293.1+/-113.3 to 264.3+/-93.6/μL by 2 months (p=<.0001, .0189, and .0004). In contrast, eosinophil counts elevated from 123.2+/-97.0 to 139.8+/-115.4 by 2 months, and to 159.6+/-132.8/μL by 6 months (p=.0349 and <.0001). Conclusions: We confirmed increases in neutrophils and monocytes in H. pylori-infected patients. Successful eradication reduced peripheral counts of neutrophil, lymphocyte, and monocyte, whereas it increased eosinophil counts. Males manifested elevated counts of every leukocyte, comparing to females. H. pylori infection influences systemic immune response and may not predispose to allergic disorders.Trial registration: The study protocol was registered on UMIN (University hospital Medical Information Network system) in Japan (R000017345) in 2014.

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Frequency of rdx A Deletion Mutation Conferring Metronidazole Resistance in Helicobacter pylori

10.51429/ejmm29308 ◽

2020 ◽

Vol 29 (3) ◽

pp. 59-64

Author(s):

Hanaa M. El Maghraby ◽

Samar Mohaseb

Keyword(s):

Helicobacter Pylori ◽

Epigastric Pain ◽

Deletion Mutation ◽

Rapid Urease Test ◽

Rrna Gene ◽

University Hospitals ◽

Metronidazole Resistance ◽

Urease Test ◽

Gastric Biopsies ◽

H Pylori

Background: Metronidazole is one of the antimicrobial drugs that can be used in combination with other drugs for eradication of Helicobacter pylori (H. pylori).Unfortunately, metronidazole resistance in H. plori is an increasing health problem which may be attributed to inactivation of many genes as rdx A gene. Objective: To determine the frequency of rdx A deletion mutation in H. pylori detected in infected patients attending at the Gastroenterology Unit, Zagazig University Hospitals. Methodology: Two gastric biopsies were taken from each enrolled patient by endoscopy. H.pylori detection was done by rapid urease test and polymerase chain reaction (PCR) amplification of 16S rRNA gene. Deletion mutation in rdx A gene was detected by conventional PCR. Results: Out of 134 doubled gastric biopsies obtained from 134 patients, 52.2% were positive for H. pylori. Epigastric pain, vomiting and gastritis were significantly associated with detection of H. pylori infection (p˂ 0.05). Deletion mutation of rdx A gene was detected in 28.6% of H. pylori positive specimens obtained from infected patients. Conclusion: Deletion mutation of rdx A gene is a frequent determinant of rdx A inactivation conferring metronidazole resistance among H. pylori.

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Incidence of Gastric Metaplasia and Helicobacter pylori Infection in Duodenal Bulb – With Specific Reference to Patients With Duodenal Ulcers

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.6.17 ◽

1999 ◽

Vol 6 (1) ◽

pp. 17-23 ◽

Cited By ~ 4

Author(s):

Minoru Kawaguchi ◽

Toshihiko Saito

Keyword(s):

Helicobacter Pylori ◽

Duodenal Bulb ◽

Mucosal Injury ◽

Transitional Zone ◽

Specific Reference ◽

Rapid Urease Test ◽

Duodenal Ulcers ◽

Gastric Metaplasia ◽

Urease Test ◽

H Pylori

We determined the incidence of gastric metaplasia in the duodenal bulb of duodenal ulcer patients and the Helicobacter pylori (H. pylori) infection rate at sites with gastric metaplasia. Biopsy of the duodenal bulb showed the presence of gastric metaplasia in 61 of 86 patients (71%) overall and in 18 of 47 patients (38.3%) who had gastrectomy at an early gastric cancer. The histological diagnosis of H. pylori infection showed good agreement (83.3%) with the result of the rapid urease test, indicating that H. pylori occurs in regions with gastric metaplasia. This finding suggests that H. pylori infects gastric metaplasia in the duodenal bulb, causing mucosal injury, which is then transformed into duodenal ulcers. The exact mechanism by which gastric metaplasia is caused is unknown, but it is believed to occur in the transitional zone in the duodenal mucosa.

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