Dynamics of the prevalence of Helicobacter pylori infection from 2015 to 2023

N. V. Bakulina, S. Tikhonov, I. V. Savilova, A. V. Zharkov, Viktoriia A. Ponomarenko
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Abstract

BACKGROUND: The global prevalence of Helicobacter pylori infection has decreased from 58.2% (1980–1990) to 43.1% (2011–2022). To develop clinical recommendations for prevention diseases associated with Helicobacter pylori, it is important to assess changes in Helicobacter pylori infection in the world and in the Russian Federation, in particular. AIM: To assess the dynamics of Helicobacter pylori infection among patients in St. Petersburg, who undergone 13С-urease breath test in the period from 2015 to 2023. MATERIALS AND METHODS: All the patients have been included in the descriptive study to conduct 13C-urease breath test. If the Delta Over Baseline was less than 2.5‰, the test was considered negative. The value of this indicator of more than 2.5‰ indicated infection with Helicobacter pylori. The database for subsequent statistical analysis included age, gender, the facts of prior eradicative therapy, test results, including degree of infection. RESULTS: Helicobacter pylori was detected in 32.7% (16,642; 95% confidence interval 32.3–33.1%) of the patients. Of the 50,884 study participants, 83.6% (42,543; 95% confidence interval 83.3–83.9%) of the patients had not received eradication therapy in the past (primary “naive” patients), 16.4% (8341; 95% confidence interval 16.1–16.7%) had undergone eradication therapy in the past therapy (treated “recurrent” patients). The average infection rate among primary patients was 36.1% (15,358; 95% confidence interval 35.6–36.6%), among recurrent patients — 15.4% (1284; 95% confidence interval 14.6–16.2%). From 2015 to 2017, a decrease in Helicobacter pylori infection was detected in “naive” and “recurrent” patients in all the groups by 14.8 and 21.1%, respectively, and from 2020 to 2023 — by 3.6 and 6.2%, respectively. The majority of both primary and recurrent patients showed a very high (IV) degree of infection — 73.0 and 66.5%, respectively. CONCLUSIONS: The study demonstrated significant reduction of Helicobacter pylori infection from 2015 to 2017 indicating that information from doctors about the importance of diagnosing and treating Helicobacter pylori infection is a priority task. The new coronavirus infection also had an impact on the incidence of the infection; however, it is still unclear what the negative consequences of the active use of antibacterial agents in patients with COVID-19 are, first of all, potential impact on Helicobacter pylori resistance to key antibacterial drugs.
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2015 年至 2023 年幽门螺杆菌感染率的动态变化
背景:全球幽门螺旋杆菌感染率已从 58.2%(1980-1990 年)降至 43.1%(2011-2022 年)。为了制定预防幽门螺旋杆菌相关疾病的临床建议,必须评估全球尤其是俄罗斯联邦幽门螺旋杆菌感染的变化情况。目的:评估2015年至2023年期间圣彼得堡接受13С-尿素酶呼气试验的患者中幽门螺杆菌感染的动态变化。材料与方法:所有患者都被纳入描述性研究,进行 13C-urease 呼气测试。如果超过基线的 Delta 值小于 2.5‰,则测试结果为阴性。如果该指标值超过 2.5‰,则表示感染了幽门螺旋杆菌。随后的统计分析数据库包括年龄、性别、之前的根除治疗情况、检测结果,包括感染程度。结果:32.7%(16642 人;95% 置信区间为 32.3-33.1%)的患者检测出幽门螺旋杆菌。在 50884 名研究参与者中,83.6%(42543 人;95% 置信区间 83.3-83.9%)的患者过去未接受过根除治疗(初治 "天真 "患者),16.4%(8341 人;95% 置信区间 16.1-16.7%)的患者过去接受过根除治疗(治疗 "复发 "患者)。初诊患者的平均感染率为 36.1%(15358 人;95% 置信区间为 35.6-36.6%),复诊患者的平均感染率为 15.4%(1284 人;95% 置信区间为 14.6-16.2%)。从 2015 年到 2017 年,所有组别中的 "初发 "和 "复发 "患者幽门螺杆菌感染率分别下降了 14.8% 和 21.1%,从 2020 年到 2023 年分别下降了 3.6% 和 6.2%。大多数初治和复治患者的感染程度都很高(IV 级),分别为 73.0% 和 66.5%。结论:研究表明,从 2015 年到 2017 年,幽门螺旋杆菌感染率明显下降,这表明向医生宣传诊断和治疗幽门螺旋杆菌感染的重要性是一项优先任务。新的冠状病毒感染也对感染率产生了影响;然而,COVID-19 患者积极使用抗菌药物的负面影响是什么仍不清楚,首先是对幽门螺旋杆菌对主要抗菌药物耐药性的潜在影响。
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