Genotyping and Association of the Presence of Helicobacter Pylori in Dental Plaque and Gastric Biopsy Specimens in Dyspeptic Patients by PCR-RFLP Technique in Southwest of Iran

The oral cavity can act as an extra gastric reservoir for H pylori, and also the presence of the bacteria in the oral cavity is associated with a higher risk of dental caries development. The aim of this study was to determine the genotype and evaluate the association of the presence of H. pylori in dental plaque and gastric biopsy specimens in dyspeptic patients in Ahvaz, Southwest of Iran. In this study, 106 patients with recruited dyspeptic complaints were selected and from each patient, two gastric antral biopsy specimens and two dental plagues were examined. The presence of H. pylori was identified by the Rapid Urease Test (RUT) and the amplification of ureAB and 16S rRNA genes. Also, to verify a hypothetical mouth-to-stomach infection route, the enzymatic digestions of three genes of cagA, vacA, and ureAB in H. pylori strains isolated from dental plaques and stomach samples were compared for each same case. H. pylori was found in the stomach of 52.8% (56 /106) and the dental plaques of 17.9% (19/106) of the studied cases. On the other hand, H. pylori was recognized in the stomach of all 19 cases with oral colonization. Following a combination of restriction fragment length polymorphism (RFLP) patterns of these three known genes on stomach and dental plague samples, 14 and 11 unique patterns were seen, respectively. However, for all H. pylori-positive cases (19), the comparison of RLFP patterns of these genes in the dental plaque and gastric biopsy specimens was different for the same case. This study showed, no significant association was observed between the presence of H. pylori in dental plaque and the stomach of the same case.

H. pylori Pattern Gastritis with Negative Helicobacter Immunohistochemical Stain: Does A Specific Comment in Pathology Report Impact Clinical Management?

Introduction/Objective The clinical significance of H. pylori (HP) pattern of gastritis with a negative Helicobacter IHC stain on gastric biopsy is unclear. Some pathologists report this pattern in cases that are highly suggestive of HP infection with a comment raising the possibility of HP infection; however, the subsequent clinical management of these patients has not been well described. Methods/Case Report We conducted a retrospective comparison study of patients with gastric biopsy between 2016 and 2019. Group 1 included patients with chronic active or chronic inactive gastritis and negative HP IHC with a comment stating the gastritis pattern is suggestive of HP. Group 2 included patients with chronic active or chronic inactive gastritis and negative HP IHC with no comment about HP pattern. Results (if a Case Study enter NA) We identified 60 patients in Group 1 which were compared to 63 patients in Group 2. Group 1 more frequently had history of HP (48.3% vs. 29.1%, p<0.05). After diagnosis, Group 1 more frequently received treatment (51.7% vs. 20.6%, p<0.001). Of those who received treatment, Group 1 more frequently received HP treatment (triple or quadruple therapy; 21.7% vs. 1.6%, p<0.001). History of HP did not affect whether a patient was treated (p>0.05). Following post-biopsy HP treatment, more patients in Group 1 received fecal antigen test (23.7% vs. 5.5%, p<0.01). Age, gender, NSAID and PPI use did not differ between groups. Conclusion Adding the diagnostic comment raising the possibility of HP for patients with HP pattern gastritis with negative HP IHC changes clinical management and it is independent of patients’ prior HP history.

Evaluation of Paromomycin Treatment for Cryptosporidium serpentis Infection in Eastern Indigo Snakes (Drymarchon couperi)

Thirty-four eastern indigo snakes ( Drymarchon couperi ) naturally infected with Cryptosporidium serpentis were randomly divided into two groups. The first group received 360 mg/kg paromomycin twice weekly in a food item for six weeks, while the second group received the food item with no treatment. Cloacal swabs were collected every two months for six months to measure C. serpentis shedding by quantitative polymerase chain reaction testing (qPCR). Snakes that were qPCR negative after six 6 months were immunosuppressed with a single dose of 4 mg/kg dexamethasone sodium-phosphate SC. These snakes were then screened by qPCR for an additional 6 months as described above. Snakes that were qPCR negative after one year of serial sampling were then re-evaluated for C. serpentis via gastric biopsy for histological and qPCR analyses. The paromomycin-treated group were significantly (p=0.008) more likely to test qPCR negative (8/17; 47%, 95% Confidence Interval [CI]: 23.2-70.7) than the control snakes (1/17; 5.8%, 95% CI: 0.01-16.9) prior to immunosuppression. However, there was no significant difference (p=0.5) in C. serpentis status following immunosuppression as only 2/17 (11.7%, 95% CI: 0.01-26.9) paromomycin-treated snakes were qPCR negative six months after immunosuppression compared to 1/17 (5.8%, 95% CI: 95% CI: 0.01-16.9) control snakes. These findings suggest that 360 mg/kg paromomycin twice weekly for six weeks in a food item is ineffective in eliminating C. serpentis in naturally infected D. couperi .