Study of Helicobacter pylori infection and its antibiogram in gastroduodenal disorders in Regional Institute of Medical Sciences Hospital

Abstract

Objective: Isolation of Helicobacter pylori from biopsy samples taken from cases of gastroduodenal disorder, correlate isolation of H. pylori with urease test, direct modified Grams-stain and H. pylori antibody test, to assess antimicrobial susceptibility pattern of H. pylori isolates. Materials and Methods: Sixty patients with gastroduodenal disorders were included in the study. Urease test, direct modified Grams-stain, H. pylori antibody test, culture and antimicrobial susceptibility were performed as per standard guidelines. Statistical analysis was performed using Fisher's exact test. Results: Antral gastritis was the most common endoscopic findings accounting 43.3%. The study revealed direct Gram-stain positivity of 20%, urease test positivity 46.7%, H. pylori antibody test positivity of 65% and culture positivity rate of 3.3%. Correlation of isolation of H. pylori with Gram-stain found to be significant statistically (P < 0.037). The correlation of isolation with urease test and H. pylori antibody and H. pylori antibody test was statistically not significant. Antimicrobial susceptibility pattern of H. pylori isolates, showed high sensitivity to gentamycin, amoxiclav, tetracycline, clarithromycin, and ciprofloxacin. Higher resistance to metronidazole was observed. Conclusion: Urease test, direct smear, H. pylori antibody test in combination proved to be helpful in the diagnosis of H. pylori infection. Culture from gastric mucosa in infected subjects is low; this could be due to patchy distribution of organisms, prior administration of proton pump inhibitors and antibiotics. Antimicrobial susceptibility testing can be carried out in cases of refractory to treatment.