Urease Test Research Articles

Comparison of Different Diagnostic Methods of Helicobacter Pylori Infection in Children

Background: Helicobacter Pylori Infection (HPI) is usually acquired during childhood, without specific treatment this infection rarely resolves spontaneously. Therefore, correct diagnosis is necessary for the effective eradication and there is no single test can be regarded as the gold standard for the identification of H. pylori.Objective: To compare the sensitivity, specificity, and accuracy of the stool antigen test, serologic test, rapid urease test, and histology for the diagnosis of H. pylori infection.Materials and Methods: This cross-sectional descriptive study was conducted at the Department of Pediatric Gastroenterology & Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from April 2019 to October 2021 on 54 children aged less than 18 years suspected to be H. pylori infection, who attended the outpatient as well as admitted. In a typical data sheet, a complete clinical history, exam results, and investigation reports were documented. Results were expressed as sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy.Results: The gastro-duodenal biopsy and Rapid Urease Test (RUT) (100%) have the highest sensitivity, followed by serology (95%), and Saturation (SAT) (70%). Highest specificity was found in gastro-duodenal biopsy 88.2% followed by RUT 67.6% & SAT 41.2% and only 32.4% by serology. The gastro-duodenal biopsy had the highest diagnosis accuracy (92.6%), followed by RUT (79.6%), serology (55.6%) and SAT (51.9%).Conclusion: In the study, the gastro-duodenal biopsy and rapid urease test both showed high sensitivity, specificity, and negative predictive value; as a result, the combination of these tests constituted the best alternative for making the diagnosis. Because of their high sensitivity, serological tests may be useful non-invasive screening methods. KYAMC Journal Volume: 14, No: 03, October 2023: 130-137.

New strategies for Helicobacter pylori isolation and sequencing analysis for virulence genes contributing to its pathogenicity.

Helicobacter pylori is a fastidious pathogen that is required a complicated medium for growth. Invading epithelial cells of the stomach. H. pylori virulence factors are classified by function, acidic resistivity, adhesion, chemotaxis and motility, molecular mimicry, immunological invasion and modulation, and toxins formation such as cytotoxin-associated genes A (cagA) and vacuolating cytotoxin A (vacA). This study aims to determine a simple and innovative technique to isolate H. pylori from gastric biopsies and assess pathogenicity by virulence factor gene detection. A total of 200 patients who were suspected of having H. pylori infection had two antral gastric biopsies undertaken. A rapid urease test (RUT) was used for one, and Brain Heart Infusion broth (BHI) was used to cultivate the other. The molecular study included diagnostics utilizing the 16sRNA housekeeping gene along with the identification of the virulence factors genes (cagA, cagT, and vacA) and sequencing, RESULT: Of the 200 antral gastric biopsies collected, 135 were positive rapid urease tests, and 17 H. pylori isolates were successfully obtained from 135 biopsies. The 16SrRNA as a housekeeping gene is confirmed, and about 53%, 70.5%, and 82.3% of the 17 isolates show carrying cagA, cagT, and vacA genes, respectively. All peptic ulcer isolates have the cagA gene, while Gastroesophageal Reflux Disease (GERD) and non-peptic ulcer disease (NPUD) isolates show the lack of the cagA gene. All bacteria, which were isolated from peptic ulcer, nodular gastritis, and gastritis patients, have a vacA gene. The effective method for isolating H. pylori is centrifuging the transport broth after 24h of incubation. The cagA toxin causes peptic ulcer while vacA toxin induces several histopathological changes in the stomach. Three virulence genes were present in all peptic ulcer-causing bacteria, while only one or none were present in the GERD and NPUD biopsy isolates.

Endoscopic Kyoto and Kimura-Takemoto Classifications Are Comparable in Predicting High-Risk Gastric Precancerous Lesions

Introduction: Severe and extensive gastric atrophy, extensive or incomplete gastric intestinal metaplasia, and gastric dysplasia are considered high-risk gastric precancerous lesions (HGPLs). Endoscopic findings based on the endoscopic Kyoto classification (EKC) and the Kimura-Takemoto classification (KTC) have been reported to be significantly associated with HGPLs. This study aimed to compare these two classifications in predicting active Helicobacter pylori (H. pylori) infection and HGPLs. Methods: This is a cross-sectional study conducted on naïve dyspeptic patients who underwent upper gastrointestinal endoscopy at a tertiary hospital. Endoscopic findings were scored according to the EKC and KTC. Mapping biopsies were taken, and H. pylori infection was determined using a locally validated rapid urease test and histology. The performance of EKC was compared with that of KTC using the area under the receiver operating characteristic curve (AUC) in predicting active H. pylori infection and HGPLs. Results: There were 292 patients with a median age of 46 and a male-to-female ratio of 1:1. The rates of active H. pylori infection and HGPLs were 61.3% and 14.0%, respectively. The EKC was better than the KTC in predicting active H. pylori infection (AUC: 0.771 vs. 0.658, respectively; p < 0.001). However, these two classifications had comparable performance in predicting HGPLs (AUC: 0.792 vs. 0.791, respectively; p = 0.956). Conclusion: Compared to EKC, KTC is inferior in predicting active H. pylori infection but has comparable performance in predicting HGPLs.

Accuracy of gastric nodule combined with rapid urease test prediction in diagnosing Helicobacter pylori infection in children.

The diagnosis of Helicobacter pylori (H. pylori) infection in children remains challenging with the lack of a rapid, cost-effective, and highly accurate diagnostic method. Consequently, this study aimed to investigate the accuracy of the combination of gastric nodule and rapid urease test (RUT) as a diagnostic method for H. pylori infection in children. The study included participants who underwent a thorough examination, including gastroscopy, a 13C breath test, RUT, and pathological methylene blue staining, with the gold standard for diagnosing of H. pylori infection being a positive result from both pathological methylene blue staining and 13C breath test. The sensitivity, specificity, positive and negative predictive values, and accuracy of the diagnostic methods were calculated. The accuracy of the different tests for H. pylori infection was evaluated in 2202 participants. A total of 730 (33.2%) children were diagnosed with H. pylori infection (pathological methylene blue staining and 13C breath test, both positive). Gastric nodule had a sensitivity of 87.1% and a specificity of 93.1%, whereas combining gastric nodule and RUT in parallel had the higher accuracy of 95.4%. The accuracy of gastric nodule diagnosis was higher in younger age groups and increased after excluding patients with a history of anti-H. pylori treatment. The findings of this study suggest that gastric nodules, particularly when combined with RUT, can be a valuable predictor of H. pylori infection in children, offering a simple and feasible alternative to other invasive methods.

A study on phenotypic characterization and genotypic determination of drug resistance of Helicobacter pylori from cases of acid peptic disease in a tertiary care center

Background: Helicobacter pylori infection is one of the major risk factors for gastroduodenal disease, and invasive or non-invasive tests are available to detect it. Aims and Objectives: The study aims to identify H. pylori phenotypically and genotypically to identify drug-resistant H. pylori in suspected cases of peptic acid disorders at a tertiary care center. Materials and Methods: This 6-month prospective and observational study was performed at Saveetha Medical College and Hospitals. Patients’ gastric biopsy samples were obtained from 105 individuals with gastroduodenal disorders who had upper gastrointestinal endoscopies at the Hospital. A fiber optic endoscope and biopsy forceps were used for the endoscopy. Biopsy samples were collected from the antrum and placed in Eppendorf tubes for fast urease, culture, gram stain, polymerase chain reaction (PCR), and histological analysis. Results: A total of 78 (74%) males and 27 (26%) females were among the 105 patients. Endoscopic findings imply gastritis, gastric ulcer, and duodenal ulcer in 74 patients (70.48%). Rapid urease test (RUT), gram stain, and histology revealed positive results in 20 cases. RUT showed that 30.47% of patients tested positive. Gram stain detected 25.1% of H. pylori infections, and 12 cases were histopathologically positive. By PCR, 21.62% of gastritis patients were positive for H. pylori infection. RUT and PCR give comparable results for detecting H. pylori infection, with a strong association between H. pylori infection and peptic ulcer disease. Conclusion: A combination of RUT and PCR is an effective diagnostic approach for H. pylori infection, allowing doctors to select the most appropriate medications for specific patients.

Analysis between symptoms of the upper gastrointestinal tract and endoscopic findings of patients undergoing upper digestive endoscopy in a reference center in the interior of Maranhão, Brazil.

To analyze clinical and endoscopic aspects of dyspeptic patients submitted to upper endoscopy in a reference center in the interior of Maranhão, Brazil. Observational, descriptive, and analytical research through interviews and endoscopic reports of 80 patients with dyspeptic complaints submitted to upper endoscopy. Among the respondents, 66.25% were women, most were aged ≥ 40 years old and had epigastric pain as their main symptom, and 29.75% had no appropriate indication to perform upper endoscopy. Mild enanthematous gastritis of the antrum was the most frequent finding, and 92.5% had non-significant findings. Rapid urease test was positive in 25%. The following findings showed a statistically significant correlation (p < 0.05): age < 40 years old, female gender, and gastric lesion with positive urease test; smoking with gastric lesion and age less than 40 years old with normal examination. Patients with significant findings had appropriate indications for upper endoscopy. The correct indication of upper endoscopy is essential for satisfactory endoscopic yields and accurate diagnosis.

Alarming Incidence of Gastric Outlet Obstruction Related to NSAIDS and Synthetic Opioid in North West India.

In recent years, there has been an alarming increase in cases of gastric outlet obstruction (GOO) at our center due to drug abuse. So, we conducted this study to know the incidence of nonsteroidal anti-inflammatory drugs (NSAIDs) and synthetic opioid abuse in cases of GOO. This was an observational study involving consecutive cases of GOO diagnosed from September 2017 to February 2019. A detailed history, including drug addiction history and clinical examination, was done. Investigations included routine biochemical and hematological tests, upper gastrointestinal endoscopy (UGIE), ultrasonography, rapid urease test (RUT), and histopathology of the diseased area. Among the 102 cases diagnosed with GOO, 62 (60.78%) cases had a history of drug addiction. The drug addiction history was as follows: NSAIDs and opioids in 56, opioids alone in four, and NSAIDs alone in two cases. The most common site of stricture was the second part of the duodenum. The features on histopathology were ulcerations of the mucosa infiltrated by eosinophils, plasma cells, and lymphocytes. There is an alarming increase in the incidence of GOO due to NSAIDs and opioid abuse at our center. Efforts should be made to control the indiscriminate use of these over-the-counter drugs to prevent dreaded complications.

Interleukin-8 genetic polymorphism and its relation to Helicobacter pylori infection and Helicobacter pylori-associated gastric diseases

Helicobacter pylori (H. pylori) infection has a variety of clinical outcomes, and host genetic factors play an important role in this process. Cytokines are important factors in mediating and controlling the inflammatory process during H. pylori infection. Interleukin-8 (IL-8) plays a critical role in the epithelial cell response to H. pylori infection and the development of H. pylori-related gastric disorders. The IL-8 gene has an A/T base pair polymorphism in the promoter region (-251), which has been linked to an increase in interleukin production by gastric epithelial cells. In this context, the goal of our study was to determine the polymorphism in the IL-8 gene and its relation to H. pylori infection and H. pylori-associated gastric diseases. Gastric biopsy specimens were collected from 44 patients with H. pylori infection and 29 patients without H. pylori infection. The rapid urease test and detection of the glmM gene were used to diagnose H. pylori infection. Polymerase chain reaction-restriction fragment length polymorphism was used to identify the polymorphism in the Il-8 gene (at position-251). The presence of the A/A and T/A genotypes of the IL-8 gene was found to be significantly associated with susceptibility to H. pylori infection (p = 0.012 and p = 0.004, respectively). Also, the IL-8 A allele was significantly associated with H. pylori infection in our study (p = 0.002). We did not find a significant association between IL-8 gene polymorphism and a higher risk of gastritis and peptic ulcer disease. In conclusion, IL-8 gene polymorphism at -251 position was significantly associated with H. pylori infection.

Relationship of Helicobacter pylori Infection with Various Components of Metabolic Syndrome in Dyspeptic Patients: A Cross-sectional Study from Western Maharashtra, India

Introduction: Helicobacter pylori (H. pylori), despite its high prevalence in the Indian population, has been subjected to limited studies concerning its potential role as a risk factor for Metabolic Syndrome (MetS) and Insulin Resistance (IR). Proposed mechanisms include inflammatory mediators, atherogenic lipid profiles, and vasoconstriction. Aim: To determine the association between H. pylori infection and MetS components, focusing on Highly sensitive C-Reactive Protein (hs-CRP) levels, to enhance understanding and management of these conditions. Materials and Methods: This cross-sectional study was conducted at the Department of Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India spanning from September 2017 to August 2019. This study involved 100 dyspeptic patients aged 18 years or older undergoing upper Gastrointestinal (GI) endoscopy. Data collection included fasting/postprandial blood parameters, serum lipids, hs-CRP, and H. pylori detection via both rapid urease test and Histopathological Examination (HPE). Physical assessments covered height, weight, Waist Circumference (WC), and blood pressure. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analysis employed unpaired t-tests, Chi-square tests, and Fisher-Exact tests using IBM Statistical Package for Social Sciences (SPSS) version 21.0. Results: The study of 100 dyspeptic patients, predominantly females, revealed a significant association between H. pylori infection and MetS (p-value&lt;0.001). H. pylori infection was associated with elevated fasting glucose (90.24%) and triglycerides (90.24%) (p-value&lt;0.001). Additionally, individuals with H. pylori infection exhibited higher inflammatory markers (p-value 0.0029). Conclusion: The above findings underscore the potential role of H. pylori as a risk factor for MetS and highlight the need for further research to elucidate mechanisms and implications for preventive strategies and clinical management, offering avenues for improved patient care and outcomes, particularly in addressing cardiovascular health.

Histopathology Features of H. pylori Gastritis Associated With Altered Lipid Profile: An Observational Study from a Tertiary Healthcare Center in North West Romania.

H. pylori infection can promote a systemic inflammatory syndrome, eventually leading to intestinal metaplasia and gastric cancer. The aim of our study was to investigate the possible association between dyslipidemia and histopathological features of H. pylori gastritis. An observational, retrospective study was conducted over the period 2017-2022 on symptomatic patients with a positive rapid urease test. A total of 121 patients who underwent upper gastrointestinal endoscopy with stomach biopsy were enrolled in this study. Based on the updated Sydney System, we investigated the association between neutrophils, mononuclear cells, intestinal metaplasia, or gastric atrophy and altered lipid profiles. A high prevalence of H. pylori infection was noticed in the studied group upon the application of the rapid urease test, being associated with dyslipidemia regardless of patient sex. All the endoscopic diagnoses (acute, chronic, or atrophic chronic gastritis, metaplasia) correlated with the histopathological features. Mononuclear cells and metaplasia were more likely to be found in H. pylori-positive patients with dyslipidemia, which is consistent with acute and chronic inflammation caused by H. pylori in the gastric mucosa. Although our study was conducted on a small scale, it offers new insights and details regarding H. pylori infection and histopathological features. Mononuclear cells and metaplasia were associated with an altered lipid profile in H. pylori-positive patients. These findings warrant future investigation, such as the evolution of gastric biopsies and lipid profiles before and after eradication.

Evidências de Helicobacter spp. em gatos domésticos na região central do Rio Grande do Sul - pré-estudo

ABSTRACT Non-Helicobacter pylori Helicobacters(NHPH) account for causing moderate and severe gastritis in humans. Moreover, they have already been documented in the oral cavity of feline animals. The current study aims to investigate Helicobacter spp. incidence in necropsied domestic cats from central Rio Grande do Sul. Stomach, liver, and bile samples derived from 30 cats’ cadavers were subjected to rapid urease test (RUT), histopathological analysis, PCR, and nucleotide sequencing to investigate the genetic material presence and to identify the main phylogenetic group. Based on RUT results, 64.2% and 53.5% of patients were positive for gastric body and pyloric antrum, respectively. Ten out of these 15 patients were male (70%) and the positive result observed for the pyloric antrum was associated with males. Mild histopathological changes were observed in most gastric and liver samples. Gastric samples subjected to PCR presented positive results in 60.7%, whereas liver samples accounted for positive results in 17.8% and bile samples, in 3.5% of cases. There was high nucleotide identity with NHPH species. This study has found evidence that NHPH can be found in the gastric and hepatic regions, as in the bile of domestic cats, besides emphasizing the zoonotic potential of this disease

Isolation and investigation of external reproduction tract mycoflora in healthy male cats.

Various infectious agents can infect the male reproductive system. The aims of this study were to provide current data on fungal and yeast flora of the external organs of reproductive system of male short hair cats including penis and prepuce. In total 28 samples were taken from external genital system of male stray cats using sterilised cotton swabs. Samples were taken based on the absence of any reproductive complications using physical examinations. The samples were transferred to sterilised Stuart transport media and were then incubated in the Sabouraud dextrose agar with chloramphenicol at 32°C for 48h. The identification of fungi and yeasts was confirmed by germ tube formation test, CHROM agar, urease testing and Corn meal agar medium with Tween 80. Fungal agents were isolated from 7 (25%) out of 28 male stray cats. Fungal isolates were obtained from the penis and prepuce of 4 (36%) and 7 (100%) male cats, respectively. The most commonly recovered species samples were Candida krusei (3.75%) and Penicillum spp. (6.86%) from the penis and prepuce of the cats, respectively. The external organs of male reproduction of cats were infected with 2-4 different fungal agents. Only 5 (45%) cats were infected with one fungus; however, in 6 (55%) cats, mixed fungal infections were isolated. Cats 3-4 years old had the highest fungal contamination in the prepuce region (4/7), while the penis at this age had the least contamination (1/4). It is concluded that the external reproduction organs of male cats could be infected by different fungal agents.

Identification of Autoantigens in Pediatric Gastric Juices.

This study aimed to investigate the presence of autoantigens in the gastric juices of children. Gastric juice and serum samples were obtained from 53 children <15 years of age who underwent gastric endoscopy. Among these, 8, 22, and 23 participants were in the age groups 0-5, 6-10, and 11-15 years, respectively. These samples were analyzed using two-dimensional electrophoresis (2-DE), immunoblot analysis, and matrix-assisted laser desorption ionization-time of-flight mass spectrometry. Furthermore, we reviewed the histopathological findings and urease test results and compared them with the results of 2-DE and immunoblot analysis. There were no statistically significant differences in urease test positivity, grades of chronic gastritis, active gastritis, or Helicobacter pylori infiltration of the antrum and body among the three age groups. Three distinct patterns of gastric juice were observed on 2-DE. Pattern I was the most common, and pattern III was not observed below the age of 5 years. Histopathological findings were significantly different among active gastritis (p=0.037) and H. pylori infiltration (p=0.060) in the gastric body. The immunoblots showed large spots at an approximate pH of 3-4 and molecular weights of 31-45 kDa. These distinct, large positive spots were identified as gastric lipase and pepsin A and C. Three enzymes, which are normally secreted under acidic conditions were identified as autoantigens. Further investigation of the pathophysiology and function of autoantigens in the stomach is required.

Eradication rate and adherence with high-dose amoxicillin and proton pump inhibitor as first-line treatment for Helicobacter pylori infection: Experience from University Hospital in Chile.

In Chile, more than 70% of adults are infected by Helicobacter pylori. Clarithromycin should not be used in any regimen if there is >15% resistance to this antibiotic, being greater than 26% in our population. In this scenario, the effectiveness of triple therapy (proton pump inhibitor [PPI], clarithromycin, amoxicillin) was only 63.8%. To evaluate the eradication rate and safety of dual therapy (esomeprazole and amoxicillin) in high doses, through a prospective, observational, and descriptive study. Patients with a positive urease test obtained in an upper digestive endoscopy were included. Any other previous H. pylori eradication regimen were excluded. All patients were treated with esomeprazole 40 mg three times a day and amoxicillin 750 mg four times a day for 14 days. The eradication rate of the dual therapy was evaluated with the H. pylori stool antigen test (the Pylori-Strip® test used) 6 weeks after completing the eradication treatment and with at least 14 days without PPI, being a negative result, confirmation of the effectiveness of this regimen. Of 122 patients, 106 had a negative H. pylori antigen in stool; The intention-to-treat and per protocol analysis, the eradication rates were 91.8% [95% CI: 87%-97%] and 94% [95% CI: 90%-98%], respectively. Four patients discontinued treatment due to adverse effects. Smoking and adherence to treatment were associated with eradication rate. In this cohort of patients with H. pylori infection, high-dose dual therapy has a high eradication rate and good adherence, raising the possibility that it could be used as first-line therapy in our country. Studies with a larger number of patients should confirm these results.

COMPARATIVE STUDY OF STAPHYLOCOCCUS AUREUS ISOLATES IN PUS AND NASAL SWABS AMONG LAHORE PATIENTS

Staphylococcus aureus predominately found in nasal and pus samples is one of the major causes of skin infections and invasive diseases like endocarditis, pneumonia, and osteomyelitis. The current study was performed over the 3 month period, from April 2022 to June 2022. A total of 368 participants’ nasal and pus swab specimens were included in this study and were collected from the different hospitals in Lahore. The objective of the study was to discern the relative prevalence of Staphylococcus aureus isolates in Pus and Nasal Swabs among Patients in Lahore. All the collected samples were cultured in sterile conditions on Blood agar, Chocolate agar, MacConkey agar, and Mannitol salt agar according to the standard laboratory guidelines. S. aureus culture plates were identified based on the colonial morphology after 48hrs. Furthermore, isolated bacteria were characterized based on Gram stain, and differential biochemical analyses like the Coagulase test, Oxidase test, Catalase test, Triple sugar iron, Urease test, Indole test, Motility agar test that was performed to reconfirm S. aureus presence in the given pus and nasal specimens. The modified Kirby Bauer disc diffusion method was employed for antimicrobial susceptibility testing and Zone sizes were interpreted according to the Clinical and Laboratory Standard Institute guidelines (2020). From a total of 368 bacterial samples, 283 were pus swabs and 85 were nasal swabs, whereas the most frequently isolated organism was gram-positive Staphylococcus aureus which accounts for 90% (330) of the total samples. Our results showed a 90 % MRSA prevalence rate in Lahore and in our study oxacillin represents high resistance against MRSA in nasal samples, whereas, clindamycin represents high resistance in pus samples respectively. The reason for this increased prevalence of MRSA is due to the irrational use of antibiotics without prior cultural reports, the absence of antimicrobial situation programs in hospitals, and the failure to look at the infection management practices which may be some of the highlighted reasons for this drawback in the hospital and clinical setup.

Comparative Study of Some Staining Methods for the Demonstration of Helicobacter pylori in Gastric Biopsies in Gombe State, Nigeria

Background: Currently there are different staining methods available for the demonstration of Helicobacter pylori in gastric biopsies sections. Most of these methods are technically demanding, slow and expensive with varying sensitivity and specificity. Aims: This study was to compare some of these techniques for the detection of H. pylori in routine gastric biopsy tissue sections in order to ascertain their reliability and effectiveness. Methodology: Sixty-five positive and seven negative cases of H. pylori were selected based on the results of rapid urease test, serology test and histopathological examination of the tissue sections. Histopathological examinations of sections stained by Hematoxylin and Eosin staining method (H&amp;E), Giemsa staining method, modified Giemsa staining method, modified McMullen staining method and immunohistochemical staining were performed. Results: The sections were evaluated by two independent observers. The sensitivity and specificity for the techniques were as follow: immunohistochemistry, 100% and 100%; modified Giemsa stain, 96.9% and 85.7%; Giemsa stain, 92.3% and 81.4%; modified McMullen stain, 89.2% and 52.9%; H&amp;E, 90.8% and 77.1%. The interobserver agreement was analyzed by Kappa (k) statistics using SPSS version 23 software. The agreement between the two observers was k: 0.859 (98.4%) for immunohistochemistry; k: 0.777 (96.9%) for modified Giemsa stain; k: 0.533 (95.2%) for Giemsa stain; k: 0.267 (92.1%) for modified McMullen stain; and k: 0.421 (93.7%) for H&amp;E stain. Conclusion: The best results were obtained by the immunohistochemical staining and the Giemsa stainings. Although the immunohistochemistry staining method gives the best result and is very reliable, but it is fairly time consuming and expensive. Therefore, considering the cost, applicability and the reliability of the modified Giemsa or Giemsa stain, we recommend both for the detection of H. pylori in gastric biopsies sections especially in resource constrained laboratories.

Diagnostic Validity of a Serological Test with the Current Infection Marker in Thai Adults before and after Helicobacter pylori Eradication Therapy.

Helicobacter pylori infection poses significant health risks, such as gastric adenocarcinoma, necessitating accurate diagnosis and effective treatment in primary care. This study evaluated the diagnostic efficacy of the serological current infection marker (CIM) test in identifying current H. pylori infection. The CIM test samples from 159 participants undergoing gastroscopy were collected, and H. pylori-positive outpatients received triple therapy based on histology or rapid urease test results. Following treatment, 45 patients underwent a 13C-urea breath test and the CIM test for eradication assessment. For pre-eradication, the CIM test demonstrated 89.6% sensitivity, 95.7% specificity, 93.8% positive predictive value, 92.6% negative predictive value, and 93.1% accuracy. Following post-eradication, the CIM test exhibited sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 71.4%, 92.1%, 62.5%, 94.6%, and 88.9%, respectively, using the 13C-urea breath test as the reference standard. The CIM test showcased commendable diagnostic performance, emphasizing its efficacy in both pre- and post-eradication scenarios. Notably, the accuracy, non-invasiveness, user-friendliness, and cost-effectiveness of the CIM test advocate for its recommendation as a preferred diagnostic tool in primary care settings for H. pylori infection detection.

Determination of the Anti-bacterial potency of Allium sativum (Garlic) extract against Agrobacterium tumefaciens causing Crown Gall Disease

The isolated crown galls (a bacterial plant disease) from Pongamia pinnata leaf were investigated to identify the causative agent. The SEM analysis revealed that the causative agent in crown gall appeared to be a slender, pink and rod-shaped bacterium. The morphological, cultural, biochemical and tumorogenesis analyses were performed to identify causative organisms in the crown gall disease. The isolate was negative for Indole, MR and VP tests, but positive for Citrate, TSI, Urease, Catalase and Oxidase tests. The causative organism also developed a tumor-like sport during the potato disc assay after 3rd week of incubation. The causative agent in crown gall was identified as Agrobacterium tumefaciens. The ethanolic extract of Allium sativum produced an inhibitory zone of 15 mm against this isolate. The current study proved that ethanolic extract of garlic can be effectively used to treat crown gall disease in the economically valuable dicot plant of Pongamia pinnata.

Identification of antibiotic-resistant pathogens and virulence genes in Escherichia coli isolates from food samples in the Dhaka University campus of Bangladesh.

The presence of antibiotic-resistant pathogens in food is a serious public health concern nowadays. This study focuses on the isolation and characterization of potentially pathogenic Escherichia coli and antimicrobial-resistant pathogens in chicken curry and potato smash samples collected from the canteens and cafeteria of Dhaka University in Bangladesh. Isolates were identified by their cultural, morphological, and biochemical tests (motility indole urease test, Kliger's iron agar test, catalase test, oxidase test, methyl red and Voges-Proskauer tests). The antibiotic susceptibility test was done by the disk diffusion method. The range of total bacterial count in the potato smash and chicken curry samples was from 1.4 × 104 to 1.6 × 108 CFU/g and from 2.4 × 103 to 2.6 × 106 CFU/g, respectively. Escherichia coli, Salmonella, Vibrio, Klebsiella, Citrobacter, Enterobacter, Proteus, Clostridium, Staphylococcus, Streptococcus, Micrococcus, Bacillus, and Sarcina strains were isolated in both samples. Isolates were highly resistant to ampicillin (90.90%) followed by colistin (52.27%), azithromycin (27.27%), and tetracycline 25%. Proteus species had the highest rate of multiple antibiotic resistance (MAR; 62.5%), followed by Citrobacter species (50%). The isolated E. coli strains were further analyzed through PCR assay to detect virulent genes (EPEC: eaeA 229 bp, bfpA 450 bp, ETEC elt 322 bp, EHEC hylA 534 bp, and EIEC ial 320 bp). One E. coli isolate had the eaeA target gene under EPEC pathotypes. Escherichia coli, as a fecal indicator, may indicate fecal contamination or poor and unhygienic food handling. The findings recommend further investigations to identify potential mechanisms of contamination and preventive measures to improve the food safety level in the canteens and restaurants.

The role of Helicobacter pylori infection in the development and course of allergic diseases in children with gastroesophageal reflux disease

Objective — to improve the prevention and treatment of esophageal lesions in children based on the study of Helicobacter pylori infection in pediatric patients with allergic diseases.&#x0D; Materials and methods. Examination involved 256 children aged 6 to 18 years, from them 118 children without allergic pathology were included in the control group. The diagnosis was verified according to the unified clinical protocols of primary and secondary medical care. H. pylori was determined with biopsy urease test or histologically. Video esophagogastroduodenoscopy with endoscopic determination of pH was used to assess the condition of mucosa of the upper gastrointestinal parts. The results were processed using the methods of non‑parametric statistics.&#x0D; Results. Helicobacter pylori infection occurred more often in children with atopic dermatitis (32%), less often and equally often (24%) at bronchial asthma and allergic rhinitis and in 16% of patients with a combination of allergic diseases. Only 2 (1.4%) patients had H. pylori‑associated chronic urticaria, which was related to the specificity of the hospital department. Helicobacter infection was observed more often in patients with allergic rhinitis and atopic dermatitis without atopic changes. When comparing the Helicobacter association in children with allergic diseases depending on age, a significant difference was established in the group of children aged 6—12 years with allergic rhinitis and mainly with atopy. Endoscopic changes in the esophageal mucosa and esophageal motility disorders in association with Helicobacter pylori more often diagnosed in patients with atopic dermatitis (10.3%), less often and equally often in patients with bronchial asthma and allergic rhinitis (7.7%), the lowest frequency of Helicobacter pylori infection was found in patients with combined allergic pathology (5.1%) and no association in patients with urticaria. Endoscopic signs of esophageal inflammation were more often detected in patients with atopic dermatitis who had Helicobacter pylori infection and esophageal motility disorders. Most often, inflammatory changes in esophageal mucosa were found in patients with allergies developed in the presence of motor disorders, the risk of their development increased in case of Helicobacter infection. It has not been proven that the presence of atopy affected the development of inflammation in the esophagus.&#x0D; Conclusions. Among allergic diseases, Helicobacter pylori infection was more often revealed in patients with atopic dermatitis (32%), allergic rhinitis (24%) and bronchial asthma (24%) without statistical significance. A significant difference in H. pylori contamination depending on age was found only in patients with allergic rhinitis (H. pylori was determined more often in elementary school age), in the rest of the patients and in the control group, no significant differences were found. Endoscopic lesions of the esophagus were more often detected in atopic dermatitis, in particular esophagitis (in 17.9%), it was Helicobacter‑associated in 10.3% of cases and was combined with moderate motor disorders in 10.3% of observations. Allergic rhinitis (15.4%) was also associated with Helicobacter pylori infection (7.7%) and was accompanied by motility disorders in 15.4% of cases. Motor disorders, which were registered both in patients with allergic diseases and in patients without allergies, played an important role in the esophagus inflammation and formation of gastroesophageal reflux disease.&#x0D;