Urease Test Research Articles

The Incidence of Bacterial Isolates Among Dental Caries Patients Attending Clinic At Irrua Specialist Teaching Hospital, Irrua, Nigeria

Despite the global public health importance of dental caries, it is greatly understudied. This study investigates the incidence and prevalent bacteria species in dental carries among patients attending dental clinic in Irrua Specialist Teaching Hospital, Irrua, Nigeria. Patients presenting with signs, symptoms and suspected cases of dental caries attending dental clinic in the hospital between May and July 2017 were recruited. Following standard laboratory procedures, swabs were obtained, morphologically and biochemically analyzed and data subjected to simple statistical analysis. Of the 340 suspected cases, 65.59% were positive for bacteria (25.11% in children and 74.89% in adult). Females were more likely (1.23 times) to be affected and 2.98 times more common in adults than children. The prevalent bacteria isolated was Streptococcus mutans (151; 67.7%), Streptococcus sobrinus (36; 16.4%), Lactobacillus acidophilus (22; 9.9%), Streptococcus salivarius (10; 4.5%) and lastly Streptococcus mitis (4; 1.8%). Biochemical characterization showed isolated Streptococus and Lactobacillus species were non-motile and negative to catalase, citrate, oxidase, indole and urease tests. This study showed the incidence of dental caries is high in the study area and that Streptococcus mutans is the most causative bacteria.

Association between mucosal surface pattern under near focus technology and Helicobacter pylori infection.

BACKGROUNDMany studies evaluated magnification endoscopy (ME) to correlate changes on the gastric mucosal surface with Helicobacter pylori (H. pylori) infection. However, few studies validated these concepts with high-definition endoscopy without ME.AIMTo access the association between mucosal surface pattern under near focus technology and H. pylori infection status in a western population.METHODSCross-sectional study including all patients referred to routine upper endoscopy. Endoscopic exams were performed using standard high definition (S-HD) followed by near focus (NF-HD) examination. Presence of erythema, erosion, atrophy, and nodularity were recorded during S-HD, and surface mucosal pattern was classified using NF-HD in the gastric body. Biopsies were taken for rapid urease test and histology.RESULTSOne hundred and eighty-seven patients were analyzed from August to November 2019. Of those, 47 (25.1%) were H. pylori+, and 42 (22.5%) had a previous H. pylori treatment. In the examination with S-HD, erythema had the best sensitivity for H. pylori detection (80.9%). Exudate (99.3%), nodularity (97.1%), and atrophy (95.7%) demonstrated better specificity values, but with low sensitivity (6.4%-19.1%). On the other hand, the absence of erythema was strongly associated with H. pylori- (negative predictive value = 92%). With NF-HD, 56.2% of patients presented type 1 pattern (regular arrangement of collecting venules, RAC), and only 5.7% of RAC+ patients were H. pylori+. The loss of RAC presented 87.2% sensitivity for H. pylori detection, 70.7% specificity, 50% positive predictive value, and 94.3% negative predictive value, indicating that loss of RAC was suboptimal to confirm H. pylori infection, but when RAC was seen, H. pylori infection was unlikely.CONCLUSIONThe presence of RAC at the NF-HD exam and the absence of erythema at S-HD were highly predictive of H. pylori negative status. On the other hand, the loss of RAC had a suboptimal correlation with the presence of H. pylori.

ETIOLOGY OF DERMATOPHYTOSIS : A STUDY FROM SOUTH INDIA

BACKGROUND: Dermatophytes are one of the most common fungal agents causing supercial skin infections. The prevalence of these infections varies from place to place and is more commonly associated with low socioeconomic status. AIMS AND OBJECTIVES: To isolate and identify the common dermatophytic species causing the infection and to know the efcacy of the antifungals commonly used against them. METHODS: One hundred and ten new cases, who consented for study were included. Skin scrapings were collected for direct microscopy by KOH and for fungal culture in Sabouraud 4% dextrose agar (SDA) with cycloheximide and dermatophyte test medium. Fungi were identied on the basis of their macroscopic and microscopic features with the help of lactophenol cotton blue staining and urease test. RESULTS: Of the 110 cases, 58 cases were KOH positive for fungal laments and culture positive for dermatophytes. Trichophyton was the predominant isolate (51 cases) with T. verrucosum being the commonest species (28 cases), followed by T. rubrum (16 patients), and T. mentagrophytes (7 cases). All species of Trichophyton were found to be most sensitive to systemic itraconazole and topical luliconazole amongst antifungals. CONCLUSIONS: Trichophyton species is the commonest organism causing fungal infections. Itraconazole and luliconazole are the most effective systemic and topical agents against them.

The Helicobacter pylori detection rate by using combination of rapid urease test at antrum and body vs histopathology in population who stop proton pump inhibitor less than 2 weeks

Background Helicobacter pylori (H pylori) assessment in patients who stop taking proton pump inhibitor (PPI) in less than 2 weeks has never been established. Experts have suggested using pathology rather than rapid urease test (RUT). Unfortunately, pathology is not widely available in limited resource areas. We aimed to evaluate the detection rate of RUT at antrum and body compared with pathology in those patients. Methods Sixty-seven patients with history of PPI use for at least 2 weeks and continued use within 2 weeks prior to gastroscopy were enrolled. Two biopsies were taken from antrum and body for RUT and pathology. Positive test was determined by either RUT or haematoxylin and eosin and giemsa or immunohistochemistry. Results Most patients were female (71.6%) with mean age of 52 years. Mean duration of PPI withhold was 3.6 ± 3.8 days. Nearly half (41.8%) were documented H pylori infection in this study. Detection rate of RUT and histopathology was 28.3% and 23.9% at antrum (P = .54, RR 1.18, 95% CI 0.67-2.11) and 34.3% and 28.4% at body (P = .28, RR 0.28, 95% CI 0.73-2.01) respectively. The detection rate was up to 38.8% when combining RUT at antrum and body but did not change when combining those locations for pathology (28.4%) (P = .06, RR 1.37, 95% CI 0.84-2.22). Conclusion In patients who have been recently taking PPI, the H pylori detection rate from combination of RUT at antrum and body is not different from pathology. In case where cost may be of concern, RUT from both antrum and corpus can be considered as the diagnostic tool. (ClinicalTrials.gov: NCT04233684).

1268 Pathology Pick up Rate in Routine Preoperative Endoscopy and its Impact on Patients Undergoing Gastric Bypass Surgery

Abstract Aim Preoperative OGD in patients undergoing bariatric surgery, has been a subject for debate for decades. The aim of this study is to evaluate the pathology pick up rate in routine preoperative endoscopy in patients undergoing Gastric Bypass surgery (LRYGB) in our unit. Method Retrospective review of patients’ records who underwent LRYBG in our unit from February 2009 to March 2020. Patients were divided into two groups according to the presence or absence of symptoms prior to bariatric surgery: Group A (Asymptomatic) and Group B (Symptomatic). Data from prospectively kept electronic OGD reports, CLO test results, histology reports and the changes in management plan were collected and analysed. Results 114 patients were included in the analysis, 85 (74.56%) were in group A and 29 in group B. OGD detected pathology in 34 patients in group A and 21 in group B (p = 0.004). Those included hiatus hernia (HH) (17.65% group A, 44.83% group B, p = 0.006); stomach ulcer (7.06% group A, 3.45% group B, p = 0.676), H.pylori infection (12.86% group A, 29.41% group B). This led to change of management in 22 patients in group A and 12 of group B (p = 0.157) excluding PPI prescription. Those changes included H.pylori eradication (10.59% group A, 17.24% group B, p = 0.153), HH repair (3.53% group A, 24.14% group B, p = 0.002). There was no cancellation or change in bariatric surgery offered in both groups. Conclusions Preoperative OGD has only significantly impacted the bariatric patient’s pathway in symptomatic patients. However, in Asymptomatic patients, OGD could be replaced by cheaper and non-invasive alternatives.

Helicobacter pylori in gastric cancer: Features of infection and their correlations with long-term results of treatment.

BACKGROUND Helicobacter pylori (H. pylori) is a spiral-shaped bacterium responsible for the development of chronic gastritis, gastric ulcer, gastric cancer (GC), and MALT-lymphoma of the stomach. H. pylori can be present in the gastric mucosa (GM) in both spiral and coccoid forms. However, it is not known whether the severity of GM contamination by various vegetative forms of H. pylori is associated with clinical and morphological characteristics and long-term results of GC treatment. AIMTo establish the features of H. pylori infection in patients with GC and their correlations with clinical and morphological characteristics of diseases and long-term results of treatment.METHODSOf 109 patients with GC were included in a prospective cohort study. H. pylori in the GM and tumor was determined by rapid urease test and by immunohistochemically using the antibody to H. pylori. The results obtained were compared with the clinical and morphological characteristics and prognosis of GC. Statistical analysis was performed using the Statistica 10.0 software. RESULTS H. pylori was detected in the adjacent to the tumor GM in 84.5% of cases, of which a high degree of contamination was noted in 50.4% of the samples. Coccoid forms of H. pylori were detected in 93.4% of infected patients, and only coccoid-in 68.9%. It was found that a high degree of GM contamination by the coccoid forms of H. pylori was observed significantly more often in diffuse type of GC (P = 0.024), in poorly differentiated GC (P = 0.011), in stage T3-4 (P = 0.04) and in N1 (P = 0.011). In cases of moderate and marked concentrations of H. pylori in GM, a decrease in 10-year relapse free and overall survival from 55.6% to 26.3% was observed (P = 0.02 and P = 0.07, respectively). The relationship between the severity of the GM contamination by the spiral-shaped forms of H. pylori and the clinical and morphological characteristics and prognosis of GC was not revealed.CONCLUSIONThe data obtained indicates that H. pylori may be associated not only with induction but also with the progression of GC.

Comparison of methods for the diagnosis of H.pylori in gastric biopsy specimens from patients with different gastrointestinal diseases

This paper presents a comparison of cultural and rapid urease tests for the detection of H.pylori presence with PCR in biopsy specimens from patients diagnosed with gastroduodenitis, chronic gastritis, duodenitis and reflux oesophagitis. In general, there was a trend towards more false positive results when using the rapid urease testing method and false negatives when using the cultural method is used, but this pattern was statistically significant only for the diagnoses of gastroduodenitis (for all methods) and chronic gastritis (there was no statistically significant difference between PCR and the cultural method). A prognostic model was constructed to determine the effect of the test method on the outcome.

Mycotic zoonoses risk from clipping instruments in Pet Shops in Sinop – MT

Pets have conquered the daily lives of families worldwide and because they have a close relationship with humans, they can transmit mycotic zoonoses such as dermatophytosis, malassezioses and candidosis. Studies show that fungi with pathogenic potential have already been granted in clipping instruments and bath articles in veterinary clinics and in Pet Shops. In the absence of data in the city of Sinop - MT, this study aimed to isolate fungi with pathogenic potential in clipping instruments used in the routine of Pet Shops and to identify etiological agents capable of causing mycotic zoonoses. Samples were carried out in 18 clipping instruments, without cleaning, from 10 Pet Shops (A, B, C, D, E, F, G, H, I, J) in the city of Sinop - MT with swabs and sterile carpets square and then seeded in Sabouraud agar with 0.05% chloramphenicol and mycobiotic agar, incubated at room temperature (25°C) for 30 - 45 days. The dermatophytes and non-dermatophyte filamentous fungi were identified using the microculture technique and urease test and as yeasts using a urease test, zymogram, auxanogram, germ tube and corn meal agar with polysorbate 80. Of the samples from 18 clipping instruments, 15 were positive for at least one fungal genus. The yeast that showed a high prevalence of isolation in clipping instruments from the studied Pet Shops (B, C, D, E, H and J) was Malassezia pachydermatis (86.7%), followed by the genus Candida spp. (C and D; 26.7%), filamentous fungi of the genus Aspergillus spp. (A; 13.3%), Microsporum canis (B; 13.3%) and Trichosporon spp. (J, 6.7%). Our results demonstrate that Pet Shops treat a large number of animals daily in a single environment, which may amplify the risk of spreading zoonoses, as an asymptomatic or sick carrier animal can potentially transmit the microorganism to other animals inside the store and thus to a large number of new pet owners. There is a need to reinforce the commercial requirements specialized in bathing and grooming in the city of Sinop - MT on the good practices of cleaning and disinfection of the elements used and the environment, eliminating or eliminating the risk of contracting mycotic zoonoses.

Kedilerin Önemli Bakteriyel Zoonozu; Helicobacter Heilmannii

Kedilerde zoonotik karaktere sahip olan H.heilmannii bakterisinin hem hayvanda hem de insanda görülme sıklığı sadece olgular dahilinde literatürlerce belirtilmiş bununla ilgili daha geniş bir hastalık ve etken taraması yapılmamıştır. Özellikle kedi sahipleri veya kedilerle aynı çevreyi paylaşan insanlarda bu bakterinin varlığı ve olası yaygınlığı gözardı edilmemelidir. İnsanlarda mukoza ilişkili lenfoid doku lenfoması (MALT) ‘ın olası nedenleri arasında da gösterilebilen H.heilmannii’nin şimdiye kadar yapılan çalışmalarda insanlardaki insidansının kedilere nazaran daha az olması bulaşmanın genellikle kedilerden insanlara doğru seyir gösterebileceğini varsaymaktadır. Kedilerde ise klinik olarak insanlara benzer şekilde tipik kronik aktif gastritis belirtileri görülebilmektedir. Erken dönemdeki teşhis için kullanılabilen Üre nefes testi, PCR, üreaz testi ve gastrik biyopsi yöntemlerinin yanısıra etkenin karakteristik morfolojisinin boyama yöntemleri ile saptanması gerekliliği unutulmamalıdır.

Comprehensive Management of Helicobacter pylori Infection

Helicobacter pylori (Hp) infection is a chronic gram-negative bacterial infection, that infects the epithelium of the stomach. This prevalence is very high and varies depending on factors such as geographical location, ethnicity, age, and socioeconomic. The key management of Hp infection is accurate diagnosis and treatment. The H. pylori diagnostic examination consists of non-invasive and invasive tests, the most common non-invasive tests are serological tests, urea breath tests (UBT), and stool antigen tests, while invasive tests are rapid urease tests, histopathology, culture, and PCR. The goal of H. pylori eradication is to heal peptic ulcers and reduce the risk of gastric cancer. Eradication therapy that is recommended worldwide and used in Indonesia is the triple drug combination therapy consisting of a PPI, clarithromycin and amoxicillin or metronidazole for 14 days. The success of eradication therapy is highly dependent on the choice of therapeutic regimen, patient compliance in taking multi-drugs with possible drug side effects, and the sensitivity of H. pylori strains to the antibiotics consumed.

A study of antifungal susceptibility pattern of dermatophytes at tertiary care center

Dermatophytes are fungi that can cause infections of the skin, hair & nails due to their ability to invade keratin. Dermatophytosis is the most common superficial fungal infection worldwide; it is common in tropics and subtropical regions. It may present in epidemic proportions in areas of high humidity: The present study aimed to identify various species causing dermatophytosis & to determine the invitro susceptibility pattern against commonly used systemic antifungal agents in our tertiary care center.A total of 149 samples were collected of infected skin, hair and nails in a period of 1 year from January 2020 to December 2020. Samples were collected under aseptic condition by skin scrapping, nail and hair clipping by using scalpel or forceps. Identification of the causative pathogen was done by performing slide culture, lacto-phenol cotton blue mount, hair perforation tests and urease tests. We adopted a newly developed agar based disk diffusion assay to test susceptibility of clinically isolated dermatophytes for antifungal susceptibility testing.Microbiological investigations revealed the presence of dermatophytic fungi in 71.8% of the samples. Trichophyton rubrum was the predominant pathogen isolated. The study showed Itraconazole to be most effective antifungal drugs against dermatophytes followed by terbinafine and fluconazole.Further intensive epidemiological and invitro antifungal susceptibility studies of dermatophytes are required which will have more public health significance.

K. PNEUMONIAE VE P. MIRABILIS TESPİTİ İÇİN TOZ ANTOSİYANİN İÇERİKLİ-ÜREAZ TESTİNİN RASYONEL HAZIRLANMASI

In this present study, we developed Brassica oleracea var. Capitata (red cabbage) extract (RCE) powder- incorporated colorimetric media for rapid, selective, sensitive detection of urease-postive bacteria, Klebsiella pneumoniae ATCC 54475 and Proteus mirabilis ATCC 25933. The major component of RCE is anthocyanin groups which are in charge of pH dependent color change. The ureas test contains certain concetration of anthocyanin, urea prepated in 0.01 M sodium phosphate buffer and sodium azide. The urea in the test was hydrolyzed by urease enzyme released from K. pneumoniae and P.mirabilis and produce ammonium (NH3) molecules which sequentially made the test media alkaline, caused deprotonation of anthocyanin and induced the color change from pink to green. Also, Escherichia coli ATCC 25922 was used a urease-negative control bacteria. The detection of K. pneumoniae and P. mirabilis was examined as a function of anthocyanin concentration and incubation time. The anthocyanin was used lyophilized powder form in the urease test to discard the in interference of free proton in liquid form owing to addition of hydrochloric acid (HCl). We also performed the digital image analysis, Delta E (∆E) for quantitative confirmation of the visual results. It was observed that the results showed that the color change from pink to green in 150 and 210 minutes of incubaiton for K. pneumoniae and P. mirabilis, respectively. Here in, we successfully prepared anthocyanin-incorporated urease test and perform colorimetric detection of K. pneumoniae and P. mirabilis with naked eyes and digital image analysis.

Assessment of the diagnostic accuracy and relevance of a novel ELISA system developed for seroepidemiologic surveys of Helicobacter pylori infection in African settings.

Beside diagnostic uncertainties due to the lack of a perfect gold standard test for Helicobacter pylori infection, the diagnosis and the prevalence estimation for this infection encounter particular challenges in Africa including limited diagnostic tools and specific genetic background. We developed and evaluated the accuracy of an enzyme-linked immunosorbent assay (ELISA) system tailored for H. pylori genetics in Africa (HpAfr-ELISA). Strains belonging to main genetic populations infecting Africans were exploited as sources for whole-cell antigens to establish in-house the ELISA system. A phase II unmatched case-control study explored the diagnostic accuracy of the HpAfr-ELISA using a training set of samples collected from dyspeptic patients from Kinshasa, the Democratic Republic of Congo (DRC) who had been tested with invasive standard tests (i.e., histology, culture, and rapid urease test) in 2017. Then the assay was cross-validated through a community-based survey assessing the prevalence of H. pylori and associated factors in 425 adults from Mbujimayi, DRC in 2018. Bayesian inferences were used to deal with statistical uncertainties of estimates (true prevalence, sensitivity, and specificity) in the study population. At its optimal cut-off-value 20.2 U/mL, the assay achieved an estimated sensitivity of 97.6% (95% credible interval [95%CrI]: 89.2; 99.9%) and specificity of 90.5% (95%CrI: 78.6; 98.5). Consistent outcomes obtained at repeated tests attested the robustness of the assay (negative and positive agreements always > 70%). The true prevalence of H. pylori was estimated 53.8% [95%CrI: 42.8; 62.7%]. Increasing age (adjusted odds ratio [aOR] > 1.0 [95% confidence interval (CI): > 1.0; 1.1]; p<0.001), overcrowding households (aOR = 3.2 [95%CI: 2.0; 5.1]; p<0.001), and non-optimal hand hygiene (aOR = 4.5 [95%CI: 2.0; 11.4]; p = 0.001) were independently associated with the H. pylori-seropositivity. The novel ELISA system has demonstrated good diagnostic accuracy and potential usefulness for management and mitigation strategies for H. pylori infection in African settings.

DIAGNOSTIC UTILITY OF THE RAPID UREASE TEST FOR HELICOBACTER PYLORI IN GASTRIC JUICE SAMPLES

Objective: The purpose of this study is to compare the diagnostic performance of the rapid urease test for H. pylori in endoscopic samples of gastric juice compared with the same test in gastric mucosa. Materials and methods: Cross-sectional, comparative and prospective study with study of concordance of diagnostic tests, carried out with patients referred to a medical center in Bogotá DC, Colombia for the performance of an esophagogastroduodenoscopy. We included 130 patients older than 18 years, without antibiotic treatment or inhibitors of gastric secretion, or with any type of immunodeficiency, or cancer. Were processed in the sensibacterpyroli test device a sample of gastric antrum for Rapid Ureasa Test RUT in mucosa and for the sample of juice 5 mL was taken with suctionator 7A-23B pulmomed (USA) R, to compare results. Results: In this study the infection by Helicobacter pylori was detected by biopsy sample in 40.8% of the patients that corresponded to 53 patients, among (59.2%) 77 patients with negative values. The prevalence of H. pylori infection in this study was 40.8%. It was calculated of VPP and NPV: 95% and NPV: 89.3%. Conclusions: rapid urease test in gastric juice is a fast and economic test, with very good sensitivity and specificity, is also very useful to detect H. pylori infection.

Prevalence of Klebsiella Pnuemonia and their In-Vitro Susceptibility Studies among Cattle Traders in Maiduguri Cattle Market, Borno State, Nigeria

This study was undertaken to assess the occurrence of Klebsiella pneumoniae and there in-vitro susceptibility among cattle traders, herdsmen and butchers in Maiduguri cattle market, Borno state, Nigeria. Two hundred and twelve sample (212) sputum samples were collected using wide mouth sterile universal container and transported immediately to Medical Micro-Biology laboratory department, Centre of Excellence, university of Maiduguri teaching hospital (U.M.T.H.) for Laboratory diagnosed. The Sputum samples were culture on MacConkey and Blood agar media and isolated then, identified using Biochemical test which include indole, citrate utilization and urease tests, but only 15 sputum samples were found infected or positive to Klebsiella pneumoniae. And their Antimicrobial susceptibility of the Klebsiella pneumoniae isolate by disc diffusion method shows that Klebsiella pneumoniae are susceptible to these Antimicrobial Drugs: Pefloxacin (93.3%), Tarivid (100%), Sparfloxacin (80%), Ciprofloxacin (93.3%) and on the other hand Klebsiella pneumoniae are resistance to these Antimicobial drugs; Streptomycin (73.3%), Septrin (80%), Augumentin (73.3%), Gentamycin (66.7%), and Amoxacillin (60%). In conclusion, recommendation have been made on how to curtail the spread of infection caused by Klebsiella in the environment, homes, and between patients. Healthcare providers are advice to follow the specific infection-control precautions.

Detection of Helicobacter Pylori infection by invasive and non-invasive techniques in patients with gastrointestinal diseases from Iraq: A validation study.

There is still no agreement on the gold standard technique for diagnosing of H. Pylori in Iraq, as well as a paucity of data on the validity of different diagnostic techniques. This study aimed to investigate the prevalence of this bacterium with different methods and compare them to the quantitative polymerase chain reaction (qPCR) as a golden standard technique among Iraqi patients. In total, 115 Iraqi patients strongly suspected of H. pylori infection were enrolled in the current study. Invasive techniques including rapid urease testing (RUT) and gastric tissue culture in addition to non-invasive techniques including 14C-Urea breath test (14C-UBT), stool antigen test (SAT), CagA-IgG serology, and qPCR were performed to confirm the H. pylori infection. The qPCR was used as the gold standard to estimate the sensitivity, specificity, positive and negative predictive values for the studied diagnostic tests. Overall, the prevalence rate of H. pylori in Iraqi patients was ranged from 47.8 to 70.4% using different methods. The positive results for each test were as follows: qPCR 81, (70.4%) UBT 79 (68.7%), SAT 77 (67%), RUT 76 (66.1%), Cag-IgG 61 (53%), and culture 55 (47.8%). The 14C-UBT showed the highest overall performance with 97.5% sensitivity, 97% specificity, and total accuracy of 97.3% followed by SAT, RUT, Cag-IgG, and culture method. Based on the accuracy of the studied methods for H. pylori detection, they can be arranged in order as follows: qPCR > UBT > SAT > RUT> CagA IgG > culture. Since a universal gold standard assay for the diagnosis of H. pylori has not yet been established in Iraq, the UBT may be recommended as first choice due to its higher performance compared to other methods.

Tailored eradication strategy vs concomitant therapy for Helicobacter pylori eradication treatment in Korean patients.

BACKGROUNDAntibiotic resistance to Helicobacter pylori (H. pylori) infection, which ultimately results in eradication failure, has been an emerging issue in the clinical field. Recently, to overcome this problem, an antibiotic sensitivity-based tailored therapy (TT) for H. pylori infection has received attention. AIMTo investigate the efficacy and safety profiles of TT for H. pylori infection treatment compared to a non-bismuth quadruple therapy, concomitant therapy (CT) regimen. METHODSWe included patients (> 18 years) with an H. pylori infection and without a history of Helicobacter eradication who visited the Gil Medical Center between March 2016 and October 2020. After being randomly assigned to either the TT or CT treatment group in 1 to 1 manner, patient compliance, eradication success rate (ESR), and patient-reported side effects profiles were assessed and compared between the two groups. H. pylori infection was diagnosed using a rapid urease test, Giemsa stain, or dual priming oligonucleotide polymerase chain reaction (DPO-PCR). Tailored eradication strategy based through the presence of a 23S ribosomal RNA point mutation. For the TT group, a DPO-PCR test, which detected A2142G and/or A2143G point mutations, and a clarithromycin resistance test were performed. Patients in the clarithromycin-resistant group were treated with a bismuth-containing quadruple combination therapy, while those with sensitive results were treated with the standard triple regimen. RESULTSOf the 217 patients with a treatment naive H. pylori infection, 110 patients [mean age: 58.66 ± 13.03, men, n = 55 (50%)] were treated with TT, and 107 patients [mean age: 56.67 ± 10.88, men, n = 52 (48.60%)] were treated with CT. The compliance (TT vs CT, 100% vs 98.13%, P = 0.30), and follow-up loss rates (8.18% vs 9.35%, P = 0.95) were not significantly different between the groups. The ESR after treatment was also not statistically different between the groups (TT vs CT, 82.73% vs 82.24%, P = 0.95). However, the treatment-related and patient-reported side effects were significantly lower in the TT group than in the CT group (22.77% vs 50.52%, P < 0.001).CONCLUSIONThe DPO-based TT regimen shows promising results in efficacy and safety profiles as a first-line Helicobacter eradication regimen in Korea, especially when physicians are confronted with increased antibiotic resistance rates.

A challenging case of abdominal distension in a 3-year old child

Introduction. Important abdominal distension can be a challenge for both paediatricians and pediatric surgeons. Case presentation. Here, we report the case of a 3-year old child admitted to Pediatric Surgery Department for significant abdominal distension, food refusal and abdominal pain. He underwent radiological investigations; conditions like congenital megacolon and mechanical obstruction were excluded. At hospital admission, abdominal distension was minimal, but it became severe after episodes of air swallowing. Sleep bruxism and behavioural changes appeared also. An abdominal computerized tomography scan and barium swallow tests showed important distension of the stomach with excessive gas, a small intestine and colon. On upper endoscopy - the urease test for Helicobacter pylori detection was positive and specific treatment was administered. In addition, a psychiatric evaluation was done because of behaviour changes. Aerophagia was suspected, and clonazepam treatment was recommended. Conclusion. This is an unreported case of association between Helicobacter pylori infection and aerophagia, which had a favourable outcome after antibiotherapy for gastritis and clonazepam for psychologic aerophagia.

Isolation, Screening and Characterization of Ureolytic Bacteria from Cave Ornament.

&lt;b&gt;Background and Objective:&lt;/b&gt; Ureolytic bacteria are bacteria capable of hydrolyzing urea. In construction, these bacteria are known to help improve soil stability. One of the habitats of ureolytic bacteria is cave ornaments such as gourdam, flowstone, stalagmite and stalactite. This study aims to find isolates and characterization of ureolytic bacteria in cave ornaments. &lt;b&gt;Materials and Methods:&lt;/b&gt; Urea-CaCl&lt;sub&gt;2&lt;/sub&gt; was used as the isolation medium and urea agar medium was used as a qualitative urease test for cave ornament bacteria isolate. This study applied a survey method and tested for gram staining, spore staining, mannitol test, catalase test and lactose test for characterization. &lt;b&gt;Results:&lt;/b&gt; There were 17 isolates positive for urease from 30 isolates from the isolates of cave ornament bacteria. The characteristics of 17 ureolytic bacteria isolates were 2 isolates gram-negative basil with negative lactose test and 1 isolate positive glucose and 1 isolate negative glucose. Total 15 isolates gram-positive basil with spore staining results, 14 isolates spore-positive with 2 isolates positive mannitol and 12 isolates negative mannitol and 1 isolate spore-negative with negative catalase. &lt;b&gt;Conclusion:&lt;/b&gt; Total 17 ureolytic bacteria isolates were found from cave ornaments. Biochemical characterization showed 1 isolate of &lt;i&gt;Proteus&lt;/i&gt; spp., 1 isolate of &lt;i&gt;Pseudomonas&lt;/i&gt; spp, 2 isolates suspected of being &lt;i&gt;Bacillus megaterium&lt;/i&gt; or &lt;i&gt;Bacillus subtilis&lt;/i&gt;, 12 isolates of &lt;i&gt;Bacillus cereus&lt;/i&gt; and 1 isolate of &lt;i&gt;Lactobacillus&lt;/i&gt; spp.

Bismuth containing quadruple therapy versus tailored therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p = .055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p = .07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $90.3 per patient in the TT group and $75.5 in the BQT group (p = .000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.