Pylori-infected Patients Research Articles

Prevalence of H. Pylori Infection among Patients with Recurrent Gastric Ulcer in Arbil City

Aim: This study's goal is to identify the prevalence of H. pylori infection among patients with recurrent gastric ulcers in Arbil, Iraq. Study design: A cross-sectional study Place & duration of the study: From Oct 2021 to Feb 2022 in the private laboratories in Arbil city/Iraq. Methodology: A total of 83 patients with recurrent gastric ulcers were admitted to the private laboratories in Arbil city. Blood samples were collected for detection of anti-Helicobacter pylori antibodies IgG and IgA in patient serum samples by the serological method by Enzyme-linked immunosorbent assays. A special questionnaire sheet was designed and used for each patient subject. Results: Among 83 screened samples, the overall seroprevalence rate of H. pylori infection patients with recurrent gastric ulcer was 47 (56.6%). H. pylori infection was more common in female patients (59.1%) compared to male patients (53.8%). The rate of Helicobacter pylori infection was higher (84.2%) among the young adult-aged patient group (21-30) years, and (63.4%) in urban patients. A higher seropositive rate of H. pylori infection was among married patients (51.8%). Regarding marital status, most of the seropositive patients were among married patients (51.8%), (64%) among nonuse therapy, (56.7%) in the A blood group, (66.6%) among severe symptom patients, and (69.2%) among patients with a previous history of H. pylori infection respectively. Conclusions: Patients with recurrent stomach ulcers had greater levels of helicobacter pylori antibodies, which were linked to negative outcomes. Keywords: H. pylori, gastric ulcer, recurrent infection IgG, IgA

Study on the Application of Health Education in the Rehabilitation of Helicobacter Pylori Infection Patients

Study on the Application of Health Education in the Rehabilitation of Helicobacter Pylori Infection Patients

Amoxicillin-vonoprazan dual therapy for Helicobacter pylori eradication: A systematic review and meta-analysis.

The efficacy and safety of amoxicillin-vonoprazan (VA) dual therapy remained unclear. This systematic review was conducted in accordance with the PRISMA 2009 guidelines. A systematic search of the Pubmed, Embase, and Cochrane database was conducted using the combination of "Helicobacter pylori or H. pylori or Hp," "amoxicillin orpenicillin," and "Vonoprazan or TAK-438 or Takecab or (potassium AND competitive) or potassium-competitive." The initial and secondary outcome of this meta-analysis was to evaluate the efficacy and safety of VA dual therapy. Three studies and 668 H. pylori infected patients were included in this meta-analysis. The crude eradication rate of VA dual therapy was 87.5% and 89.6% by ITT and PP analysis, respectively. No significant differences were observed regarding the VA dual therapy and vonoprazan-amoxicillin-clarithromycin (VAC) triple therapy according to ITT (RR=0.99, 95% CI, 0.93-1.05, P=0.65) and PP (RR=0.99, 95% CI, 0.94-1.05, P=0.82) analysis. The side effect of VA dual therapy was 19.1% (95% CI, 5.9-32.4), which was lower than that of VAC triple therapy but there was no statistical significance (RR=0.75, 95% CI, 0.59-1.06, P=0.12). VA dual therapy shows acceptable efficacy, good safety and avoid unnecessary antibiotic use in the first-line treatment for H. pylori infection. However, its application in other regions need to be further explored.

Frequency And Factors Leading To Helicobacter Pylori Infection Among Dyspeptic Patients.

Helicobacter pylori is infecting 50 percent or more of the world's population, putting it the most ubiquitous infection on the world. This study is done with the objective to determine the frequency and risk factors of Helicobacter pylori infection among dyspepsia patients at Patel Hospital Karachi. This cross-sectional study was conducted at the gastroenterology department at the Patel Hospital in Karachi from 10th Jan to 10th July 2021. All patients with dyspepsia for at least 6 months having age 20-60 years of either gender were included. Three samples from stomach (2 from antrum,1 from corpus) for biopsies were collected from each patient. The specimen was sent to the microbiology department of the hospital and was reported as having histopathological confirmation of Helicobacter pylori infection. Of 111 patients with dyspepsia, mean age of the patients was 44.19±16.41 years. Most of the patients (n=65, 58.6%) were males and 46 (41.4%) were females. The mean duration of dyspepsia was 11.48±5.53 months. Helicobacter pylori was discovered to be present in 93 percent of individuals (83.8 percent). The odds of Helicobacter pylori infection were found to be 7.99 times higher among patients over 40 years old (AOR: 7.99, 95 percent CI: 2.02-31.64, p: 0.003), 3.93 times higher among patients with >9 months of dyspepsia (AOR: 3.93, 95 percent CI: 1.09-14.16, p: 0.036), and 11.85 times higher among smokers as compared to non-smokers (AOR: 11.85, 95 percent CI: 1.42-99.08, p-value 0.023). The rate of Helicobacter pylori infection in patients with dyspepsia was found to be higher. Furthermore, increasing age, increase duration of dyspepsia and smoking is found to be independent risk factors.

Helicobacter pylori Infection in Cirrhotic Patients With Portal Hypertensive Gastropathy: A New Enigma?

The relationship between Helicobacter pylori (H. pylori) infection and Portal hypertensive gastropathy (PHG) is still a debatable matter. The aim of this study is to find out how common H. pylori infection is in cirrhotic patients with PHG and to see if there’s a link between H. pylori infection and PHG severity. Out of 340 cirrhotic patients who had upper Gastrointestinal Tract (GIT) endoscopy for early varices screening, 160 cirrhotic patients were selected and divided into 2 groups; 80 cirrhotic patients with PHG (cases) and 80 cirrhotic patients without PHG (controls). Gastric biopsies were taken from all enrolled patients for histological evaluation for the presence or absence of H. pylori infection. H. pylori was found in 44 cirrhotic patients (55%) who had PHG (cases), compared to 22 cirrhotic patients (27.5%) who did not have PHG (controls). The prevalence of H. pylori infection was significantly higher in patients with PHG (p < 0.001). The severity of PHG was associated with H. pylori infection (p < 0.001). The response to eradication therapy of H. pylori infection was must better in patients without PHG (p = 0.045). By multi-variant analysis, H. pylori infection, splenic diameter, and portal vein diameter were independent predictors for PHG presence. After treating H. pylori infection in patients who tested positive for H. pylori, there was a significant reduction in PHG severity (p < 0.001). Patients with PHG have a greater prevalence of H. pylori infection. PHG is more severe in patients infected with H. pylori. To improve PHG severity, cirrhotic patients must have their H. pylori infection eradicated.

Immunotyping of lymphocytes in the gastric mucosa of patients infected by H. pylori in two regions with contrast in the risk of developing gastric cancer

To compare the immune response in gas tric mucosa of H. pylori infected patients in two regions comparing the risk of developing gastric can cer. 71 participants with symptoms of dyspepsia were included. The samples for biopsies were collected from different regions of the gastric mucosa; the identification of H. pylori was carried out by culture and polymerase chain reaction (PCR) of the ureA gene. For the characteri zation of the histopathological alterations and the immunophenotyping of lymphocytes, anti-human mouse monoclonal antibodies specific for each antigen were used: T lymphocytes: CD3 and CD8; B lymphocytes: CD20; Natural Killer Cells: CD56; Macrophages: CD68. The prevalence of H. pylori was 83.1%, the predominant types of gastritis were chronic gastritis and multifocal atrophic gastritis with intestinal metaplasia (63.4% and 22.5%, respectively). The cellular response was charac terized mainly by polymorphonuclear lymphocytes and positive anti-CD8 reactivity both in stroma and epithelium. Multifocal atrophic gastritis was more prevalent in the high-risk region for gastric cancer (GC) while non-atrophic gastritis and the expression of CD3 and CD8 antigens in the foveolar epithelium was higher in the low-risk region.

The prognosis value of proteasome activator subunit 3 expression in gastric cancer.

Gastric cancer (GC) is a highly aggressive malignant tumor, and, therefore, the prognosis evaluation of this disease is important. Proteasome activator subunit 3 (PSME3) is highly expressed in GC; however, its exact role in GC has yet to be clarified. The gene expression profiles for GC were downloaded to find a candidate prognostic biomarker, and PSME3 was selected. The expression level of the PSME3 gene in GC tissues was analyzed using a public database. The biological processes and signal pathways that PSME3 was involved in were further analyzed. Immunohistochemical staining of 181 GC tissues was performed to detect the expression of the PSME3 protein. The correlation between PSME3 expression and GC prognosis and its clinical and pathological parameters were investigated. It was found that PSME3 mRNA expression was higher in GC than in adjacent gastric tissues, and high PSME3 expression was significantly correlated with tumor stage, histological subtype, lymph node metastasis status, and Helicobacter pylori infection in patients with GC (all p<0.01). Bioinformatics showed that PSME3 mainly played an oncogenic role in the development of GC by regulating the cell cycle and inhibiting apoptosis. The PSME3 protein was overexpressed in 64.6% (117/181) of the analyzed samples, and overexpression of PSME3 was associated with a significantly poor prognosis. In addition, multivariate analysis suggested that PSME3 overexpression, tumor, node, metastasis stage, and tumor size are independent prognostic biomarkers for GC. We conclude that the overexpression of PSME3 was associated with a poor prognosis in patients with GC, and PSME3 might play an oncogenic role in the occurrence and development of GC.

Helicobacter Pylori specific antibodies among multiple sclerosis patients

Background: Multiple sclerosis (MS) is one of the most common neurological diseases that occurs predominantly in young adults and more commonly in women. MS is a chronic inflammatory disease characterized by demyelinating lesions in the brain, spinal cord, and optic nerve. This study aimed to compare Helicobacter pylori infection in patients with MS and the control group.Methos: the study was case-control. And population consisted of patients referred to a neurological specialty clinic in Isfahan from 2015 to 2018, 107 cases in the case group and 107 in the control group. The case group was referred to causes such as headache, dizziness, and other diseases that had no established association with Helicobacter pylori. Case and control groups by referring to a laboratory through IgA and IgG antibodies against Helicobacter pylori were investigated.Results: The mean age in the case and control group was 32 years. The mean IgA in the case group was 17.03 and in the control group 29.25, which was statistically significant (p-value=0.001). The mean IgG in the case group was 26.53 and in the control group was 48.69 which statistically significant (P=0.001). After the adjustment of the IgA and IgG levels on the variables such as age, gender, smoking, and history of autoimmune disease, there was a significant difference between the two groups (P-value=0.001) and in the control group, the IgA level was 11.42 and IgG levels were 21.2 points higher than the control group.Conclusion: Generally. The results of this study showed that serum IgA and IgG antibodies in the control group were more than in the case group and there was a negative correlation between Helicobacter pylori infection and MS, and according to previous studies, the results of this study suggest that Helicobacter pylori infection has a protective role in the pathogenesis of MS.

Frequency of Helicobacter Pylori Infection in Patients with Functional Dyspepsia

Objective: To determine the frequency of Helicobacter Pylori (H. Pylori) infection in patients of dyspepsia. Patients and Methods: A total number of 150 patients with diagnosis of dyspepsia, both male and female having age 18-60 years and having duration of symptoms of dyspepsia from &gt; 6 months were included from June-2021 to February-2022. Baseline characteristics such as age, gender, duration of symptoms, educational status and marital status was noted. In laboratory gram staining and rapid urease test was done to diagnose H. pylori. Diagnostic endoscopy was done in all patients. Biopsy specimens was taken from abnormal lesions for histopathological diagnosis of H. pylori infection. Results: Mean age was 40.11±9.08 years. Mean duration of symptoms was 13.24±5.42 months. There were 72(48%) male patients and 78(52%) female patients. Helicobacter pylori was found present in 86 (50.89%) and it was absent in 83 (49.11%) patients Conclusion: In present study, H. Pylori was diagnosed in 50.89% patients which is very high, so the patients presenting with functional dyspepsia should always be evaluated first for the possibility of H. Pylori infection. Keywords: Helicobacter pylori, dyspepsia.

Analysis of the state of immunity in patients with chronic gastritis infected with &lt;i&gt;Helicobacter pylori&lt;/i&gt;

Helicobacter pylori is considered an etiological agent of chronic gastritis and a number of other diseases of the gastrointestinal tract. The immune response to H. pylori is characterized by the development of both pro-inflammatory and tolerogenic reactions. Against this background, the possibility of forming autoimmune shifts is also assumed. The purpose of the present study was to conduct a comparative analysis of the state of immunity in patients with chronic gastritis in the exacerbation stage associated with and not associated with H. pylori infection. There were used whole peripheral blood (n = 50) and serum (n = 49) samples from 162 patients with primary chronic gastritis at the exacerbation stage, in which the presence or absence of H. pylori DNA was tested by real-time PCR in gastric juice. In the peripheral blood of patients, the relative content of CD4+FoxP3+ cells (T regulators) and CD4+CD161+ cells (IL-17 producing cells) was evaluated using flow cytofluorometry and monoclonal antibodies method, the level of mRNA FoxP3 and mRNA IL-17A was determined using real time RT-PCR, and the concentration of IL-2 and IL-23 was determined using enzyme immunoassay. It has been shown that in H. pylori-infected patients with chronic gastritis in the exacerbation stage in comparison with patients not infected with H. pylori, the content of CD4+FoxP3+ cells, CD4+CD161+ cells does not change in the blood, also with the level of mRNA FoxP3 and mRNA IL-17A. Since the equilibrium between the populations of Th17 cells and T regulators is modulated by IL-2, which is important for generating the population of T regulators, but inhibits polarization of the immune response towards Th17 cells, we conducted a comparative assessment of the serum IL-2 level in patients with chronic gastritis. All patients showed an increase in IL-2 content in comparison with the norm. In this case, the concentration of IL-2 in the blood of infected H. pylori patients was statistically significantly higher than in H. pylori-uninfected patients. An important regulator of the function of Th17 cells is also IL-23, which induces the differentiation of naive T lymphocytes into Th17 cells involved in inflammatory and autoimmune reactions. In this regard, we determined the level of this cytokine in the blood of patients with chronic gastritis. Multiple increase of IL-23 concentration in comparison with normal level and higher content of IL-23 in H. pylori-infected patients in comparison with uninfected patients were revealed. On the basis of the obtained data, it can be concluded that an increase in the concentration of IL-23 does not exclude the possibility of forming autoimmune shifts with its participation in persons with helicobacter infection, but the issue requires further study.

Dyspepsia: terminology, causes and risk factors, patient management

Clarification of the term dyspepsia is associated with the development of ideas about functional diseases of the gastrointestinal tract (GIT) and the development and implementation of the Rome criteria for these diseases. Dyspepsia is a complex of symptoms related to the gastroduodenal region and includes epigastric pain and burning sensation, epigastric fullness after eating, and early satiety. Dyspepsia is widespread, with about 20% of the adult population having these symptoms. It is important to note that in the majority of individuals with dyspepsia (up to 80%), the organic, systemic or metabolic cause of symptoms cannot be identified using traditional diagnostic methods, indicating its functional nature. In H. pylori-infected patients with dyspepsia, symptoms may be associated with gastritis if successful eradication is followed by sustained remission (H. pylori-associated dyspepsia). If dyspepsia persists after etiological treatment of bacterial gastritis, a diagnosis of functional dyspepsia should be established. A feature of functional dyspepsia is the frequent overlap of its clinical variants (postprandial distress syndrome (PPDS) and epigastric pain syndrome SBE) in one patient, as well as the frequent combination with other functional diseases (for example, irritable bowel syndrome (IBS)) and gastroesophageal reflux disease (GERD). For the symptomatic treatment of functional dyspepsia, drugs of various groups are prescribed: gastric acid supressants, prokinetics, selective serotonin reuptake inhibitors, tricyclic antidepressants, as well as new drugs for this indication (H1 blockers, budesonide). The effectiveness of proton pump inhibitors, including in combination with prokinetics, has a high level of scientific evidence.

A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection.

BackgroundHelicobacter pylori infection is a major cause of peptic ulcers and gastric cancer. This study aimed to compare the eradication rate and essential costs of culture-based and empiric therapy strategies in treating pediatric H. pylori infection.MethodsWe retrospectively enrolled patients aged <18 years with a diagnosis of H. pylori infection who received esophagogastroduodenoscopy at two medical centers in southern Taiwan from 1998 to 2018. Patients with positive cultures and minimum inhibitory concentration test results were allocated to a culture-based strategy, and those with negative cultures or without culture as an empiric therapy strategy. We collected demographic data and eradication rates, and calculated the total essential costs of treating a hypothetical cohort of 1,000 pediatric patients based on the two strategies.ResultsNinety-six patients were enrolled, of whom 55 received a culture-based strategy and 41 received an empiric therapy strategy. The eradication rates with the first treatment were 89.1 and 75.6% in the culture-based and empiric therapy strategy, respectively. There were no significant differences in age, sex, and endoscopic diagnosis between the two strategies. For every 10% increase in those receiving a culture-based strategy, the total cost would have been reduced by US$466 in a hypothetical cohort of 1,000 patients. For every 10% increase in successful eradication rate, the total cost was reduced by US$24,058 with a culture-based strategy and by US$20,241 with an empiric therapy strategy.ConclusionsA culture-based strategy was more cost effective than an empiric therapy strategy in treating pediatric H. pylori-infected patients.

Prevalence of Virulence Genes and Antigen Pattern in Helicobacter pylori-Infected Patients and the Level of Some Inflammatory Cytokines Compared with Non-infected Individuals

Background: The worldwide prevalence of Helicobacter pylori is about 50%. This bacterium needs a number of virulence factors for pathogenesis. Objectives: This study aimed to determine the prevalence of virulence genes (ureB, cytotoxin-associated gene A [cagA], and vacuolating cytotoxin [vacA]), as well as the antigenic profile in H. pylori strains. Methods: Eighty-five patients with abdominal pain, including 46 H. pylori-positive and 39 H. pylori-negative cases, were enrolled in this study. The serum levels of interleukin (IL)-17F, tumor necrosis factor α (TNF-α), and interferon γ (IFN-γ) cytokines were measured by multiplex kits and flow cytometry. After molecular identification by the ureC gene, vacA, cagA, and ureB genes were detected by polymerase chain reaction (PCR). Finally, after antigenic extraction, the whole-cell protein was exhibited by sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS-PAGE). Results: The prevalence of vacA, ureB, and cagA genes were 91.3%, 67.39%, and 50%, respectively. The frequency of genes and cell surface antigens were not significantly different based on the gastritis severity (P &gt; 0.05). IL-17F significantly (P = 0.046) increased in the presence of 19.5 kDa (outer membrane protein [OMP]). Moreover, the OMP antigen significantly enhanced immunoglobulin A (IgA; P = 0.013). In the presence of the 66-kDa (ureB) antigen, the serum level of IFN-γ increased (p = 0.041). Finally, the CagA protein led to increased IgG antibody levels (p = 0.027). Conclusions: Early detection of H. pylori infection can play a crucial role in managing it. Our results suggest that IL-17F, TNF-α, and IFN-γ cytokines could be diagnostic markers. However, further studies are required to fully investigate this suggestion.

An observational study of Helicobacter pylori infection in patients with chronic plaque psoriasis

Objectives To determine the prevalence of Helicobacter pylori infection in patients with chronic plaque psoriasis and to determine the association of H. pylori infection with the severity of chronic plaque psoriasis. Patients and methods The prospective case–control pilot study was conducted in the outpatient Department of Dermatology from November 2017 to April 2019. A total of 50 patients with chronic plaque psoriasis and 50 consenting healthy controls were included in the study. A cutaneous examination of the morphology, site, and extent of the lesions was done. Psoriasis area and severity index scores were calculated for all patients. H. pylori stool antigen test was performed for all cases and controls. The data were entered into MS Excel spreadsheet, and analysis was done using the Statistical Package for the Social Sciences (SPSS), version 21.0. Results The mean age of patients with psoriasis was 37.24±11.7 years, with 64% males and 36% females. H. pylori was positive in 24/50 patients with psoriasis. Compared with controls, patients with psoriasis had significantly higher H. pylori positivity rate (48 vs. 26%, P=0.023). Compared with the patients with H. pylori negative status (n=26), H. pylori positivity (n=24) showed significant association with site and disease progression (P=0.016) but not with disease duration (P=0.907). The median psoriasis area and severity index score in H. pylori-positive patients was significantly higher than that in patients with negative H. pylori (13.55 vs. 4.65, P=0.002). Conclusion The small number of patients studied showed that H. pylori infection is associated with psoriasis, with the progression and the severity of psoriasis, bearing a direct association with increased positivity for H. pylori.

Helicobacter pylori infection in patients with inflammatory bowel diseases: a single-centre, prospective, observational study in Egypt

ObjectiveConflicting results have been reported by numerous epidemiological studies investigating the association between Helicobacter pylori (H. pylori) infection and inflammatory bowel disease (IBD). We aimed in this study to assess...

Association of Helicobacter pylori infection with chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease (COPD) is a disease that is systematically characterized by an abnormal inflammatory response affecting the airways, interstitium and vascular bed through reactions to gas and particles, especially cigarette smoking. Recent studies have shown an association between Helicobacter pylori infection and various inflammatory diseases. H. pylori is a gram-negative, microbial bacterium that can be resistant to acidic stomach conditions and can interfere with gastric urease production. In this study, we examined the relationship between H. pylori infection in patients with COPD and the prevalence of H. pylori infection. Objectives: Determining the association between H. pylori infection and COPD. Patients and Methods: This case-control study is based on the Persian cohort study of patients who were referred to the digestive disease research center after being identified in the pulmonary clinic for H. pylori fecal antigen. Information on demographic variables and other related variables were obtained. Finally, the collected information was entered into SPSS software version 24 and the results were displayed descriptively using distribution and frequency tables and graphs and analytical statistics were analyzed using t test and logistic regression. Results: Out of 250 patients, 134 (53.6%) tested positive for H. pylori and 116 (46.4%) tested negative. Out of a total of 250 non-infected people; 106 patients (42.4%) were positive and 144 patients (57.6%) were negative. The two groups were statistically significantly different based on the chi-square test (P = 0.012). Conclusion: Our study showed a direct and significant relationship between H. pylori and COPD, which can be due to the effect of bacteria on lung growth in early life and also the development of systemic inflammation throughout life.

Age of eradication and failure rates of clarithromycin-containing triple therapy for Helicobacter pylori: A 15-year population-based study.

Failure rates of clarithromycin-containing triple therapy for H. pylori are rising. To determine the trend of failure rates of clarithromycin-containing triple therapy in different age groups in Hong Kong over the past 15 years. This is a population-based retrospective age-period-cohort study involving all adult H. pylori-infected patients who had received the first course of clarithromycin-containing triple therapy in 2003-2017. Failed eradication was identified by the need of retreatment within 2 years of eradication. Logistic regression model was used to characterize the risk of retreatment. 113,526 H. pylori-infected patients were included. The overall failure rate increased from 4.83% in 2003 to 10.2% in 2016 (p for linear trend <0.001). When stratified by age of eradication, patients 75 years or above had the lowest retreatment rate of 5.11%, which progressively increased in younger patients (60-74 years: OR 1.26, 95% CI 1.15-1.38; 45-59 years: OR 1.36, 95% CI 1.24-1.48; 18-44 years: OR 1.55, 95% CI 1.41-1.69). The results remained consistent when stratified by year of birth, and period of eradication. Other risk factors for retreatment included female (OR 1.24, 95% CI 1.18-1.30), triple therapy containing metronidazole (OR 2.30, 95% CI 2.12-2.50), and shorter duration of therapy (10 days: OR 0.88, 95% CI 0.79-0.97; 14 days: OR 0.67, 95% CI 0.58-0.77 vs 7 days). While failure rates of clarithromycin-containing triple therapy progressively increased over the past 15 years, the failure rate was particularly high among younger patients, which could undermine the potential benefits of early H. pylori eradication.

Prevalence of Helicobacter pylori Infection in Patients with Primary Open Angle Glaucoma

Prevalence of Helicobacter pylori Infection in Patients with Primary Open Angle Glaucoma

Susceptibility-Guided Therapy vs. Bismuth-Containing Quadruple Therapy as the First-Line Treatment for Helicobacter pylori Infection: A Systematic Review and Meta-Analysis.

BackgroundThe increased antibiotic resistance of Helicobacter pylori (H. pylori) has led to the decreased efficacy of H. pylori regimens.AimTo evaluate the efficacy, safety, and compliance of susceptibility-guided therapy (SGT) vs. bismuth-containing quadruple therapy (BQT) as the first-line treatment for H. pylori infection.Materials and MethodsThis meta-analysis was performed in accordance with the PRISMA 2009 guidelines. A systematic search in PubMed, Embase, and Cochrane databases was conducted using the combination of “H. pylori or H. pylori or Hp,” “bismuth quadruple,” and “tailored eradication OR tailored therapy OR susceptibility-guided therapy OR personalized therapy OR antibiotic susceptibility testing.”ResultsFive studies with 2,110 H. pylori-infected patients were enrolled. The pooled eradication rates of SGT and BQT were 86 vs. 78% (p < 0.05) and 92 vs. 86% (p > 0.05) by intention-to-treat (ITT) and per-protocol (PP) analyses, respectively. SGT has a significantly superior efficacy than BQT [pooled risk ratio (RR) = 1.14, p < 0.05] in a subgroup of cultures with the susceptibility test. The pooled side effect rate was 20% in SGT and 22% in BQT, which showed no significant difference (p > 0.05). The compliances of SGT and BQT were 95 and 92%, respectively.ConclusionCompared with BQT, SGT showed a higher efficacy and similar safety as the first-line treatment of H. pylori infection in areas with high antibiotic resistance. The decision-making of first-line regimens for H. pylori infection should depend on the availability and cost-effectiveness of susceptibility tests and bismuth in local areas.

The Prevalence of Helicobacter Pylori Infection in Patients with Chronic Kidney Disease Undergoing Hemodialysis

Abstract The aim of this study was to analyze the prevalence of Helicobacter pylori infection and gastroduodenal lesions in Montenegrin patients with chronic kidney disease on hemodialysis. The study included 55 hemodialysis patients with dyspeptic symptoms and 50 control subjects with normal kidney function who had also dyspepsia. After dyspepsia assessment by an interview, all subjects underwent gastroduodenoscopy and histopathological analysis of biopsy specimens, taken from the corpus and antrum of the stomach. Helicobacter pylori was confirmed in 50.9% of corpus mucosa i.e. 60.6% of antrum mucosa of maintenance hemodialysis patients. There were no significantly differences in endoscopic findings of the stomach and bacterial presence between the two study groups of participants (p = 0.451), while duodenal lesions were prevalent in control subjects (p &lt; 0.001). The atrophy of corpus mucosa was more common in hemodialysis patients (p = 0.007), especially in those who have been on hemodialysis for a longer time (p &lt; 0.001) and had lower pH (p = 0.011). The prevalence of Helicobacter pylori infection shown an inverse relationship with dialysis duration. Contrary, a positive relationship between Helicobacter pylori and the concentration of bicarbonate was demonstrated (p = 0.031). The prevalence of Helicobacter pylori and atrophic mucosal changes in Montenegrin hemodialysis patients depends on dialysis duration and acid-base balance.