MICROBIOLOGICAL ASPECTS OF THE DEVELOPMENT OF H. PYLORI ANTIMICROBIAL RESISTANCE

Abstract

Infection caused by Helicobacter pylori (H. pylori) is one of the most common human infections. The discovery of H. pylori contributed to a revolution in the ideas of aetiology, pathogenesis, treatment and prevention of some diseases, i.e. gastric ulcer, duodenal ulcer, gastritis, duodenitis. Ulcerative disease in almost 100% of cases is associated with H. pylori. Such factors as distress, psychological and genetic factors are also associated with the development of the disease. Н. pylori are detected in 80-100% of patients with chronic gastritis, and in 90 – 100% of patients with duodenal ulcer. Traditionally, Н. pylori-associated diseases are treated by gastroenterologists and general practitioners, although they are infectious diseases in their essence. In our country, the quite typical is the type of the infection with its onset in childhood and very high prevalence rate in adults. Another characteristic of "national" Н. pylori is a pronounced carcinogenic potential that is accompanied by gastric malignancies. For preventing and managing a number of H. pylori-associated diseases, eradication therapy (ET) is used. Literally, eradication means the complete destruction of something. In medical terminology, this word is applied to integrated therapeutic methods aimed at eliminating a pathogen, and antibacterials are the non-alternative components of the eradicating therapy. The presence of flagella, as well as a smooth cell wall and spiral shape, allows this microorganism to move in the mucus along the pH gradient. The cell wall of H. pylori is smooth; the electron-dense glycocalyx (capsule-like membrane) including carbohydrate-containing polymers needed for adhesion of the microorganism on the surface of epithelial cells is outside of the cell membrane. H. pylori produce highly active enzymes such as urease, oxidase and mucinase. Flagella provide the mobility, which is necessary for colonizing the mucous membrane. Biological and biochemical properties, pathogenicity factors can impede antibacterial therapy to some extent. The effectiveness of the number of modes of antibacterial therapy often recommended for H. Pylori-associated diseases is increasingly reducing due to the ever-increasing resistance of bacterium to many antimicrobial drugs such as : metronidazole, amoxicillin, tetracyclines, clarithromycin, furazolidone.