Prevalence of Helicobacter pylori in Vinnytsia region and the effectiveness of the eradication schemes according to 13C-urease breath tests (2006 — 2019)

Abstract

Objective — On the basis of analysis of the results of breath tests with 13C‑labeled urea, to study the dynamics of the level of H. pylori infection and to assess the effectiveness of H. pylori eradication schemes in patients with disorders of the upper gastrointestinal tract (GIT) — residents of the Vinnytsia region.Materials and methods. The analysis has been carried out with 2095 results of breath tests with 13C‑labeled urea, performed on infrared analyzer (IRIS, Wagner, Germany) during the years 2006 — 2019 in the clinical diagnostic gastroenterological laboratory of the Vinnytsia National Pirogov memorial Medical University. The results of breath tests with 13C‑labelled urea were divided into two data arrays. The first data array included results of 1189 breath tests (644 women and 545 men), performed in patients with upper gastrointestinal tract disorders for the primary H. pylori infection diagnosis, the second consisted of 906 breath tests results (476 women and 430 men), performed in patients with upper gastrointestinal tract disorders in order to monitor the effectiveness of H. pylori eradication.Results. Based on the results of the analysis of breath tests, performed for the primary diagnosis of H. pylori infection in patients of upper gastrointestinal tract disorders, it has been established that in the years 2006, 2007 and 2008 the H. pylori infection level did not differ from each other (p > 0.05) and amounted to 68.1 %, 63.3 %, 64.8 %, respectively. Starting from year 2009, in patients who did not receive previous anti‑helicobacter pharmacotherapy, the H. pylori infection level has significantly decreased (p < 0.05 and < 0.01). The mean rate of the effective H. pylori eradication for the whole observation period was 76.4 % regardless of the treatment regimen. The comparison of the efficacy of eradication pharmacotherapy depending on gender showed that in the years 2006 and 2007 the rate of successful eradication pharmacotherapy in women was significantly (р < 0.01) lower vs men and was 53.5 % and 60.0 % vs 77.9 % vs 91.3 % respectively. The number of successful H. pylori eradications was significantly higher (p < 0.01) in the group of patients who were administered anti‑helicobacter pharmacotherapy schemes in accordance with the Maastricht recommendations (81.3 % versus 65.6 %).Conclusions. According to the results of the analysis of breath tests with 13C‑labeled urea, performed for the primary diagnosis of H. pylori, it has been established, that in patients with disorders of the upper gastrointestinal tract since 2009, the primary infection with H. pylori significantly decreased. There were significant differences regarding primary infection with H. pylori between men and women with upper gastrointestinal tract disorders. The lowest level of H. pylori infection among patients with upper gastrointestinal tract disorders was observed in the age group under 20 years old (39.6 %), and the maximal H. pylori infection was diagnosed in the age group over 70 years old (66.7 %). The scheme proton pump inhibitor + clarithromycin + amoxicillin + bismuth subcitrate in standard doses demonstrated the highest efficacy of 87.0 % among the schemes, administered in accordance with с Maastricht recommendations. The scheme proton pump inhibitor + clarithromycin + derivatives of metronidazole in standard doses had the lowest efficacy (68.1 %).