<i>Helicobacter pylori</i> infection is an infectious disease and the empiric therapy paradigm should be changed

Li, Hong; Yang, Tiankuo; Tang, Hong; Tang, Xiaoqiong; Shen, Yanjiao; Benghezal, Mohammed; Tay, Chin Yen; Marshall, Barry J.

doi:10.1093/pcmedi/pbz009

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…Given the limited number of antibiotics that are appropriate for H. pylori eradication in children, and the worldwide increase of antibiotic resistance, the recent ESPGHAN/NASPGHAN guidelines have recommended antimicrobial susceptibility testing to guide the H. pylori eradication treatment in children ( Jones et al, 2017 ). However, due to the fastidious culture of H. pylori and the lack of an easy and cost-effective testing method, antimicrobial susceptibility testing for H. pylori is almost universally unavailable in medical centers ( Montes and Pérez-Trallero, 2017 ; Li et al, 2019 ; Tang et al, 2020a , b ). Under such circumstances, profiling regional or population-specific antibiotic resistance patterns is of great importance in guiding the development of effective empiric treatment regimens.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China

et al. 2021

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The number of antibiotics that are appropriate for Helicobacter pylori eradication in children is limited. Profiling regional or population-specific antibiotic resistance is essential in guiding the H. pylori eradication treatment in children. The aim of this study was to evaluate the antibiotic resistance in H. pylori strains isolated from children and adolescents in Southwest China. Gastric biopsies from 157 pediatric patients with or without previous H. pylori eradication treatment were collected for H. pylori culture. Susceptibility to amoxicillin (AML), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET), furazolidone (FZD), and rifampicin (RIF) was determined by E-test or a disk diffusion assay. A total of 87 patients from three ethnic groups (Han/Tibetan/Yi) were H. pylori culture positive (55.4%). The overall resistance rates were 55.2% for CLR, 71.3% for MTZ, 60.9% for RIF, and 18.4% for LEV. No isolate was found to be resistant to AML, TET, and FZD. Among the 53 treatment-naïve pediatric patients, primary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 45.3, 73.6, 15.1, and 60.4%, respectively. Among the 34 treatment-experienced patients, secondary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 70.6, 67.6, 23.5, and 61.8%, respectively. Isolates exhibiting simultaneous resistance to clarithromycin and metronidazole were 28.3 and 52.9% among the treatment-naïve and treatment-experienced patients, respectively. In conclusion, among pediatric patients in Southwest China, resistance rates were high for clarithromycin, metronidazole, levofloxacin, and rifampicin, whereas nil resistance was found to amoxicillin, tetracycline, and furazolidone. Our data suggest that the standard clarithromycin-based triple therapy should be abandoned as empiric therapy, whereas the bismuth quadruple therapy (bismuth/PPI/amoxicillin/tetracycline) would be suitable as first-line empiric treatment regimen for this pediatric population. Tetracycline and furazolidone may be considered for treating refractory H. pylori infections in adolescent patients.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China

et al. 2021

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“…Without the specific antibiotic treatment, this infection can cause chronic active gastritis which can subsequently leads to peptic ulcer in 15-20% of the patients and gastric malignancy and mucosa-associated lymphoid tissue (MALT) lymphomain approximately 1-3%. Chronic H.pylori infection has been identified as one of the most important etiological factors for gastric cancer which is third leading cause of cancer death globally 8 . Javed et al, have reported prevalence of H. Pylori infection 92% among patients of gastritis 9 .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of C-14 Urea Breath Test for Detection of Helicobacter Pylori in Patients With Gastritis

Dar

Butt²,

Mir³

et al. 2021

PAFMJ

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Objective: To evaluate the diagnostic accuracy of C-14 Urea Breath Test for detection of helicobacter pylori infection in patients with gastritis. Study Design: Cross-sectional validation study. Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Feb to Aug 2016. Methodology: After fulfilling inclusion and exclusion criteria, 110 patients of both genders, aged between 18-50 years, were enrolled. Prior written informed consent was obtained from each patient. First, they were assessed by C-14 Urea Breath Test, followed by endoscopic biopsy and histopathology. Results of C-14 Urea Breath Test were compared to histopathology diagnosis which was taken as gold standard. Results: Patients’ ages ranged from 18-50 years with a mean ± SD of 37.45 ± 10.21 years. Seventy four (67.3%) of them were males and 36 (32.7%) were females. Sixty four (58.2%) patients were suspected of helicobacter pylori on C-14 Urea breath test. However, histopathology of endoscopic biopsy confirmed helicobacter pylori in 66 (60%) patients yielding 64 true positive, 44 true negative and 2 false negative cases. Calculated sensitivity was 96.97%, specificity 100% and accuracy was 98.18% for C-14 Urea Breath Test with negative and positive predictive values of 95.65% and 100% respectively. Conclusion: C-14 Urea Breath Test is highly accurate, sensitive and specific test for detection of helicobacter pylori infection, irrespective of patient’s age and gender.

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“…The phages which are specifically isolated against H.pylori are named as* phi HPE1 and *phi HPE2 and their host ranges were investigated against four different strains of H.pylori in which all were susceptible to either *phi HPE1 or *phi HPE2 [26], another H.pylori specific phage was isolated which was named KHP30 [27], despite its very fruitful characteristics still there is no available collection of phages specifically against H.pylori and very little research work and scientific literature is available about H.pylori phages the given phages which are isolated uptill now are fully characterised and the next target is to study in detail and examine the virulence factors responsible in eradicating H.pylori [128].…”

Section: Phages Exploited Against Helicobacter Pylorimentioning

confidence: 99%

“…This may lead to antimicrobials that have the narrowest range imaginable. Zinc fingers [22][23][24][25], transcription activation-like effector nucleases [26], peptide nucleic acids [27],…”

Section: Introductionmentioning

confidence: 99%

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2022

BJSTR

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Helicobacter pylori is a spiral-shaped, Gram-negative, microaerophilic flagellate. It may cause duodenal/gastric ulcer disease, gastritis, gastric adenocarcinoma, mucosa-associated tissue lymphoma, and primary B-cell gastric lymphoma. The delay in creating an H. pylori vaccination has led to novel treatment options. Eradication treatment is difficult since there are so many medication combinations with different effectiveness and toxicity. Herbal medicines have recently been proposed as a storehouse for innovative bioactive chemicals mostly in existing drug manufacturing landscape. Commercial viability of highly effective medication has not yet been shown after a number of research have been conducted to find highly active and well-tolerated medicines. These include extended DDS that increases the anti-h.pylori activity of antimicrobials in the stomach and can be used peptic ulcer disease therapy. Since most antibiotics are unstable in acidic environments, a gastro protective GRDDS is needed. Bacteriophages may replace antibiotic treatment due to their host specificity and restricted range of action. Gene editing tools may cleave species-specific sections of the bacterial DNA and can act as antimicrobial. Zinc fingers, PNAs, and CRISPR-Cas systems are used to modify genes. Studies have also shown the antibacterial activity of metallic nanoparticles, indicating their usage in medical devices.

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Helicobacter pylori infection is an infectious disease and the empiric therapy paradigm should be changed

Cited by 22 publications

References 18 publications

Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China

Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China

Diagnostic Accuracy of C-14 Urea Breath Test for Detection of Helicobacter Pylori in Patients With Gastritis

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