Abstract

The genus Helicobacter is composed of bacteria that colonize both the human and animal gastrointestinal tract. Helicobacter pylori infects half of the world’s population, causing various disorders, such as gastritis, duodenitis and gastric cancer. Additionally, non-Helicobacter pylori Helicobacter species (NHPH) are commonly found in the stomach of pigs, dogs and cats. Most of these species have zoonotic potential and prevalence rates of 0.2–6.0%, and have been described in human patients suffering from gastric disorders undergoing a gastric biopsy. The aim of this study was to determine the occurrence of Helicobacter spp. in the stomach of patients with gastric cancer (n = 17) and obese (n = 63) patients. Furthermore, the outcome of the Helicobacter eradication treatment and the current infection status was evaluated. Overall, based on the genus-specific PCR followed by sequencing, DNA from Helicobacter spp. was detected in 46.3% of the patients, including single infections with H. pylori in 43.8% of the patients and mixed infections with H. pylori and canine- or feline-associated H. felis in 2.5%. About 32.5% of the patients had been subjected to previous Helicobacter eradication therapy and the triple standard therapy was the most frequent scheme (42.3%). In 48.0% of the patients who received eradication treatment, bacteria were still detected, including one mixed infection. In 23.1% of the patients who reported that a subsequent test had been performed to confirm the elimination of the bacteria, Helicobacter were still detected. In conclusion, although in a smaller percentage, NHPH may also be present in the human stomach. Thus, specific NHPH screening should be included in the diagnostic routine. The continued presence of H. pylori in the stomach of patients recently subjected to eradication schemes raises questions about the efficacy of the current Helicobacter treatments.

Highlights

  • The Helicobacter genus consists of a group of Gram-negative, motile bacteria, colonizing the stomach and intestinal tract of humans and animals [1]

  • A total of 221 gastric samples belonging to 80 patients were evaluated in this study, comprising 34 samples obtained from 17 gastric cancer (GC) patients and 187 samples from 63 OB patients

  • Histological analysis using H&E staining confirmed the presence of malignant epithelial neoplasia in tissue fragments from GC patients, while gastric samples from OB patients showed no signs of neoplastic transformation

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Summary

Introduction

The Helicobacter genus consists of a group of Gram-negative, motile bacteria, colonizing the stomach and intestinal tract of humans and animals [1]. Helicobacter pylori (H. pylori) is the most common gastric Helicobacter species, with an average worldwide prevalence of 58%, and is considered a major public health issue [2,3,4]. In the majority of the cases, the gastritis is superficial, but progression to gastric or duodenal ulcers (10–20%) and/or gastric (adeno)carcinoma (1–2%) can occur [4,5]. H. pylori is considered a Group I carcinogen by the International Agency for Research on Cancer [4,6,7]. Multiple studies have shown that H. pylori eradication reduces gastric inflammation, thereby (i) preventing the progression towards pre-malignant lesions, (ii) decreasing the incidence of gastric carcinoma [7,8,9], and [10] improving corpus gastritis and dysplasia lesions [10]. Treatment efficacy has been declining in the last decade due to several factors such as side effects, including increasing antimicrobial resistance and the high costs of the antibiotic treatments [11]

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