Are Histopathological Changes of H. pylori Infection in Young Dyspeptic Patients Necessitate Endoscopy?

BACKGROUND: Helicobacter pylori is an important gastrointestinal infective bacteria with many serious complications including gastric erosions and ulceration, duodenal ulcer, gastric carcinoma and MALT gastric lymphoma. The gastric biopsy is commonly performed in H. pylori-positive dyspeptic individuals, and many previous researchers studied the histopathological features of infected gastric biopsies however little previous studies focused on the histopathological findings in young population in comparison to the older one. AIM: To make a focus on the histopathological effects of H. pylori infection in young patients compared with the older one and predicts the need for endoscopy in this population, also to estimates the prevalence of infection in Iraqi patients. MATERIAL AND METHODS: the sample for this study is 180 patients in total, they attended Marjan medical city in Iraq for dyspepsia of more than 3 months and prepared for OGD. Patients asked for their permission to do immunological tests for H. pylori. Both serology for H. pylori antibodies and stool for antigen tests are used, and the case is included in the study only if both tests were positive, after OGD, the gastric biopsies are processed and examined histopathologically. RESULTS: Normal gastric biopsy is the most common histopathological finding in young (< 25 years) patients (75%) while chronic atrophic gastritis is the most common one in patients > 25 years age (57%). The prevalence of Helicobacter pylori infection in dyspeptic patients was 73.3%, the correlation between infection and sex was insignificant (p-value 0.06), and no significant correlation between infection and age (p-value 0.07) was concluded. CONCLUSION: H. pylori-related histopathological changes of gastric mucosa in young (< 25 years) are commonly mild and does not necessitate endoscopy at this age unless there are alarming signs.

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Successful isolation of Helicobacter pylori after prolonged incubation: A case report of prolonged incubation for H. pylori

Archives of Biological Sciences ◽

10.2298/abs1204297b ◽

2012 ◽

Vol 64 (4) ◽

pp. 1297-1299

Author(s):

Tatjana Babic ◽

Biljana Miljkovic-Selimovic ◽

Branislava Kocic ◽

A. Nagorni ◽

Ljiljana Ristic

Keyword(s):

Helicobacter Pylori ◽

Normal Growth ◽

Gastric Biopsy ◽

Gram Stain ◽

Ulcus Ventriculi ◽

Prolonged Incubation ◽

Primary Isolation ◽

Successful Isolation ◽

Gastric Biopsies ◽

H Pylori

The culture of Helicobacter pylori from a gastric biopsy is the ?gold standard? in the diagnosis of H. pylori infection. However, the primary isolation of H. pylori from gastric biopsies is rather demanding. The duration of incubation for the isolation of H. pylori has been recommended to be five to seven days: in the present case, we found that a prolonged incubation period allowed the successful isolation of H. pylori from a patient with ulcus ventriculi. Biopsies were placed directly into transport medium and processed for culture within two hours. On day 14, one suspected H. pylori-like colony appeared on one of the plates. The isolate was confirmed to be H. pylori based on its typical colony morphology, negative Gram stain, and positive urease, catalase and oxidase tests. The isolate, requiring 14 days recovery, later exhibited the normal growth characteristics of H. pylori strains, indicating its unusually long incubation requirement was a temporary predicament.

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Correlation between virulence markers of Helicobacter pylori in the oral cavity and gastric biopsies

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201700000-24 ◽

2017 ◽

Vol 54 (3) ◽

pp. 217-221 ◽

Cited By ~ 4

Author(s):

Myriam Lucrecia MEDINA ◽

Marcelo Gabriel MEDINA ◽

Luis Antonio MERINO

Keyword(s):

Helicobacter Pylori ◽

Oral Cavity ◽

Virulence Genes ◽

Gastric Biopsy ◽

Oral Diseases ◽

Cross Sectional ◽

Virulence Markers ◽

Significant Difference ◽

Gastric Biopsies ◽

H Pylori

ABSTRACT BACKGROUND: The clinical outcome of Helicobacter pylori infection has been associated with virulence factors. The presence of these factors is useful as molecular markers in the identification of the high risk for developing severe gastric pathologies. OBJECTIVE: To correlate the presence of virulence markers cagA and bab2A of H. pylori in oral and gastric biopsy samples. METHODS: An observational, prospective, descriptive, and cross-sectional study was carried out between September 2011 and September 2012. Patients suffering dyspepsia with indication for upper gastrointestinal video endoscopy who attended the Gastroenterology Service of the Hospital Dr. Julio C. Perrando were included. Epidemiological investigation was completed. To detect the bacteria and their virulence genes, samples of saliva, dental plaque and gastric biopsy were taken and processed by PCR. RESULTS: Sixty-one patients were selected for this study (30 women and 31 men). H. pylori was detected in 31 gastric biopsies and 31 oral samples. Significant difference between oral and gastric samples was found in cagA genotype. Agreement between oral and gastric genotypes was found in 38.7% of samples from the same patient. CONCLUSION: This study is the first in provide information about the genotypes of the Argentinean Northeast H. pylori strains. Despite the high prevalence of H. pylori infection, the most of patients had less virulent genotypes in oral cavity and gastric tissue. The cagA / babA2 combination was not frequent in the samples studied. There was not a statistical correlation between the virulence genes and gastroduodenal or oral diseases. Although in some patients the same genotype was found both in oral and gastric samples, it cannot be ensure that they corresponding to the same strain because a DNA sequencing was not performed.

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Determination of Helicobacter pylori Virulence Genes in Gastric Biopsies by PCR

ISRN Gastroenterology ◽

10.1155/2013/606258 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Tamer Essawi ◽

Wail Hammoudeh ◽

Israr Sabri ◽

Walid Sweidan ◽

Mohammad A. Farraj

Keyword(s):

Helicobacter Pylori ◽

Virulence Genes ◽

Gastric Biopsy ◽

Strong Indication ◽

Specific Primers ◽

Biopsy Specimens ◽

Pcr Identification ◽

Gastric Biopsies ◽

H Pylori

Aim. The aim of this study was to identify the presence of H. pylori in biopsy specimens from symptomatic patients by PCR. In addition, the rate of cagA, vacA, iceA1, and iceA2 virulence genes was determined. Materials and Methods. One hundred antral gastric biopsy specimens were collected during endoscopy from patients suffering from gastroduodenal symptoms. The samples were collected by the gastroenterologists in their own clinics in Ramallah, Palestine. DNA was extracted from the biopsies and subsequently used for PCR identification of H. pylori and the virulence genes using specific primers. Results. The rate of positive H. pylori in the collected biopsies was 44%. The rates of the virulence genes in this sample: cagA, vacA, iceA1, and iceA2 were 65.9%, 40.9%, 63.6%, and 84.1%, respectively. Conclusion. The iceA2 gene was the most frequent in this study. Much research is necessary to determine the presence of an association of this gene with gastric pathology. Variation in the rates of the iceA gene in different countries is a strong indication of its geographical distribution. This study would provide important information regarding the prevalence of virulence genes (vacA, cagA, iceA1, and iceA2) in H. pylori strains in the sample tested in this country.

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Disappearance of Helicobacter without Antibiotics in 12 Patients with Gastritis

Canadian Journal of Gastroenterology ◽

10.1155/1997/423496 ◽

1997 ◽

Vol 11 (2) ◽

pp. 167-172 ◽

Cited By ~ 6

Author(s):

Hugh James Freeman

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Natural History ◽

Gastric Biopsy ◽

Endoscopic Procedures ◽

History Of ◽

Gastric Biopsies ◽

H Pylori ◽

Upper Gastrointestinal

Detection ofHelicobacter pyloriin endoscopic gastric biopsies has been associated with a variety of diseases, including ulcers and gastritis. Although the natural history ofH pyloriin the gastric mucosa is unknown, antibiotic regimens have been used for eradication. Gastric biopsies from 6050 endoscopic procedures done by a single gastroenterologist from 1981 to 1994 were evaluated. Of these, 2860 from April 1, 1991 to September 30, 1994 had silver-stained biopsies to facilitateH pyloridetection, and at least two upper endoscopic procedures were done with gastric biopsies in 188 patients. Twelve of the 188 patients with an initially positiveH pylorigastric biopsy becameH pylori-negative without antibiotic treatment forH pylorior other infection; 10 received omeprazole and two received no drug treatment. In two of the 12 patients recurrentH pyloriin the gastric mucosa was also documented. These findings indicate thatH pylorimay disappear and reappear in the gastric mucosa with no specific antibiotic eradication regimen, although omeprazole may eradicateH pyloriin vivo in some patients. The natural history ofH pyloriin gastric biopsies is poorly understood. Improved understanding, especially regarding the pathogenesis of upper gastrointestinal ulcerative and inflammatory disease processes, is essential before recommendations for specific antibiotic eradication regimens can be made.

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Comparison of Immunohistochemistry and Conventional Stains for Helicobacter Pylori Detection in Gastric Biopsies of Patients Receiving Proton Pump Inhibitors

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.2020752 ◽

2020 ◽

Author(s):

Kongsak Loharamtaweethong ◽

Napaporn Puripat

Keyword(s):

Helicobacter Pylori ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Giemsa Staining ◽

P Value ◽

Predictive Values ◽

Staining Methods ◽

Gastric Biopsies ◽

H Pylori ◽

Sensitivity Specificity

Objective: To evaluate the diagnostic performance of different staining methods for Helicobacter pylori (H. pylori) in patients treated with proton pump inhibitors (PPI) Material and Methods: This is a retrospective study involving 75 gastric biopsies from patients with and without PPI therapy between October 2018 and September 2019. Slides were stained with hematoxylin and eosin (H&E); Giemsa and immunohistochemical staining (IHC) was done using polyclonal anti-H. pylori antibodies. Statistical analysis was performed to determine any association between the results of different staining methods and PPI consumption. Sensitivity, specificity and positive-negative predictive values of H&E and Giemsa stains were calculated. Results: Overall, H. pylori infection was detected in 33.3% of patients using IHC, 26.7% using H&E, and 28.0% via Giemsa staining. A strong correlation was found between PPI consumption and low H. pylori density detected via IHC (p-value=0.015) but not using H&E and Giemsa staining. The sensitivity of H&E and Giemsa was markedly reduced as a result of PPI consumption (57.1% to 18.2% vs. 85.7% to 27.3%, respectively). Conclusion: Identification of H. pylori using IHC in patients treated with PPI was superior to H&E and Giemsa stains. Both H&E and Giemsa stains showed a marked decrease in sensitivity in patients receiving PPI. The results indicate that IHC should be performed in patients with PPI therapy instead of H&E or Giemsa stains, and PPI should be discontinued for at least 14 days before the performance of endoscopy.

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Helicobacter Pylori Infection in Sjögren’s Syndrome: Co-incidence or Causality?

Current Rheumatology Reviews ◽

10.2174/1573397114666181113102427 ◽

2019 ◽

Vol 15 (3) ◽

pp. 238-241

Author(s):

Massoud Saghafi ◽

Nafiseh Abdolahi ◽

Reza Orang ◽

Mohammad Reza Hatef ◽

Mohammad Hadi Molseghi

Keyword(s):

Helicobacter Pylori ◽

Serum Level ◽

Sjögren’S Syndrome ◽

Sjögren's Syndrome ◽

Sjogren’S Syndrome ◽

Sjogren's Syndrome ◽

Control Group ◽

P Value ◽

H Pylori ◽

Sjögren‘S Syndrome

Background and Aim: Lymphoid cell infiltration and destruction of exocrine glands, specifically lacrimal and salivary glands are characteristics of Sjogren’s syndrome (SS). An etiological role has been proposed for Helicobacter pylori (H. pylori), interacting in the clinical course and complications of SS (including gastric cancer and lymphoma). The aim of this study was to identify the probable correlation between H. pylori infection and Sjogren’s syndrome (SS). Methods: In this case-control study, ELISA method was used to determine serum level of IgA and IgM anti H. pylori antibody in 43 subjects with SS according to the international criteria and 95 healthy subjects as control. SPSS-17 was used to analyze data with t-test. P value <.05 were considered significant. Results: Serum level of IgM (34.9% vs. 10.5%, p-value= 0.001) and IgA (67.4% vs. 46.3% p value= 0.021) anti H. pylori antibody were significantly higher in SS patients compared to the control group. There was a positive correlation between age and H. pylori infection (r=0.2, Pvalue= 0.05). Conclusion: Patients with SS had a higher prevalence of H. pylori infection compared to the normal population. Eradication of H. pylori is recommended particularly in older patients with SS.

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Analysis of babA, cagE and cagA Genes in Helicobacter pylori from Upper Gastric Patients in the North of Iran

Infectious Disorders - Drug Targets ◽

10.2174/1871526518666180515113218 ◽

2019 ◽

Vol 19 (3) ◽

pp. 274-278 ◽

Cited By ~ 1

Author(s):

Saba Fakhrieh Asl ◽

Mehrnaz Pourvahedi ◽

Ali Mojtahedi ◽

Mohammad Shenagari

Keyword(s):

Helicobacter Pylori ◽

Gastric Diseases ◽

Specific Primers ◽

The North ◽

Different Types ◽

North Of Iran ◽

Gastric Biopsies ◽

Pcr Method ◽

Non Ulcer Dyspepsia ◽

H Pylori

Objective:Helicobacter pylori is a Gram-negative bacterium which has a serious effect on up to half of the world’s population and has been related to different gastric diseases. The goal of this study was to assess the frequency of babA, cagE and cagA genotypes among H. pylori strains isolated from gastric biopsies of endoscopic patients in the north of Iran.Methods:The present study was performed on 90 strains of H. pylori isolated from patients with gastric diseases (Gastric ulcer (GU), Duodenal ulcer (DU), Gastritis (G), Non-ulcer dyspepsia (NUD) and Gastric adenocarcinoma (GC)). DNA was extracted from all isolated strains and PCR method was performed to detect the prevalence of babA2, cagE and cagA genes using specific primers.Results:Among 90 samples of H. pylori, babA2, cagE, and cagA genes were detected in 42.2%, 30% and 82.2% of strains respectively. The statistical analysis showed that the prevalence of cagA gene in GU, G, DU, and NUD was significantly higher than other genes. Moreover, cagA, and babA2 genes were significantly more prevalent in GC patients compared to cagE gene. Our isolates exhibited 8 distinct arrangements of virulence patterns. The occurrence of cagA (35.6%) was the most prevalent pattern followed by cagA/babA2 (20%) and cagA/babA2/cagE (14.4%).Conclusion:In summary, as first report from Guilan province in the north of Iran, we showed significant association between the presence of babA2, cagE, and cagA genes in different types of gastric disorders.

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Perfil Epidemiológico de Pacientes Submetidos à Biópsia Gástrica em um Hospital Escola do Sul de Minas Gerais/ Epidemiological Profile of Patients Undergo Gastric Biopsy in a School Hospital of Minas Gerais

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v4i3.229 ◽

1970 ◽

Vol 4 (3) ◽

pp. 48-57

Author(s):

Isabela Maria A. Ribeiro Simões ◽

Ana Carolina Mauad Coli ◽

Roseane de Souza Candido Irulegui

Keyword(s):

Helicobacter Pylori ◽

Age Groups ◽

Epidemiological Data ◽

Minas Gerais ◽

Gastric Biopsy ◽

Gastric Ulcers ◽

Histopathological Diagnosis ◽

Gastric Diseases ◽

H Pylori ◽

Epidemiological Profile

Objetivo: Determinar a prevalência de lesões benignas e neoplasia gástrica através do estudo de biópsias realizadas em um Hospital Escola do Sul de Minas Gerais, no período entre 2007 e 2011. Materiais e Métodos: A pesquisa documental foi quantitativa e retrospectiva, baseada na análise dos registros de biópsias e prontuários. Realizou-se o levantamento de dados referentes à idade, gênero, cor, profissão, diagnóstico histopatológico e presença de Helicobacter pylori nas amostras. Resultados: O número total de biópsias gástricas analisadas foi de 1225, cujo perfil populacional encontrado foi: idade média de 56,75 anos, sexo masculino (52%), cor branca (81,9 %), aposentado (30%). Os diagnósticos mais frequentes foram: gastrites (71,9%), pólipos (14,2%), adenocarcinomas (5,9%), úlceras gástricas (6%), linfomas (0,4%), sem alterações (0,4%) e outros (1,2%). Em outros, encontram-se achados de malignidade, metaplasia e xantelasma gástrico. Em relação à presença de Helicobacter pylori nas amostras, o resultado encontrado foi de24% positivas, 46% negativas e 30% não pesquisadas. Conclusão: Os resultados confirmam a alta frequência das doenças gástricas e sua incidência nas diversas faixas etárias, além do envolvimento do H. pylori em tais afecções. É de grande importância a caracterização dos dados epidemiológicos, o que permite prováveis direcionamentos para programas de prevenção e informação para a população. Palavras-chave: biópsia gástrica, gastropatia, perfil epidemiológico. ABSTRACTObjective: To determine the prevalence of benign lesions and gastric cancer through study of biopsies performed at a school hospital in southern Minas Gerais, in the period between 2007 and 2011.Materials and Methods: The research was quantitative and retrospective, based on analysis of biopsies records and medical records. We conducted the survey data regarding age, sex, color, profession, histopathological diagnosis and the presence of Helicobacter pylori in the samples. Results: The total number of gastric biopsies analyzed was 1225. Population listing was found: mean age of 56.75 years, male (52%), white (81.9%), retired (30%). The most frequent diagnoses were gastritis (71.9%), polyps (14.2%), adenocarcinomas (5.9%), gastric ulcers (6%), lymphoma (0.4%), unchanged (0, 4%) and others (1.2%). In others, there are: findings of malignancy, metaplasia, gastric xanthelasma. Regarding the presence of Helicobacter pylori in the sample, the result was: 24% positive, 46% negative, 30% non searched. Conclusion: The results confirm the high frequency of gastric diseases and their incidence in the various age groups additionally to the involvement of H. pylori in such conditions. It is of great importance to characterize the epidemiological data, allowing probable directions for prevention and information programs for population. Keywords: gastric biopsy, gastropathy, epidemiological profile

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Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

SAGE Open Medicine ◽

10.1177/2050312119832093 ◽

2019 ◽

Vol 7 ◽

pp. 205031211983209 ◽

Cited By ~ 2

Author(s):

Seung-Joo Nam ◽

Sung Chul Park ◽

Sang Hoon Lee ◽

Dong Wook Choi ◽

Sung Joon Lee ◽

...

Keyword(s):

Helicobacter Pylori ◽

Observational Study ◽

Prospective Observational Study ◽

Eradication Rate ◽

Laboratory Data ◽

P Value ◽

Diabetic Patients ◽

Multicenter Prospective Observational Study ◽

H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

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The cellular and flagella morphologies of ulcerogenic Helicobacter pylori paediatric strains.

Microscopy and Microanalysis ◽

10.1017/s143192761300072x ◽

2013 ◽

Vol 19 (S4) ◽

pp. 21-22

Author(s):

I. Vitoriano ◽

K.D. Saraiva-Pava ◽

A.P.A. Matos ◽

F.F. Vale ◽

A. Santos ◽

...

Keyword(s):

Helicobacter Pylori ◽

Optical Microscopy ◽

Young Patients ◽

Rare Event ◽

Uranyl Acetate ◽

Bacterial Suspension ◽

Antioxidant Defences ◽

Tem Analysis ◽

Thin Sections ◽

H Pylori

Helicobacter pylori is a pathogenic spiral-shaped, microaerophilic, gram-negative bacterium, that inhabits the human stomach. Infection is usually acquired during childhood and always elicits an acute immune response that is, however, inefficient in bacteria clearance. Therefore, in the absence of effective treatment, infection and gastritis (non ulcer dyspepsia, NUD) persist throughout the patient’s life. Depending on its severity and pattern, in about 15% of infected adults, this silent destruction of the gastric mucosa may further progress to peptic ulcer disease (PUD) (gastric and duodenal ulcers, GU and DU respectively) and/or gastric cancer. Infection with H. pylori is also the major cause for the development of paediatric PUD, a rare event that may occur shortly after infection. In addition to the still undisclosed genetic susceptibility of these young patients, the virulence of the implicated H. pylori strain plays a crucial role in the paediatric PUD pathogenesis. Recently, we proved by in vitro infection assays that, compared with paediatric NUD-associated isolates, a group of paediatric ulcerogenic-strains present a greater ability to induce a marked decrease in the gastric cells viability and to cause them severe cytoskeleton damage and mucins’ production/secretion impairment. Moreover, we showed that their enhanced virulence result from a synergy between the ability to better adapt to the hostility of their niche and the expression of cagA, vacAs1, oipA ‘‘on’’ status, homB and jhp562 virulence factors. Accordingly, these ulcerogenic strains share a particular proteome profile, providing them with better antioxidant defences, a metabolism favouring the biosynthesis of aromatic amino acids and higher motility.We are now characterizing/comparing the cellular and flagella morphologies of H. pylori strains isolated from Portuguese children, associated with DU, GU or NUD, belonging to the vast and multiethnic collection of the Instituto Nacional de Saúde Dr. Ricardo Jorge (Portugal). For that, bacteria were grown in H. pylori selective medium (Biogerm, Maia, Portugal) at 37ºC in a microaerobic environment (Anoxomat®, MART Microbiology BV, Drachten, The Netherlands) for 24 h. For Leifson staining analysis, a drop of each bacterial suspension (in PBS) was spread in cleaned microscope slides, stained with the Leifson dye solution until a golden film developed on the dye surface and a precipitate appeared throughout the sample, and analysed by optical microscopy. For Transmission-Electronic-Microscopy (TEM) studies bacterial pellets were fixed sequentially in glutaraldehyde, osmium tetroxide and uranyl acetate, dehydrated in ethanol and embedded in Epon-Araldite. Thin sections contrasted with uranyl acetate and lead citrate were observed with a JEOL 100-SX electron microscope.Corroborating the better swimming abilities of the PUD strains, as previously shown by motility assays, optical microscopy analysis of Leifson stained slides demonstrated marked differences in the morphology of the studied strains (Figure 1). The H. pylori strain associated with DU (Hp 1152/04) seem longer than all the others and, in contrast, that associated with GU (Hp 499/02) is the shortest one and presents a, more pronounced, spiral morphology. Moreover, our preliminary data on TEM analysis indicate the presence of more abundant and apparently more organized flagella in the GU-associated strain Hp 499/02, in contrast to the NUD control strain, Hp 655/99 (Figure 2).Work supported by Research Grant 2011 – Sociedade Portuguesa de Gastrenterologia.

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