Prevalence Of Helicobacter Pylori Research Articles

Correlation between Periodontitis and Gastritis Induced by Helicobacter pylori: A Comprehensive Review.

The goal of this comprehensive review was to verify if the prevalence of Helicobacter pylori (Hp) bacteria in patients with dyspepsia is higher in the oral cavity of periodontal or non-periodontal patients. The bibliographic search was conducted on scientific studies published in PubMed, Cochrane Library, SciELO, and BVS. The focus question was: "In patients with dyspepsia and periodontitis, is the prevalence of Hp bacteria in the oral cavity higher than in patients with only dyspepsia or without any disease?" The inclusion criteria were human studies in English, Portuguese, or Spanish languages, published between 2000 and 2022, that included patients over the age of 18 and aimed to evaluate the presence of Hp bacteria in the oral cavity and in the protective mucosal layer of the gastric lining of patients with the diseases (periodontitis and dyspepsia) or without disease; clinical trials, randomized controlled clinical trials, comparative studies, case-control studies, cross-sectional studies, and cohort studies. The methodological quality evaluation of the included articles was performed using the Joanna Briggs Institute tools. The final scores could be of "Low" quality (at least two "no" [red] or ≥ five "unclear" found), "Moderate" quality (one "no" [red] was found or up to four "unclear" criteria were met), or "High" quality (all green [yes] or at maximum two "unclear"). Of 155 potentially eligible articles, 10 were included in this comprehensive review after the application of the eligibility criteria. The selected studies were scrutinized regarding the relationship between Hp colonization in the oral cavity and stomach, its impact on severity and complications of gastric infection, as well as the effect of the presence of oral and gastric Hp on dental and systemic parameters. Hp can colonize periodontal pockets regardless of its presence in the stomach. There was a higher prevalence of oral biofilm in dyspeptic patients with periodontal disease, and worse control of bleeding and low oral hygiene was observed in periodontal compared to non-periodontal patients. For que quality assessment, the scientific studies included presented low to moderate methodological quality. Conclusions: It is possible to conclude that Hp is a bacterium that can colonize dental plaque independently of the stomach and vice versa; however, when both diseases are found, its presence may be more significant. Supra and subgingival dental plaque may be a reservoir of Hp, suggesting that patients with gastric infections are more likely to have Hp in the oral cavity. The results must be carefully analyzed due to the limitations present in this review.

A multifaceted ecological approach to explore links between environmental factors and the epidemiology of disorders of gut-brain interaction.

Disorders of gut-brain interaction (DGBI) are characterized by debilitating symptoms not explained by structural or biochemical abnormalities. While functional conditions present with complex, likely heterogeneous pathophysiology, we aimed to investigate if proxy measures of sociocultural and environmental factors are associated with the prevalence of various DGBI in populations across the world. We performed an ecological study utilizing peer-reviewed published datasets reporting for 26 countries prevalence rates of DGBI (Rome Foundation Global Epidemiology Study, RFGES), with six independent variables: Helicobacter pylori prevalence and household size as proxy measures for orofecal infections, gross domestic product per capita (GDP), and median age as a proxy measures for socioeconomic development, density of fast food outlets (FFO) per 100,000 population as proxy measure for processed food exposure, and suicide mortality rate per 100,000 people, and world happiness scores were used as a proxy for psychological stress. The data were retrieved from publicly accessible datasets (United Nations, CIA World Factbook, World Bank, World Happiness Report, commercial/financial reports of a global FFO chain). We used linear regression to assess variables in univariate and multivariate analysis and report standardized β coefficients with 95% confidence intervals (CI). The regression model revealed that the overall prevalence of DGBI was inversely associated with both GDP per capita (β = -0.57, 95% CI: -0.92, -0.22, p = 0.002) and happiness scores (β = -0.433 95% CI: 0.821, -0.065, p = 0.023), while being positively associated with H. pylori prevalence (β = 0.40, 95% CI: 0.008, 0.81, p = 0.046). The prevalence of functional constipation (FC) was also inversely associated with GDP per capita (β = -0.50, 95% CI: -0.86, -0.13, p = 0.01) and happiness scores (β = -0.497, 95% CI: -0.863, -0.132, p = 0.01), while being positively associated with H. pylori prevalence (β = 0.53, 95% CI: 0.16, 0.91, p = 0.007). The Multivariate model analysis revealed that combining the factors of H. pylori prevalence, suicide rate, household size and happiness scores showed statistically significant association with FC (p = 0.039). Household size (β = -0.43, 95% CI: -0.82, 0.038, p = 0.033) and suicide rates (β = 0.55, 95% CI: 0.19, 0.90, p = 0.004) were statistically significantly associated with functional diarrhea. Irritable bowel syndrome (IBS) was associated with GDP per capita (β = -0.40, 95% CI: -0.79, -0.014, p = 0.043) and happiness scores (β = -0.390, 95% CI: -0.778, -0.003, p = 0.049). Utilizing publicly available data, the prevalence of DGBI across diverse countries is linked to various socio-cultural and environmental factors. Collectively, the data suggests that the prevalence of DGBI is increased in less prosperous regions of the world.

Assessment and Empirical Treatment of Chronic Abdominal Pain from Suspected Helicobacter Pylori Infection In a Remote Setting

The prevalence of Helicobacter Pylori (H. Pylori) remains globally high, with an estimated 50% of the words population believed to be infected. Despite the continually high incident rates of infection 90% of those infected remain asymptomatic. H.Pylori is a gram-negative, microaerophilic bacteria, mostly found in stomach of affected individuals that causes inflammation and ulceration. Definitive routes of transmission and subsequent infection are still debated. The most likely mechanism of transmission is thought to be intrafamilliar, this encapsulates fecal-oral, gastric-oral, oral-oral and sexual vectors. Contaminated foods and water sources are also highly likely mechanisms of transmission. Therefore in developing countries with poor sanitation, potentially contaminated water sources and regions with social-economic hardship experience increased symptomatic cases of H.Pylori.

Helicobacter Pylori Prevalence in Communities from Southern Regions of Romania with Limited Access to Health Services: A Cross-sectional Study

Helicobacter Pylori Prevalence in Communities from Southern Regions of Romania with Limited Access to Health Services: A Cross-sectional Study

Current and Future Perspectives on the Management of Helicobacter pylori: A Narrative Review.

The prevalence of Helicobacter pylori (H. pylori), a pathogen, has decreased globally in the last decade. To date, the management of H. pylori has focused on a reactive approach, whereby those diagnosed are treated with antimicrobials and acid suppression in combination. This review article provides an overview of the shift in the management of H. pylori from a reactive approach towards a proactive 'screen and treat' approach; the article reflects the current pharmacological landscape for H. pylori treatment by exploring similarities such as the first-line prescription of quadruple therapy in most countries and provides a summary table of the best practice guidance from Europe, Asia, and North America. It explores significant ongoing challenges in management, such as rising antimicrobial resistance rates, and explores a potential 'work smart' approach to antimicrobial susceptibility testing. We explore the role of registry databases in providing data on treatment efficacy and safety and how they can support a strategic approach to H. pylori treatment. We question if such a database's availability, update, and regular audit should serve as a key quality indicator in a population screening programme. Despite a call for vaccination against H. pylori and decades of research, not many have made it to a phase-three clinical trial. We explore the challenges that have complicated the development of such a vaccine, such as the genetic diversity of H. pylori, immunotolerance, and limitations of mouse models in research; we reflect on how these challenges are contributing to a low likelihood of having a vaccine in the short-medium term. Lastly, it explores the heterogeneity in research on probiotics and their role as an adjunct in the management of H. pylori.

Recalcitrant intussusception: exploring potential associations with Helicobacter pylori infection - a case report and literature review

BackgroundIntussusception, a common cause of abdominal pain in children, often lacks clear underlying causes and is mostly idiopathic. Recurrence, though rare, raises clinical concerns, with rates escalating after each episode. Factors like pathological lead points and Henoch-Schönlein purpura (HSP) are associated with recurrent cases. On the other hand, the prevalence of Helicobacter pylori (H. pylori), often asymptomatic, in children has been declining. Although its infection is reported to be linked with HSP, its role in recurrent intussusception remains unexplored. Further research is needed to understand the interplay among H. pylori (culprit pathogen), HSP (trigger), and intractable intussusception so as to develop effective management strategies.Case presentationA two-year-old girl experienced four atypical episodes of intussusception at distinct locations, which later coincided with HSP. Despite treatment with steroids, recurrent intussusception persisted, suggesting that HSP itself was not a major cause for intractable presentations. Subsequent identification of H. pylori infection and treatment with triple therapy resulted in complete resolution of her recalcitrant intussusception.ConclusionThis instructive case underscored a sequence wherein H. pylori infection triggered HSP, subsequently resulting in recurrent intussusception. While H. pylori infection is not common in young children, the coexistence of intractable intussusception and steroid-resistant recurrent HSP necessitates consideration of H. pylori infection as a potential underlying pathogen.

The Trends of Pediatric Duodenal Ulcer and Predictors of Recurrence

Duodenal ulcer (DU) causes various symptoms in children. The prevalence of Helicobacter pylori (Hp)-associated DU has been reducing in some regions, yet the updated trend in Taiwan is unknown. Risk factors of DU recurrence have not been comprehensively investigated in children. This retrospective study included children diagnosed with DU to evaluate the demographics, symptoms, diagnostics, treatment, and outcomes. Specific populations (infant, surgery required) were sorted for subgroup analysis. Predictors of DU recurrence was analyzed in patients who received endoscopic follow-ups. A total of 488 children were included. Most patients were male (72.5%), school-aged (11.3±4.8 years old), and with varied underlying diseases in one-fifth. The annual incidences were around 3-5%, with a declining trend of case numbers and the Hp-positive proportion. Hp infection, concurrent gastric ulcer, perforation, and mortality were noted in 32.7%, 16%, 1.6%, and 1% of patients. Patients with or without Hp infection showed different clinical features but similar outcomes. The characteristics of subpopulations were depicted respectively. Male sex, lower Hb level, and perforation were independent risk factors associated with recurrence. Hp-positive DU seems to wane. Patients with male sex, lower Hb level, or perforation at diagnosis carried a higher risk of recurrence, which may warrant active surveillance and endoscopic follow-up.

Study of Prevalence of Gastritis Caused by H. pylori and Correlation of Urease Test with Serology (ELISA) Test

ABSTRACT Introduction: H. pylori are a pathogen of global importance. Gram-negative curved flagellate bacilli are implicated as one of the most trivial complaints of and are associated with peptic ulcer disease gastritis ulcer and gastric malignancy. This study was performed to find out the prevalence of Helicobacter pylori (H. pylori) infection in patients presenting the symptoms related with gastritis with or without chemically known peptic ulcer. Materials and Methods: The study was undertaken with the help of the Christensen and quotes urease test on endoscopic biopsy specimen and correlated with the detection of immunoglobulin IgG in the serum against H. pylori by an ELISA technique. Results: A total of 67 cases were analyzed in which 29 (43%) cases were positive for H. pylori. The endoscopic findings of acid peptic diseases show 21 (31.4%) cases of stomach ulcer, and 3 (4.5%) have esophagitis, whereas 43 (64.1%) have nonulcer dyspepsia. There is strong positive association between the urease tesr and ELISA test. Conclusion: The urease test is a quick and inexpensive test with high specificity and sensitivity, but since it is an invasive test, it has reduced patient compliance.

Burden of Stomach Cancer Incidence, Mortality, Disability-Adjusted Life Years, and Risk Factors in 204 Countries, 1990-2019: An Examination of Global Burden of Disease 2019.

Stomach cancer is a global health problem and is one of the leading causes of cancer deaths worldwide. This study investigates the spatial and temporal patterns of stomach cancer burden in 204 countries in the last three decades. The estimates of stomach cancer burden and itsrisk factors were obtained from the Global Burden of Disease (GBD) 2019 study, covering the years 1990 to 2019, across 204 countries within 21 world regions. GBD employs the cause-of-death ensemble modeling framework to calculate disease-specific mortality estimates. Estimated average percent change (EAPC) of absolute counts (incidence, mortality, and disability-adjusted life years (DALYs)) and age-standardized rates (age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDALR)) was calculated in the regions to illustrate the relative changes between 1990 and 2019. Joinpoint regression was used to analyze global trends of stomach cancer burdenin the last three decades. Incidence of stomach cancer globally increased from 883,396 cases in 1990 to 1.3 million cases in 2019andnumber of deathsdue to stomach cancer rose from 788,317 in 1990 to 957,185 in 2019. Between 1990 and 2019, the global ASIR decreased from 22.4 per 100,000 to 15.6 per 100,000, the ASMR decreased from 20.5 per 100,000 to 11.9 per 100,000and the ASDALRdeclined from 493.4 per 100,000 to 290.6per 100,000. Trend analysis using joinpoint regression revealed the slowest rise in incident cases and largest decline in ASIR between 2004 and 2016. In 2019, East Asia had the highest number of incident cases, totaling 626,489, followed by high-income Asia-Pacific (128,168) and South Asia (99,399). The ASIR was thehighest in East Asia (30.2/100,000)followed by high-income Asia-Pacific (28.2/100,000) and Andean Latin America (22.4/100,000), while high-income North America had the lowest ASIR at 6.1/100,000. In terms of absolute counts, the top three countries in 2019 were China, India, and Japantogether accounting for 61.5% of global incident cases, 58.6% of deaths, and DALYs. Mongolia had the highest ASIR (43.7 per 100,000), followed by Bolivia (34.0 per 100,000) and China (30.6 per 100,000) in 2019, while the lowest ASIR was 3.3 per 100,000 in Malawi. Globally, for both sexes combined, 7.8% of stomach cancer DALYs were associated with a diet high in sodium and 17.2% were linked to smoking. Among males, 24.0% of stomach cancerDALYs were attributable to smoking, compared to only 4.3% in females in 2019. Significant progress has been made globally in the fight against stomach cancer, with the ASIR decreasing by 30.3% and the ASMR by 41.2% between 1990 and 2019. To further reduce the burden of stomach cancer, it is essential to address factors such as Helicobacter pylori prevalence, obesity, and smoking. Additionally, improvements in early detection, socioeconomic development (including better public sanitation, hygiene, and drinking water), and dietary habits are imperative.

Comparison of the Efficacy of Two-Week Vonoprazan Versus Lansoprazole-Based Quadruple Sequential Antibiotic Therapy in Eradicating Helicobacter pylori Infection: A Non-randomized Clinical Trial.

The prevalence of Helicobacter pylori is escalating in developing countries, exacerbated by unjustified antibiotic usage, which leads to increased resistance. This trend has been notably amplified since the COVID-19 pandemic. Consequently, the effectiveness of existing eradication regimens has been compromised. This study aimed to compare the efficacy of two weeks of vonoprazan-based quadruple sequential therapy and lansoprazole-based quadruple sequential therapy in treating H. pylori infection. Methods: A non-randomized clinical trial was conducted over 18 months at the Department of Gastroenterology, Lahore General Hospital, Lahore, Pakistan. It included patients presenting with dyspepsia, as defined by the Rome IV criteria, and who tested positive on the urea breath test. Patients were divided into two groups, i.e., Group A and Group B. Group A patients received lansoprazole 30 mg + amoxicillin + tinidazole + tab. colloidal bismuth subcitrate for the first seven days, followed by lansoprazole + levofloxacin + azithromycin + colloidal bismuth subcitrate. Group B patients received vonoprazan + amoxicillin + tinidazole + colloidal bismuth subcitrate for the first seven days, followed by vonoprazan + levofloxacin + azithromycin + colloidal bismuth subcitrate. Both regimes continued for 14 days. Four weeks after 14 days of the treatment, an early morning urea breath test was conducted to evaluate the efficacy of the treatment. Patients were scheduled for follow-up visits at seven and 14 days post-treatment initiation to record adverse events and assess compliance with the treatment regimen. Patients who lost the follow-up and remained non-compliant to the medications were excluded from the final data analysis as per standard protocols of the per-protocol analysis. Results: A total of 252 patients were included. In Group A and Group B, 6/126 (4.76%) and 8/126 (6.35%) of the patients were lost to follow-up, respectively. The non-compliance rate in Group A was 5/126 (3.97%), compared to Group B with 3/126 (2.38%). Finally, the per-protocol analysis of the resultsincluded 115 patients in each group. Baseline characteristics, including demographics, lifestyle, and clinical factors, were comparable between groups with p-values of 0.138 for age, 0.356 for gender, 0.126 for BMI, 0.495 for residence, 0.500 for water source, 0.866 for meal habit, 0.863 for smoking, 0.188 for nonsteroidal anti-inflammatory drug(NSAID) use, 0.145 for proton pump inhibitor(PPI) use, 0.213 for antibiotics, and 0.456 for treatment history. Both treatments effectively eradicated H. pylori, as determined by a negative urea breath test at four weeks post-treatment, with Group B showing a higher eradication rate of 96.5% compared to 92.2% in Group A, although the difference was not statistically significant (p = 0.153).There was no difference in adverse effects in both treatment groups (p-value > 0.05). Conclusion: The study found that while the vonoprazan-based regime exhibited a slightly higher eradication rate of H. pylori compared to lansoprazole, the difference was not statistically significant. It was concluded that both regimens demonstrated comparable efficacy and similar profiles of adverse effects in treating H. pylori infection.

Helicobacter pylori prevalence in Indonesia: Higher infection risk in Eastern region population

Background Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive epidemiologic study is necessary to explore infection susceptibility by demographic characteristics, especially between Indonesia’s Eastern and Western regions. Methods We included our recent survey and data from our previous studies with 1,172 endoscopic examinations from 19 cities throughout Indonesia from January 2014 to March 2017. H. pylori infection was diagnosed based on a combination of four different tests. Using a criterion of one positive result between four tests, we found that 190 subjects (190/1,158; 16.4%) were H. pylori positive. A total of 939 subjects who has complete data were analyzed for risk factors of H. pylori infection. Results Prevalence was slightly higher in the Eastern region compared with the Western region of Indonesia (79/277; 59.4% vs. 54/529; 40.6%). Living in the Eastern region imposes a higher risk of infection (OR 5.33, 95%CI 1.17–24.26). Timor ethnicity had the highest prevalence (15/28; 53.6%), followed by Buginese ethnicity (21/74; 28.4%), and Papuan ethnicity (18/64; 28.1%) in the Eastern region. As an ethnicity with a high prevalence (37/109; 33.9%), Batak was an outlier among the low prevalence areas in the Western region. In general, age, living in the Eastern region, Batak ethnicity, Protestant, Catholic, and alcohol drinking were independent risk factors associated with H. pylori infection in Indonesia (OR 1.03, 95%CI 1.02–1.05; OR 5.33, 95%CI 1.17–24.26; OR 5.89, 95%CI 1.58–21.94; OR 5.47, 95%CI 2.16–13.86; OR 5.05, 95%CI 1.43–17.80; OR 2.30, 95%CI 1.14–4.61, respectively). Conclusions Several ethnicities and habits were concluded to increase the risk of infection as the interaction of host, agent, and environment is inseparable in affecting disease susceptibility.

Prevalence of Helicobacter pylori and Associated Risk Factors among Dyspeptic Patients and Dogs in Matrouh Province Regarding the Zoonotic Risks

Prevalence of Helicobacter pylori and Associated Risk Factors among Dyspeptic Patients and Dogs in Matrouh Province Regarding the Zoonotic Risks

Frequency, distribution and determinants of Helicobacter pylori infection in adults and adolescents with gastric symptoms: cross-sectional epidemiological inquiry in district Haripur, Pakistan.

Helicobacter pylori (HP) is a vital element in the etiology of peptic ulcers and gastric cancer. This research aimed to determine the frequency, distribution, and determinants of HP infection in adults and adolescents with gastric symptoms in district Haripur, Khyber Pakhtunkhwa, Pakistan. This cross-sectional study was performed from June 2018 to June 2020 at the Medical Laboratory Technology Department, The University of Haripur, Pakistan. Presence of HP was a research variable, while sex, age groups, education status, overcrowding, dining habits, milk intake, drinking water source and animal contact were grouping variables. Immuno-chromatographic technique (ICT) was used to for serological detection of HP antibodies. All variables were represented by frequency and percentage with 95%CI. Prevalence of HP and its distribution by eight socio-demographic variables was testified by the chi-square goodness-of-fit test while association was testified by chi-square test of association. Out of total 1160 cases, 557 (48%) were positive for HP. Population prevalence was higher in men, in the age group 20-40 years, illiterate, family size ≤ 10 persons, taking restaurant food, using tetra pack, using municipal water, and having animal contact. The observed prevalence of HP was similar to its expected prevalence in the population. The observed distribution of HP in the sample was different from its expected distribution in population by eight socio-demographic variables. Presence of HP was associated with all eight socio-demographic variables besides age groups.

Leveraging the Multidimensional Poverty Index to estimate Helicobacter pylori prevalence in districts in Karnataka, India.

The prevalence of Helicobacter pylori (Hp) in India is approximately 64%. However, substantial regional variations necessitate high-fidelity, locality-specific studies to characterise its population distribution in India. We conducted a cross-sectional study including 2998 dyspeptic patients at a tertiary care centre in Karnataka and investigated the relationship between Hp prevalence and the Multidimensional Poverty Index (MPI) by district. Helicobacter pylori prevalence in our population was 43.2% with a significant correlation between district-specific Hp prevalence and MPI. This data can be leveraged for evaluating local Hp infection control strategies, planning interventions for Hp hotspots in Karnataka and predicting a dyspeptic patient's risk of Hp infection.

The Effect of Direct Oral Anticoagulants on Gastric Mucosa and Helicobacter Pylori Prevalence in Dyspeptic Patients: A Retrospective Cross-Sectional Study.

Backgroundand aim Although direct oral anticoagulants (DOACs) are widely used and their side effects related to bleeding at various body sites have been well studied in the literature, less is known about their local impact on gastric mucosa. Some studies suggest that the higher risk of gastrointestinal (GI) bleeding associated with DOACs may be due to their direct local anticoagulant effects on the gastric mucosa. In this study, we aim to evaluate whether this potential local effect has a favorable outcome on the gastric mucosa and the prevalence of Helicobacter pylori (HP). Materials and methods A total of 125 patients with dyspepsia were included in the study. Sixty patients who had been using a DOAC for at least one month were classified as the "DOAC group," while 65 patients who had not used DOACs were designated as the "control group." Demographic, laboratory, and pathological findings for these patients were retrospectively analyzed from their medical files. Results Patients in the DOAC group were significantly less likely to have antral gastritis (AnG) (p = 0.028), while the frequencies of HPand atrophic gastritis (AtG) were similar between the two groups. Although not statistically significant, the DOAC group showed fewer instances of intestinal metaplasia (IM) and a higher number of upper GI ulcers. Patients who had been using DOACs for more than 12 months had increased incidences of IM, upper GI ulcers, AnG, and HP compared to those who had been using DOACs for 12 months or less. The Rivaroxaban subgroup showed significantly lower HP positivity compared to patients using other DOACs (p = 0.042). Among all subgroups, the Rivaroxaban group had the lowest frequency of AnG (p = 0.024). Conclusion While DOACs seem to prevent AnG, HP, and IM at their early use stages, unfavorable gastric mucosa manifestations might increase with prolonged use. Higher upper GI ulcer prevalence is another controversial result of this issue. Rivaroxaban shines amongst other DOACs with its lesser HP and AnG association. These exciting findings should be supported by randomized controlled trials with large patient populations.

Serum Anti-Helicobacter pylori IGG Antibody Test Among Patients with Diabetes: A Cross-Sectional Study

Diabetes patients frequently experience numerous and serious chronic infections because of their weakened cellular and humoral immune systems. Regrettably, there is insufficient information on the prevalence of Helicobacter pylori (H. pylori) infection among diabetics, especially in southern Libya. This study aimed to determine how frequently these bacteria were infected among diabetes patients in various parts of Ubari. This study was conducted on 150 diabetic patients of both sexes, who visited the health centers in different Ubari areas. Their ages ranged from 20 to 80. Analysis of blood serum samples to measure Helicobacter pylori IgG antibodies by the enzymatic immunoassay (ELISA) and the rapid test (cassette rapid test). Biochemistry parameters such as Blood glucose concentration, cumulative glucose, ?-amylase, LDH, Serum cholesterol, Triglycerides, LDL, and HDL, as well as the blood group, were also measured. Other data collected was the body mass index. A questionnaire was used to find out some habits, such as smoking, the use of spices in food, and the type and duration of diabetes. Data showed the rate of infection with H. pylori bacteria through immunological testing was 45.33% in both sexes; however, it was significantly higher in males than females, 28% and 17%, respectively. The infection rate was found to be higher in the age group 41–60 years, and there was no significant difference in bacterial infection between patients with type I and type II diabetes (20.7 and 24.7%), respectively. Similarly, there was no effect of body mass index on the rate of infection.

Comparison of Risk and Severity of Helicobacter Pylori Infection in Non-Native Versus US Native Pediatric Patients.

Helicobacter pylori (HP) infection is associated with gastritis, peptic ulcer disease (PUD) in the stomach and duodenum, and an increased risk of gastric cancer. The risk of infection, secondary symptoms, and negative outcomes is known to be increased in low- and middle-income countries and vastly less substantial in the United States and Europe. Current North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines recommend endoscopic diagnosis and susceptibility-guided therapy, which is not reflected by current adult guidelines for therapy. In this study, we complete a single-center retrospective review of HP risk by nativity status, as well as the results of the use of standard empiric therapy in HP and PUD patients. We retrospectively reviewed all endoscopies with patients aged 1-21 years with a known nativity status and identified all HP diagnoses. We also completed the classification of Kyoto scores and classified patients as gastritis versus PUD. Treatment records were obtained, as well as downstream documentation of the impact of empiric therapy. HP prevalence and severity were compared between non-native and native US populations. In total 332 patients were identified, with 59 HP diagnoses. However, 64 patients were immigrants, and 268 were US natives. Totally 39.1% of all immigrant patients had an endoscopically identified HP infection, compared to only 12.7% of US native patients (P < 0.01, relative risk 3.07). HP severity was worse in immigrant patients (Kyoto score 1.5 versus 0.89; P = 0.008). Empiric high-dose amoxicillin triple therapy was equally effective in reducing symptoms in gastritis versus PUD patients. Immigrant patients have a substantially higher risk and severity of HP infection than US natives. Empiric therapy remains highly effective at relieving symptoms. These findings in aggregate suggest that North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines may not adequately serve non-native pediatric patients, with an additional prospective multicenter study needed to confirm. In addition, a prospective study of treatment based on stool antigen tests, as well as a larger prospective study of empiric therapy, may suggest alterations to our approach in line with recent changes to adult Gastroenterology practice.

Primary antibiotic resistance in Helicobacter pylori in China: a systematic review and meta-analysis

The incidence of Helicobacter pylori (HP) is 25-50% in developed countries and 80% in developing countries, including 56.2% in China. However, antibiotic resistance of HP is a threat to HP control. The purpose of this study was to comprehensively evaluate primary drug resistance of HP in China. The full text of reports of the primary antibiotic resistance prevalence of HP was obtained from multiple databases (PubMed, Web of Science, Evimed, Cochrane Library, and China National Knowledge Internet). Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis. The Newcastle-Ottawa Scale was used to assess the article quality. In total, 38804 HP samples from 22 trials were extracted. The results suggested that the overall prevalence of amoxicillin, clarithromycin, metronidazole, and levofloxacin resistance among HP in adults was as follows: mean difference (MD)=1.35%, 95% confidence interval (CI) [1.03%, 1.68%]; MD=23.76%, 95% CI [20.23%, 27.3%]; MD=69.32%, 95% CI [64.85%, 73.8%]; and MD=29.45%, 95% CI [4.90, 176.96], respectively. From the results of sensitivity and publication bias, we find that these results are robust and had little publication bias. Our research showed that in China, the prevalence of HP resistance to primary antibiotics warrants attention, especially with regard to metronidazole, levofloxacin, and clarithromycin.

Regulatory B cells (Bregs) in Helicobacter pylori chronic infection.

Helicobacter pylori (H.pylori) infection is linked with a wide variety of diseases and was reported in more than half of the world's population. Chronic H.pylori infection and its final clinical outcome depend mainly on the bacterial virulence factors and its ability to manipulate and adapt to human immune responses. Bregs blood levels have been correlated with increased bacterial load and infection chronicity, especially Gram-negative bacterial infection. This study aimed to identify prevalence and virulence factors of chronic H.pylori infection among symptomatic Egyptian patients and to examine its possible correlation to levels of regulatory B cells (Bregs) in blood. Gastric biopsies and blood samplesfrom each of 113 adult patients, who underwent upper endoscopy, were examined for the detection of H.pylori by culture and PCR methods. Conventional PCR was used to determine various virulent genes prevalence and association to clinical outcome. Flow cytometry was used to evaluate Bregs levels. Helicobacter pylori prevalence was 49.1% (55/112). Regarding virulence genes incidence, flaA gene was detected in 73% (40/55), vir B11 in 56.4% (31/55), hopZ1 in 34.5% (19/55), hopZ2 in 89% (49/55), babA2 in 52.7% (29/55), dupA jhp917 in 61.8% (34/55), vacA m1/m2 in 70.9% (39/55), and vacA s1/s2 in 69% (38/55) strains. Bregs levels were significantly lower in H.pylori-infected patients (p= 0.013), while total leukocyte count (TLC) showed no significant differences. Helicobacter pylori infection prevalence was almost 49%, and the infection was found to be related to inflammatory conditions as gastritis and ulcers rather than malignant transformations. Also, we found that CD24+ CD38+ B cells were downregulated in H.pylori-infected patients.

The Prevalence of Helicobacter pylori in the Stools of Pregnant Women with Hyperemesis Gravidarum

The Prevalence of Helicobacter pylori in the Stools of Pregnant Women with Hyperemesis Gravidarum