Helicobacter最新文献_第5页

Tracking the Helicobacter pylori Epidemic in Adults and Children in China 追踪幽门螺杆菌在中国成人和儿童中的流行情况。

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-28 DOI: 10.1111/hel.13139

Zixing Wang, Yaoda Hu, Ran Fei, Wei Han, Xiaoxiao Wang, Dongbo Chen, Shaoping She

Background

The Helicobacter pylori epidemic in China accounts for up to a third of gastric cancers worldwide. We aim to monitor the temporal and spatial dynamics of H. pylori infection in both adults and children across China.

Materials and Methods

We developed a surveillance system consisting of a data collection component that harnessed survey reports in natural populations and an analysis component that accounted for the differences in survey time and location, population age structure, and H. pylori detection method. System outputs were estimates of the prevalence of H. pylori in adults and children (aged ≤ 14 years) presented at three hierarchical levels (regional, provincial, and prefectural).

Results

The overall prevalence of H. pylori infection declined sharply in adults (63.3%, 52.5%, 43.4%, and 38.7%) and less sharply in children (23.1%, 26.1%, 16.0%, and 15.7%) in 1983–1999, 2000–2009, 2010–2014, and 2015–2019, respectively. The changes were asynchronous across regions, with the most marked declines in the Northwest, the Hong Kong-Macao-Taiwan region, and the East. We estimated that 457.6 million adults and 44.5 million children have been infected with H. pylori, with cross-province disparities in prevalence ranging from 24.3% to 69.3% among adults and 2.9% to 46.3% among children. In general, the risk level of gastric cancer increased as the prevalence of H. pylori increased. The correlation was statistically significant for both adult men (Spearman coefficient of correlation: 0.393, p = 0.0146) and women (0.470, p = 0.0029).

Conclusions

The tracking system would be important for the continuous and stratified tracking of the Helicobacter pylori epidemic across China and can be used to furnish an evidence base for the formulation of tailored prevention strategies.

背景：幽门螺杆菌在中国的流行占全球胃癌发病率的三分之一。我们旨在监测中国成人和儿童幽门螺杆菌感染的时空动态：我们开发了一个监测系统，该系统由数据收集部分和分析部分组成，前者利用自然人群的调查报告，后者考虑了调查时间和地点、人群年龄结构以及幽门螺杆菌检测方法的差异。系统的输出结果是成人和儿童（年龄小于 14 岁）幽门螺杆菌感染率的估计值，按三个层次（地区、省和都道府县）显示：1983-1999年、2000-2009年、2010-2014年和2015-2019年，成人幽门螺杆菌感染率分别为63.3%、52.5%、43.4%和38.7%，儿童感染率分别为23.1%、26.1%、16.0%和15.7%。各地区的变化并不同步，西北地区、港澳台地区和东部地区的下降最为明显。我们估计有 4.576 亿成人和 4450 万儿童感染了幽门螺杆菌，成人感染率的跨省差异从 24.3% 到 69.3%，儿童感染率的跨省差异从 2.9% 到 46.3%。一般来说，幽门螺杆菌感染率越高，患胃癌的风险就越大。成年男性（斯皮尔曼相关系数：0.393，P = 0.0146）和女性（0.470，P = 0.0029）的相关性在统计学上都很显著：结论：幽门螺杆菌追踪系统对持续、分层追踪幽门螺杆菌在中国的流行情况具有重要意义，可为制定有针对性的预防策略提供证据基础。

{"title":"Tracking the Helicobacter pylori Epidemic in Adults and Children in China","authors":"Zixing Wang, Yaoda Hu, Ran Fei, Wei Han, Xiaoxiao Wang, Dongbo Chen, Shaoping She","doi":"10.1111/hel.13139","DOIUrl":"10.1111/hel.13139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The <i>Helicobacter pylori</i> epidemic in China accounts for up to a third of gastric cancers worldwide. We aim to monitor the temporal and spatial dynamics of <i>H</i>. <i>pylori</i> infection in both adults and children across China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We developed a surveillance system consisting of a data collection component that harnessed survey reports in natural populations and an analysis component that accounted for the differences in survey time and location, population age structure, and <i>H</i>. <i>pylori</i> detection method. System outputs were estimates of the prevalence of <i>H</i>. <i>pylori</i> in adults and children (aged ≤ 14 years) presented at three hierarchical levels (regional, provincial, and prefectural).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall prevalence of <i>H</i>. <i>pylori</i> infection declined sharply in adults (63.3%, 52.5%, 43.4%, and 38.7%) and less sharply in children (23.1%, 26.1%, 16.0%, and 15.7%) in 1983–1999, 2000–2009, 2010–2014, and 2015–2019, respectively. The changes were asynchronous across regions, with the most marked declines in the Northwest, the Hong Kong-Macao-Taiwan region, and the East. We estimated that 457.6 million adults and 44.5 million children have been infected with <i>H</i>. <i>pylori</i>, with cross-province disparities in prevalence ranging from 24.3% to 69.3% among adults and 2.9% to 46.3% among children. In general, the risk level of gastric cancer increased as the prevalence of <i>H</i>. <i>pylori</i> increased. The correlation was statistically significant for both adult men (Spearman coefficient of correlation: 0.393, <i>p</i> = 0.0146) and women (0.470, <i>p</i> = 0.0029).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The tracking system would be important for the continuous and stratified tracking of the <i>Helicobacter pylori</i> epidemic across China and can be used to furnish an evidence base for the formulation of tailored prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge and Practices of Helicobacter pylori Infection Management Among Physicians in Gansu Province, China: A Cross-Sectional Study 中国甘肃省医生对幽门螺杆菌感染管理的认识和实践：横断面研究

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-27 DOI: 10.1111/hel.13137

Na Liu, Qian Luo, Lingzhu Gou, Xiping Shen, Dekui Zhang

Background and Aims

Physicians' knowledge and practices regarding the diagnosis, treatment, and follow-up of Helicobacter pylori (H. pylori) infection can impact the effectiveness of eradication therapy. This study aimed to investigate the current state of knowledge and practices concerning H. pylori infection management among physicians in Gansu Province, northwest China.

Materials and Methods

From October to November 2023, 557 physicians from 14 cities and prefectures in Gansu Province participated in this multicenter cross-sectional study and completed a survey questionnaire.

Results

A total of 519 valid questionnaires were collected. 43.2% of the physicians supported H. pylori screening for high-risk populations or individuals with H. pylori–related diseases. The awareness of target screening populations varied among these physicians, ranging from 69.6% to 98.2%. Most physicians preferred the urea breath test (UBT) as the method for diagnosing H. pylori infection (98.3%) and for follow-up after eradication therapy (98.5%). 89.6% of the physicians preferred bismuth-containing quadruple therapy for initial eradication, with amoxicillin and clarithromycin being the most commonly used antibiotic combination (56.3%). In addition, 84.6% of the physicians indicated that they would inquire about the antibiotic usage history for most patients before treatment, 93.8% would ask patients about their previous eradication history, and 94.2% would inform patients about treatment-related considerations. However, only 43.5%, 27.7%, and 29.7% of the physicians were aware of the high resistance rates of H. pylori to clarithromycin, levofloxacin, and metronidazole, respectively, in Gansu Province. Subgroup analysis revealed that the performance of gastroenterologists, nongastroenterologists, and physicians from different levels of hospitals differed in the diagnosis, treatment, and follow-up of H. pylori infection.

Conclusions

Knowledge and practices regarding H. pylori infection management among physicians in Gansu Province, China, need further improvement. Strengthening targeted continuing education to increase the overall management level of H. pylori infection is recommended.

背景和目的医生对幽门螺杆菌（H. pylori）感染的诊断、治疗和随访方面的知识和实践会影响根除治疗的效果。本研究旨在调查中国西北部甘肃省医生对幽门螺杆菌感染管理的知识和实践现状。材料与方法 2023年10月至11月，来自甘肃省14个地市的557名医生参与了这项多中心横断面研究，并填写了调查问卷。结果共回收有效问卷 519 份。43.2%的医生支持对幽门螺杆菌高危人群或幽门螺杆菌相关疾病患者进行筛查。这些医生对目标筛查人群的了解程度各不相同，从 69.6% 到 98.2% 不等。大多数医生首选尿素呼气试验（UBT）作为诊断幽门螺杆菌感染的方法（98.3%）和根除治疗后的随访方法（98.5%）。89.6%的医生首选含铋四联疗法进行初始根除，阿莫西林和克拉霉素是最常用的抗生素组合（56.3%）。此外，84.6% 的医生表示会在治疗前询问大多数患者的抗生素使用史，93.8% 的医生会询问患者之前的根除史，94.2% 的医生会告知患者治疗相关注意事项。然而，只有 43.5%、27.7% 和 29.7% 的医生知道甘肃省幽门螺杆菌对克拉霉素、左氧氟沙星和甲硝唑的耐药率较高。分组分析显示，消化内科医生、非消化内科医生和不同级别医院的医生在幽门螺杆菌感染的诊断、治疗和随访方面的表现存在差异。结论中国甘肃省医生在幽门螺杆菌感染管理方面的知识和实践有待进一步提高。建议加强有针对性的继续教育，提高幽门螺杆菌感染的整体管理水平。

{"title":"Knowledge and Practices of Helicobacter pylori Infection Management Among Physicians in Gansu Province, China: A Cross-Sectional Study","authors":"Na Liu, Qian Luo, Lingzhu Gou, Xiping Shen, Dekui Zhang","doi":"10.1111/hel.13137","DOIUrl":"https://doi.org/10.1111/hel.13137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Physicians' knowledge and practices regarding the diagnosis, treatment, and follow-up of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection can impact the effectiveness of eradication therapy. This study aimed to investigate the current state of knowledge and practices concerning <i>H. pylori</i> infection management among physicians in Gansu Province, northwest China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From October to November 2023, 557 physicians from 14 cities and prefectures in Gansu Province participated in this multicenter cross-sectional study and completed a survey questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 519 valid questionnaires were collected. 43.2% of the physicians supported <i>H. pylori</i> screening for high-risk populations or individuals with <i>H. pylori</i>–related diseases. The awareness of target screening populations varied among these physicians, ranging from 69.6% to 98.2%. Most physicians preferred the urea breath test (UBT) as the method for diagnosing <i>H. pylori</i> infection (98.3%) and for follow-up after eradication therapy (98.5%). 89.6% of the physicians preferred bismuth-containing quadruple therapy for initial eradication, with amoxicillin and clarithromycin being the most commonly used antibiotic combination (56.3%). In addition, 84.6% of the physicians indicated that they would inquire about the antibiotic usage history for most patients before treatment, 93.8% would ask patients about their previous eradication history, and 94.2% would inform patients about treatment-related considerations. However, only 43.5%, 27.7%, and 29.7% of the physicians were aware of the high resistance rates of <i>H. pylori</i> to clarithromycin, levofloxacin, and metronidazole, respectively, in Gansu Province. Subgroup analysis revealed that the performance of gastroenterologists, nongastroenterologists, and physicians from different levels of hospitals differed in the diagnosis, treatment, and follow-up of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Knowledge and practices regarding <i>H. pylori</i> infection management among physicians in Gansu Province, China, need further improvement. Strengthening targeted continuing education to increase the overall management level of <i>H. pylori</i> infection is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimization of Minocycline-Containing Bismuth Quadruple Therapy for Helicobacter pylori Rescue Treatment: A Real-World Evidence Study 优化米诺环素含铋四联疗法对幽门螺旋杆菌的拯救治疗：真实世界证据研究。

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-22 DOI: 10.1111/hel.13138

Yu Huang, Shuhan Qiu, Yixian Guo, Jinnan Chen, Meixuan Li, Zhaohui Ding, Wei Zhang, Xiao Liang, Hong Lu

Background

The optimal dosage of minocycline remains unclear for Helicobacter pylori (H. pylori) eradication. We aimed to evaluate the efficacy and safety of four different regimens with minocycline and metronidazole compared to classical bismuth quadruple therapy for H. pylori rescue treatment.

Materials and Methods

From March 2021 to March 2024, refractory H. pylori-infected patients with at least two previous treatment failures who received 14-day therapy with b.i.d. proton pump inhibitor 20 mg and bismuth 220 mg, plus tetracycline 400 mg q.i.d and metronidazole 400 mg q.i.d (BQT), or minocycline 50 mg q.i.d and metronidazole 400 mg q.i.d (PBMn₄M₄), or minocycline 50 mg t.i.d and metronidazole 400 mg t.i.d (PBMn₃M₃), or minocycline 50 mg b.i.d and metronidazole 400 mg q.i.d (PBMn₂M₄), or minocycline 50 mg b.i.d and metronidazole 400 mg t.i.d (PBMn₂M₃) were included in this retrospective study. H. pylori eradication was assessed by ¹³C-urea breath test at least 6 weeks after treatment. All adverse effects during treatment were recorded.

Results

Totally, 823 patients were enrolled: 251 with BQT, 97 with PBMn₄M₄, 191 with PBMn₃M₃, 108 with PBMn₂M₄, and 176 with PBMn₂M₃. The eradication rates of BQT, PBMn4M4, PBMn3M3, PBMn2M4, and PBMn2M3 were 89.2%, 87.6%, 91.6%, 88.0%, and 91.5%, respectively, by intention-to-treat analysis; 96.1%, 97.7%, 97.8%, 96.9%, and 97.6%, respectively, by modified intention-to-treat analysis; 97.1%, 97.5%, 97.7%, 96.8%, and 97.6%, respectively, by per-protocol analysis. Metronidazole resistance did not affect the efficacy of all groups. PBMn₂M₃ group achieved the greatest compliance and the fewest moderate and severe adverse events.

Conclusions

The novel bismuth-containing quadruple therapy with a low dose of minocycline and metronidazole is an alternative to classical bismuth quadruple therapy for H. pylori rescue treatment with superior safety and compliance.

Trial Registration

ClinicalTrials.gov identifier: NCT06332599

背景：米诺环素根除幽门螺杆菌的最佳剂量仍不明确。我们旨在评估米诺环素和甲硝唑四种不同方案与经典的铋剂四联疗法相比，在幽门螺杆菌抢救治疗中的有效性和安全性：从 2021 年 3 月到 2024 年 3 月，至少接受过两次治疗失败的难治性幽门螺杆菌感染患者接受了为期 14 天的治疗：质子泵抑制剂 20 毫克和铋 220 毫克，加上四环素 400 毫克 q.i.d 和甲硝唑 400 毫克 q.i.d (BQT)，或米诺环素 50 毫克 q.i. d 和甲硝唑 400 毫克 q.i. d (BQT)。d和甲硝唑 400 毫克 q.i.d (PBMn4M4)，或米诺环素 50 毫克 t.i.d 和甲硝唑 400 毫克 t.i.d (PBMn3M3)，或米诺环素 50 毫克 b.i.或米诺环素 50 毫克口服和甲硝唑 400 毫克 q.i.d (PBMn2M4)，或米诺环素 50 毫克口服和甲硝唑 400 毫克 t.i.d (PBMn2M3)。幽门螺杆菌根除情况在治疗后至少 6 周通过 13C- 尿素呼气试验进行评估。治疗期间的所有不良反应均记录在案：共有 823 名患者入选：251 名 BQT 患者、97 名 PBMn4M4 患者、191 名 PBMn3M3 患者、108 名 PBMn2M4 患者和 176 名 PBMn2M3 患者。通过意向治疗分析，BQT、PBMn4M4、PBMn3M3、PBMn2M4 和 PBMn2M3 的根除率分别为 89.2%、87.6%、91.6%、88.0% 和 91.5%；通过修正意向治疗分析，根除率分别为 96.1%、97.7%、97.8%、96.9% 和 97.6%；通过按方案分析，根除率分别为 97.1%、97.5%、97.7%、96.8% 和 97.6%。甲硝唑耐药性不影响各组疗效。PBMn2M3组的依从性最好，中度和严重不良反应最少：结论：新型含铋四联疗法与低剂量米诺环素和甲硝唑是经典含铋四联疗法的替代品，可用于幽门螺杆菌的抢救性治疗，具有更高的安全性和依从性：试验注册：ClinicalTrials.gov identifier：试验注册：ClinicalTrials.gov 标识符：NCT06332599。

{"title":"Optimization of Minocycline-Containing Bismuth Quadruple Therapy for Helicobacter pylori Rescue Treatment: A Real-World Evidence Study","authors":"Yu Huang, Shuhan Qiu, Yixian Guo, Jinnan Chen, Meixuan Li, Zhaohui Ding, Wei Zhang, Xiao Liang, Hong Lu","doi":"10.1111/hel.13138","DOIUrl":"10.1111/hel.13138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal dosage of minocycline remains unclear for <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication. We aimed to evaluate the efficacy and safety of four different regimens with minocycline and metronidazole compared to classical bismuth quadruple therapy for <i>H. pylori</i> rescue treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From March 2021 to March 2024, refractory <i>H. pylori</i>-infected patients with at least two previous treatment failures who received 14-day therapy with b.i.d. proton pump inhibitor 20 mg and bismuth 220 mg, plus tetracycline 400 mg q.i.d and metronidazole 400 mg q.i.d (BQT), or minocycline 50 mg q.i.d and metronidazole 400 mg q.i.d (PBMn<sub>4</sub>M<sub>4</sub>), or minocycline 50 mg t.i.d and metronidazole 400 mg t.i.d (PBMn<sub>3</sub>M<sub>3</sub>), or minocycline 50 mg b.i.d and metronidazole 400 mg q.i.d (PBMn<sub>2</sub>M<sub>4</sub>), or minocycline 50 mg b.i.d and metronidazole 400 mg t.i.d (PBMn<sub>2</sub>M<sub>3</sub>) were included in this retrospective study. <i>H. pylori</i> eradication was assessed by <sup>13</sup>C-urea breath test at least 6 weeks after treatment. All adverse effects during treatment were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Totally, 823 patients were enrolled: 251 with BQT, 97 with PBMn<sub>4</sub>M<sub>4</sub>, 191 with PBMn<sub>3</sub>M<sub>3</sub>, 108 with PBMn<sub>2</sub>M<sub>4</sub>, and 176 with PBMn<sub>2</sub>M<sub>3</sub>. The eradication rates of BQT, PBMn4M4, PBMn3M3, PBMn2M4, and PBMn2M3 were 89.2%, 87.6%, 91.6%, 88.0%, and 91.5%, respectively, by intention-to-treat analysis; 96.1%, 97.7%, 97.8%, 96.9%, and 97.6%, respectively, by modified intention-to-treat analysis; 97.1%, 97.5%, 97.7%, 96.8%, and 97.6%, respectively, by per-protocol analysis. Metronidazole resistance did not affect the efficacy of all groups. PBMn<sub>2</sub>M<sub>3</sub> group achieved the greatest compliance and the fewest moderate and severe adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The novel bismuth-containing quadruple therapy with a low dose of minocycline and metronidazole is an alternative to classical bismuth quadruple therapy for <i>H. pylori</i> rescue treatment with superior safety and compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06332599</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rapid Antimicrobial Susceptibility Test of Helicobacter pylori to Metronidazole via Single-Cell Raman Spectrometry 通过单细胞拉曼光谱法快速检测幽门螺杆菌对甲硝唑的抗菌药敏感性

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-16 DOI: 10.1111/hel.13136

Lu Sun, Min Liu, Yanan Gong, Kangle Zhai, FengYun Lv, Lihua He, Xinguang Xue, Xiaolu Liu, Hairui Wang, Dongjie Fan, Yuanhai You, Mengyang Fang, Luyang Sun, Jian Xu, Jianzhong Zhang

Background

Metronidazole is a first-line antibiotic to treat Helicobacter pylori infections. However, the Clinical Laboratory Standards Institute guidelines recommend against using antimicrobial susceptibility test (AST) to test metronidazole resistance, due to the unreliable predictive power which can result in treatment failure.

Objectives

The aim of this study was to establish an 8-h, metabolic-phenotype based AST for H. pylori metronidazole susceptibility using D₂O-probed Raman microspectroscopy.

Methods

Minimal inhibitory concentration (MIC) measured by conventional AST (E-test) were compared with expedited MIC via metabolic activity (eMIC-MA) for 10 H. pylori isolates. Raman barcodes of cellular-response to stress (RBCS) incorporating protein and carbohydrate Raman bands, were utilized to identify a biomarker to distinguish metronidazole susceptibility.

Results

Specifically, eMIC-MA produces metronidazole susceptibility results showing 100% agreement with E-test, and determines the bactericidal dosage for both high- and low-level resistant H. pylori strains. In addition, RBCS not just reliably distinguish between metronidazole-susceptible and -resistant strains, but reveal their distinct mechanisms in bacterial responses to metronidazole.

Conclusion

The speed, accuracy, low cost, and rich information content that reveals the mode-of-action of drugs suggest the method's value in guiding metronidazole prescriptions for H. pylori eradication and in rapid screening based on drug-resistance mechanism.

背景甲硝唑是治疗幽门螺旋杆菌感染的一线抗生素。然而，临床实验室标准协会（Clinical Laboratory Standards Institute）指南建议不要使用抗菌药物敏感性试验（AST）来检测甲硝唑耐药性，因为其预测能力不可靠，可能导致治疗失败。本研究旨在利用 D2Obed 拉曼微光谱技术建立一种基于代谢表型的 8 小时幽门螺杆菌甲硝唑药敏试验。方法对 10 个幽门螺杆菌分离株进行传统 AST（E-test）和通过代谢活动（eMIC-MA）加速 MIC 测定的最小抑菌浓度（MIC）比较。利用包含蛋白质和碳水化合物拉曼条带的细胞应激反应拉曼条形码（RBCS）来确定区分甲硝唑敏感性的生物标志物。结果具体来说，eMIC-MA 得出的甲硝唑药敏结果与 E-test 得出的结果 100%吻合，并能确定高耐药性和低耐药性幽门螺杆菌菌株的杀菌剂量。此外，RBCS 不仅能可靠地区分甲硝唑易感菌株和耐药菌株，还能揭示它们对甲硝唑的不同反应机制。结论 RBCS 的快速、准确、低成本和揭示药物作用模式的丰富信息内容表明，该方法在指导甲硝唑根除幽门螺杆菌处方和根据耐药机制进行快速筛查方面具有重要价值。

{"title":"Rapid Antimicrobial Susceptibility Test of Helicobacter pylori to Metronidazole via Single-Cell Raman Spectrometry","authors":"Lu Sun, Min Liu, Yanan Gong, Kangle Zhai, FengYun Lv, Lihua He, Xinguang Xue, Xiaolu Liu, Hairui Wang, Dongjie Fan, Yuanhai You, Mengyang Fang, Luyang Sun, Jian Xu, Jianzhong Zhang","doi":"10.1111/hel.13136","DOIUrl":"https://doi.org/10.1111/hel.13136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metronidazole is a first-line antibiotic to treat <i>Helicobacter pylori</i> infections. However, the Clinical Laboratory Standards Institute guidelines recommend against using antimicrobial susceptibility test (AST) to test metronidazole resistance, due to the unreliable predictive power which can result in treatment failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to establish an 8-h, metabolic-phenotype based AST for <i>H</i>. <i>pylori</i> metronidazole susceptibility using D<sub>2</sub>O-probed Raman microspectroscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Minimal inhibitory concentration (MIC) measured by conventional AST (E-test) were compared with expedited MIC via metabolic activity (eMIC-MA) for 10 <i>H</i>. <i>pylori</i> isolates. Raman barcodes of cellular-response to stress (RBCS) incorporating protein and carbohydrate Raman bands, were utilized to identify a biomarker to distinguish metronidazole susceptibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Specifically, eMIC-MA produces metronidazole susceptibility results showing 100% agreement with E-test, and determines the bactericidal dosage for both high- and low-level resistant <i>H</i>. <i>pylori</i> strains. In addition, RBCS not just reliably distinguish between metronidazole-susceptible and -resistant strains, but reveal their distinct mechanisms in bacterial responses to metronidazole.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The speed, accuracy, low cost, and rich information content that reveals the mode-of-action of drugs suggest the method's value in guiding metronidazole prescriptions for <i>H</i>. <i>pylori</i> eradication and in rapid screening based on drug-resistance mechanism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142234866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction to “Long-Term Effects of Fecal Microbiota Transplantation on Gut Microbiota After Helicobacter pylori Eradication With Bismuth Quadruple Therapy: A Randomized Controlled Trial” 更正："使用四联铋剂疗法根除幽门螺杆菌后，粪便微生物群移植对肠道微生物群的长期影响：随机对照试验"

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-12 DOI: 10.1111/hel.13127

J. T. Zhao, Y. Zhang, X. W. Wang, et al., “Long-Term Effects of Fecal Microbiota Transplantation on Gut Microbiota After Helicobacter pylori Eradication With Bismuth Quadruple Therapy: A Randomized Controlled Trial,” Helicobacter 29, no. 4 (2024): e13079.

In the Correspondence section next to the Abstract on the first page, the corresponding author's information was incorrect. Yan-Ling Wei, Dong-Feng Chen and Chun-Hui Lan should all be listed as co-corresponding authors, and the contents are as follows:

Chun-Hui Lan, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: [email protected].

Dong-Feng Chen, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: [email protected].

Yan-Ling Wei, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: [email protected].

We apologize for this error.

J.J. T. Zhao, Y. Zhang, X. W. Wang, et al：随机对照试验"，《幽门螺杆菌》第 29 卷第 4 期（2024 年）：e1.4 (2024): e13079.在第一页摘要旁的通信部分，通讯作者信息有误。魏艳玲、陈东风和蓝春晖均应为共同通讯作者，内容如下：蓝春晖，陆军军医大学大坪医院消化内科、重庆市消化系统恶性肿瘤重点实验室。电子邮箱：[email protected]：[email protected].陈东风，陆军军医大学大坪医院消化恶性肿瘤重庆市重点实验室消化内科。电子邮箱：[email protected]：[email protected].魏艳玲，陆军军医大学大坪医院消化内科、重庆市消化系统恶性肿瘤重点实验室。电子邮箱：[email protected]：[email protected].我们对此错误深表歉意。

{"title":"Correction to “Long-Term Effects of Fecal Microbiota Transplantation on Gut Microbiota After Helicobacter pylori Eradication With Bismuth Quadruple Therapy: A Randomized Controlled Trial”","authors":"","doi":"10.1111/hel.13127","DOIUrl":"https://doi.org/10.1111/hel.13127","url":null,"abstract":"<p>J. T. Zhao, Y. Zhang, X. W. Wang, et al., “Long-Term Effects of Fecal Microbiota Transplantation on Gut Microbiota After <i>Helicobacter pylori</i> Eradication With Bismuth Quadruple Therapy: A Randomized Controlled Trial,” <i>Helicobacter</i> 29, no. 4 (2024): e13079.</p><p>In the Correspondence section next to the Abstract on the first page, the corresponding author's information was incorrect. Yan-Ling Wei, Dong-Feng Chen and Chun-Hui Lan should all be listed as co-corresponding authors, and the contents are as follows:</p><p>Chun-Hui Lan, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: <span>[email protected]</span>.</p><p>Dong-Feng Chen, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: <span>[email protected]</span>.</p><p>Yan-Ling Wei, Department of Gastroenterology, Chongqing Key Laboratory of Digestive Malignancies, Daping Hospital, Army Medical University, Chongqing, China. Email: <span>[email protected]</span>.</p><p>We apologize for this error.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Associated With Decision to Treat or Not to Treat Helicobacter pylori Infection in Children: Data From the EuroPedHp Registry 决定治疗或不治疗儿童幽门螺杆菌感染的相关因素：来自 EuroPedHp 登记处的数据

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-09 DOI: 10.1111/hel.13134

Thu Giang Le Thi, Katharina Werkstetter, Kallirroi Kotilea, Patrick Bontems, José Cabral, Maria Luz Cilleruelo, Michal Kori, Josefa Barrio, Matjaž Homan, Nicolas Kalach, Rosa Lima, Marta Tavares, Pedro Urruzuno, Zrinjka Misak, Vaidotas Urbonas, Sibylle Koletzko, for the Helicobacter pylori Special Interest Group of ESPGHAN

Background

European and North-American guidelines on management of H. pylori infection in children provide the option not to treat even if the infection is endoscopically confirmed. We used data from the EuroPedHp Registry to identify factors associated with therapy decisions.

Methods

We included treatment-naïve patients reported between 2017 and 2020 from 30 centers in 17 European countries. Multivariable logistic regression identified factors including comorbidities within and outside the gastrointestinal (GI) tract influencing the decision for or against therapy.

Results

Of 1165 patients (52% females, median age 12.8), 28% (321/1165) reported any alarm symptom, 26% (307/1165) comorbidities, and 16% (192/1165) did not receive eradication treatment. Therapy was initiated less often in children having any GI comorbidity (57%, n = 181), particularly in those with eosinophilic esophagitis (60%, n = 35), inflammatory bowel disease (54%, n = 28), and celiac disease (43%, n = 58), compared to those with non-GI (86%, n = 126) or no comorbidity (89%, n = 858), despite similar frequencies of alarm and non-alarm symptoms, ulcers, erosions, and nodular gastritis. Patients with GI and without comorbidities remained more likely untreated in high versus low H. pylori prevalence countries (p < 0.0001). In children without comorbidities, factors favoring therapy included older age, being overweight, having symptoms, erosions, antral nodularity, and available antibiotic susceptibility results.

Conclusion

In this cohort, H. pylori-infected children with GI comorbidities compared to no comorbidity showed 75% reduced chance of receiving eradication therapy. We found no evidence supporting different management strategies in infected patients with GI comorbidities compared to all pediatric patients with endoscopically proven H. pylori infection.

背景欧洲和北美的儿童幽门螺杆菌感染管理指南规定，即使内镜确诊感染，也可以选择不治疗。我们利用 EuroPedHp 注册中心的数据来确定与治疗决策相关的因素。方法我们纳入了 17 个欧洲国家 30 个中心在 2017 年至 2020 年间报告的治疗无效患者。多变量逻辑回归确定了影响治疗决定的因素，包括胃肠道（GI）内外的合并症。结果 1165 名患者（52% 为女性，中位年龄为 12.8 岁）中，28%（321/1165）报告有任何报警症状，26%（307/1165）有合并症，16%（192/1165）未接受根除治疗。与非消化道疾病（86%，n = 126）或无合并症（89%，n = 858）的儿童相比，尽管出现报警和非报警症状、溃疡、糜烂和结节性胃炎的频率相似，但有消化道合并症（57%，n = 181）的儿童，尤其是嗜酸性粒细胞食管炎（60%，n = 35）、炎症性肠病（54%，n = 28）和糜烂性胃炎（43%，n = 58）的儿童接受治疗的频率较低。在幽门螺杆菌流行率高的国家和流行率低的国家，有消化道疾病和无合并症的患者更有可能未接受治疗（p < 0.0001）。在无合并症的儿童中，有利于治疗的因素包括年龄较大、超重、有症状、糜烂、前胃结节以及抗生素药敏结果。结论在该队列中，有消化道合并症的幽门螺杆菌感染儿童与无合并症儿童相比，接受根除治疗的几率降低了 75%。与所有经内镜证实感染幽门螺杆菌的儿童患者相比，我们没有发现证据支持对有消化道合并症的感染患者采取不同的治疗策略。

{"title":"Factors Associated With Decision to Treat or Not to Treat Helicobacter pylori Infection in Children: Data From the EuroPedHp Registry","authors":"Thu Giang Le Thi, Katharina Werkstetter, Kallirroi Kotilea, Patrick Bontems, José Cabral, Maria Luz Cilleruelo, Michal Kori, Josefa Barrio, Matjaž Homan, Nicolas Kalach, Rosa Lima, Marta Tavares, Pedro Urruzuno, Zrinjka Misak, Vaidotas Urbonas, Sibylle Koletzko, for the Helicobacter pylori Special Interest Group of ESPGHAN","doi":"10.1111/hel.13134","DOIUrl":"https://doi.org/10.1111/hel.13134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>European and North-American guidelines on management of <i>H. pylori</i> infection in children provide the option not to treat even if the infection is endoscopically confirmed. We used data from the EuroPed<i>Hp</i> Registry to identify factors associated with therapy decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included treatment-naïve patients reported between 2017 and 2020 from 30 centers in 17 European countries. Multivariable logistic regression identified factors including comorbidities within and outside the gastrointestinal (GI) tract influencing the decision for or against therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1165 patients (52% females, median age 12.8), 28% (321/1165) reported any alarm symptom, 26% (307/1165) comorbidities, and 16% (192/1165) did not receive eradication treatment. Therapy was initiated less often in children having any GI comorbidity (57%, <i>n</i> = 181), particularly in those with eosinophilic esophagitis (60%, <i>n</i> = 35), inflammatory bowel disease (54%, <i>n</i> = 28), and celiac disease (43%, <i>n</i> = 58), compared to those with non-GI (86%, <i>n</i> = 126) or no comorbidity (89%, <i>n</i> = 858), despite similar frequencies of alarm and non-alarm symptoms, ulcers, erosions, and nodular gastritis. Patients with GI and without comorbidities remained more likely untreated in high versus low <i>H. pylori</i> prevalence countries (<i>p</i> < 0.0001). In children without comorbidities, factors favoring therapy included older age, being overweight, having symptoms, erosions, antral nodularity, and available antibiotic susceptibility results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort, <i>H. pylori-</i>infected children with GI comorbidities compared to no comorbidity showed 75% reduced chance of receiving eradication therapy. We found no evidence supporting different management strategies in infected patients with GI comorbidities compared to all pediatric patients with endoscopically proven <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142160146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastric Cancer Screening: Intention to Adhere and Patients' Perspective 胃癌筛查：坚持筛查的意愿和患者的观点

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-09 DOI: 10.1111/hel.13135

João Carlos Silva, Mário Dinis-Ribeiro, Fernando Tavares, Diogo Libânio

Background and Aims

Gastric cancer (GC) is the third cause of cancer mortality worldwide. A screening strategy that combines an upper gastrointestinal endoscopy (UGIE) with a screening colonoscopy may be cost-effective in intermediate-risk regions. This study aimed to evaluate the intention to adhere to combined endoscopic screening and assess knowledge of GC symptoms, risk factors, and barriers to screening.

Methods

Cross-sectional study enrolling individuals eligible for CRC screening in northern Portugal, where a populational fecal occult blood test (FOBT) program is implemented. The validated PERCEPT-PREVENT tool was applied across three groups: (a) not yet invited to CRC screening, (b) FOBT-positive referred to colonoscopy, and (c) primary colonoscopy screening.

Results

A high acceptance rate was observed for combined endoscopic screening (94%; n = 264) [not yet invited to CRC screening 98% (n = 90) vs. FOBT-positive referred to colonoscopy 90% (n = 103) vs. primary colonoscopy 97% (n = 71); p = 0.017], with the vast majority reporting intention to adhere in the setting of full reimbursement (97%; n = 255). Most respondents were unaware of any possible GC symptom (76%; n = 213), risk factor (73%; n = 205), and UGIE-related complication (85%; n = 237). Regular follow-up with the primary care physician (Odds Ratio (OR) 27.59, 95% confidence interval (CI) 2.99–254.57), lower perceived negative health consequences of UGIE (OR 1.40, 95% CI 1.13–1.74), and lower perceived financial burden (OR 2.46, 95% CI 1.04–5.85) were the only factors independently associated with a higher intention to undergo combined screening.

Conclusions

Willingness to undergo combined endoscopic screening was notably high and positively impacted by lower perceived barriers. Additional efforts should be undertaken to improve levels of digestive health literacy.

背景和目的胃癌（GC）是全球第三大癌症死因。在中危地区，将上消化道内镜检查（UGIE）与结肠镜检查相结合的筛查策略可能具有成本效益。本研究旨在评估坚持进行联合内镜筛查的意向，并评估对消化道疾病症状、风险因素和筛查障碍的了解程度。方法在葡萄牙北部地区进行横断面研究，招募符合 CRC 筛查条件的人群，该地区正在实施一项人群粪便潜血试验 (FOBT) 计划。经过验证的 PERCEPT-PREVENT 工具适用于三类人群：(a) 尚未被邀请进行 CRC 筛查的人群；(b) FOBT 阳性转诊至结肠镜检查的人群；(c) 结肠镜初筛人群。结果联合内镜筛查的接受率很高（94%；n = 264）[尚未受邀进行 CRC 筛查的接受率为 98%（n = 90），而 FOBT 阳性转诊结肠镜检查的接受率为 90%（n = 103），初诊结肠镜检查的接受率为 97%（n = 71）；p = 0.017]，绝大多数受访者表示有意在全额报销的情况下坚持筛查（97%；n = 255）。大多数受访者不知道任何可能的 GC 症状（76%；n = 213）、风险因素（73%；n = 205）和 UGIE 相关并发症（85%；n = 237）。定期接受初级保健医生随访（比值比 (OR) 27.59，95% 置信区间 (CI)2.99-254.57）、较低的 UGIE 负面健康后果感知（OR 1.40，95% CI 1.13-1.74）和较低的经济负担感知（OR 2.46，95% CI 1.04-5.85）是唯一与较高的联合筛查意愿独立相关的因素。结论接受联合内镜筛查的意愿明显较高，并受到较低感知障碍的积极影响。应进一步努力提高消化系统健康知识水平。

{"title":"Gastric Cancer Screening: Intention to Adhere and Patients' Perspective","authors":"João Carlos Silva, Mário Dinis-Ribeiro, Fernando Tavares, Diogo Libânio","doi":"10.1111/hel.13135","DOIUrl":"https://doi.org/10.1111/hel.13135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Gastric cancer (GC) is the third cause of cancer mortality worldwide. A screening strategy that combines an upper gastrointestinal endoscopy (UGIE) with a screening colonoscopy may be cost-effective in intermediate-risk regions. This study aimed to evaluate the intention to adhere to combined endoscopic screening and assess knowledge of GC symptoms, risk factors, and barriers to screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional study enrolling individuals eligible for CRC screening in northern Portugal, where a populational fecal occult blood test (FOBT) program is implemented. The validated PERCEPT-PREVENT tool was applied across three groups: (a) not yet invited to CRC screening, (b) FOBT-positive referred to colonoscopy, and (c) primary colonoscopy screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A high acceptance rate was observed for combined endoscopic screening (94%; <i>n</i> = 264) [not yet invited to CRC screening 98% (<i>n</i> = 90) vs. FOBT-positive referred to colonoscopy 90% (<i>n</i> = 103) vs. primary colonoscopy 97% (<i>n</i> = 71); <i>p</i> = 0.017], with the vast majority reporting intention to adhere in the setting of full reimbursement (97%; <i>n</i> = 255). Most respondents were unaware of any possible GC symptom (76%; <i>n</i> = 213), risk factor (73%; <i>n</i> = 205), and UGIE-related complication (85%; <i>n</i> = 237). Regular follow-up with the primary care physician (Odds Ratio (OR) 27.59, 95% confidence interval (CI) 2.99–254.57), lower perceived negative health consequences of UGIE (OR 1.40, 95% CI 1.13–1.74), and lower perceived financial burden (OR 2.46, 95% CI 1.04–5.85) were the only factors independently associated with a higher intention to undergo combined screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Willingness to undergo combined endoscopic screening was notably high and positively impacted by lower perceived barriers. Additional efforts should be undertaken to improve levels of digestive health literacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142160173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vonoprazan Dual or Triple Therapy Versus Bismuth-Quadruple Therapy as First-Line Therapy for Helicobacter pylori Infection: A Three-Arm, Randomized Clinical Trial 沃诺普拉赞双重或三重疗法与铋剂-四重疗法作为幽门螺杆菌感染的一线疗法：三臂随机临床试验。

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-09-07 DOI: 10.1111/hel.13133

Ka Shing Cheung, Tao Lyu, Zijie Deng, Shaowei Han, Li Ni, Juan Wu, Jing Tong Tan, Jian Qin, Ho Yu Ng, Wai K. Leung, Wai-Kay Seto

<div> <section> <h3> Background</h3> <p>We compared efficacy of vonoprazan-dual or triple therapies and bismuth-quadruple therapy for treatment-naive <i>Helicobacter pylori</i> (HP) infection in Southern China, where primary resistance rates of clarithromycin and levofloxacin are >30%.</p> </section> <section> <h3> Methods</h3> <p>This was an investigator-initiated, three-arm, randomized clinical trial in Southern China. Between March 2022 and August 2023, treatment-naïve HP-infected adults were randomly assigned to receive one of three 14-day regimens (1:1:1 ratio): vonoprazan-dual (VA-dual; vonoprazan 20 mg twice daily and amoxicillin 1 g thrice daily), vonoprazan-triple (VAC-triple; vonoprazan 20 mg/amoxicillin 1 g/clarithromycin 500 mg twice daily), or bismuth-quadruple therapy containing bismuth, esomeprazole, tetracycline, and metronidazole. Primary outcome was noninferiority in HP eradication, evaluated by UBT 4–6 weeks post-treatment by intention-to-treat (ITT) and per-protocol (PP) analysis (based on subjects who completed 14-day treatment and rechecked UBT). Bonferroni-adjusted <i>p</i>-value of <0.017 was used to determine statistical significance.</p> </section> <section> <h3> Results</h3> <p>A total of 298 subjects (mean age: 35.7 ± 8.4 years; male: 134 [45.0%]; VC-dual: 100, VAC-triple: 98, bismuth-quadruple: 100) were enrolled, and 292 (98.0%) had UBT rechecked. ITT analysis showed that both VA-dual (eradication rate of 96.0%) and VAC-triple therapies (95.9%) were noninferior to bismuth-quadruple therapy (92.0%) (difference: 4.0%, 95% CI: −2.9% to 11.5%, <i>p</i> < 0.001; and 3.9%, 95% CI: −3.1% to 11.5%, <i>p</i> < 0.001, respectively). PP analysis also revealed noninferiority (96.7% or 96.7% vs. 97.4%, with difference: −2.9% and −2.9%, <i>p</i> = 0.009 and 0.010, respectively). The frequency of adverse events was 39.0%, 56.1%, and 71.0% in VA-dual, VAC-triple, and bismuth-quadruple therapies, respectively.</p> </section> <section> <h3> Conclusions</h3> <p>VA-dual and VA-triple therapies are highly effective and noninferior to bismuth-quadruple therapy in Southern China. Given the lower adverse effects and fewer antibiotic use, VA-dual therapy is the preferred first-line treatment for HP infection.</p> </section> <section> <h3> Trial Registration</h3> <p>Chinese Clinical Trial Registry (No. ChiCTR2200056375). Registered on February 4, 2022, https://www.chictr.org.cn/showproj.aspx?proj=14131.</p> </section>

背景：在克拉霉素和左氧氟沙星耐药率大于30%的中国南方地区，我们比较了vonoprazan-二联或三联疗法和铋剂-四联疗法对未经治疗的幽门螺旋杆菌（HP）感染的疗效：这是一项由研究者发起的三臂随机临床试验。在2022年3月至2023年8月期间，接受过治疗的HP感染成人被随机分配到三种14天治疗方案（1:1:1比例）中的一种：vonoprazan-双联疗法（VA-双联疗法；vonoprazan 20 毫克，每天两次；阿莫西林 1 克，每天三次）、vonoprazan-三联疗法（VAC-三联疗法；vonoprazan 20 毫克/阿莫西林 1 克/克拉霉素 500 毫克，每天两次）或含铋剂、埃索美拉唑、四环素和甲硝唑的铋剂-四联疗法。主要结果是根除 HP 的非劣效性，通过治疗后 4-6 周的 UBT 评估，采用意向治疗 (ITT) 和每方案 (PP) 分析（基于完成 14 天治疗并复查 UBT 的受试者）。结果的 Bonferroni-adjusted p 值：共有 298 名受试者（平均年龄：35.7 ± 8.4 岁；男性：134 [45.0%]；VC-双联：100 人，VAC-三联：98 人，Bismuth-四联：100 人）入组：其中 292 人（98.0%）接受了 UBT 复查。ITT 分析显示，VA-双疗法（根除率为 96.0%）和 VAC-三联疗法（95.9%）均不劣于铋剂-四联疗法（92.0%）（差异为 4.0%，95% C%）：差异：4.0%，95% CI：-2.9% 至 11.5%，P在华南地区，VA-二联疗法和VA-三联疗法疗效显著，且不劣于铋剂-四联疗法。鉴于不良反应较少、抗生素用量较少，VA-二联疗法是治疗人乳头瘤病毒感染的首选一线疗法：试验注册：中国临床试验注册中心（编号：ChiCTR2200056375）。注册时间：2022年2月4日，https://www.chictr.org.cn/showproj.aspx?proj=14131。

{"title":"Vonoprazan Dual or Triple Therapy Versus Bismuth-Quadruple Therapy as First-Line Therapy for Helicobacter pylori Infection: A Three-Arm, Randomized Clinical Trial","authors":"Ka Shing Cheung, Tao Lyu, Zijie Deng, Shaowei Han, Li Ni, Juan Wu, Jing Tong Tan, Jian Qin, Ho Yu Ng, Wai K. Leung, Wai-Kay Seto","doi":"10.1111/hel.13133","DOIUrl":"10.1111/hel.13133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We compared efficacy of vonoprazan-dual or triple therapies and bismuth-quadruple therapy for treatment-naive <i>Helicobacter pylori</i> (HP) infection in Southern China, where primary resistance rates of clarithromycin and levofloxacin are >30%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an investigator-initiated, three-arm, randomized clinical trial in Southern China. Between March 2022 and August 2023, treatment-naïve HP-infected adults were randomly assigned to receive one of three 14-day regimens (1:1:1 ratio): vonoprazan-dual (VA-dual; vonoprazan 20 mg twice daily and amoxicillin 1 g thrice daily), vonoprazan-triple (VAC-triple; vonoprazan 20 mg/amoxicillin 1 g/clarithromycin 500 mg twice daily), or bismuth-quadruple therapy containing bismuth, esomeprazole, tetracycline, and metronidazole. Primary outcome was noninferiority in HP eradication, evaluated by UBT 4–6 weeks post-treatment by intention-to-treat (ITT) and per-protocol (PP) analysis (based on subjects who completed 14-day treatment and rechecked UBT). Bonferroni-adjusted <i>p</i>-value of <0.017 was used to determine statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 298 subjects (mean age: 35.7 ± 8.4 years; male: 134 [45.0%]; VC-dual: 100, VAC-triple: 98, bismuth-quadruple: 100) were enrolled, and 292 (98.0%) had UBT rechecked. ITT analysis showed that both VA-dual (eradication rate of 96.0%) and VAC-triple therapies (95.9%) were noninferior to bismuth-quadruple therapy (92.0%) (difference: 4.0%, 95% CI: −2.9% to 11.5%, <i>p</i> < 0.001; and 3.9%, 95% CI: −3.1% to 11.5%, <i>p</i> < 0.001, respectively). PP analysis also revealed noninferiority (96.7% or 96.7% vs. 97.4%, with difference: −2.9% and −2.9%, <i>p</i> = 0.009 and 0.010, respectively). The frequency of adverse events was 39.0%, 56.1%, and 71.0% in VA-dual, VAC-triple, and bismuth-quadruple therapies, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VA-dual and VA-triple therapies are highly effective and noninferior to bismuth-quadruple therapy in Southern China. Given the lower adverse effects and fewer antibiotic use, VA-dual therapy is the preferred first-line treatment for HP infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Chinese Clinical Trial Registry (No. ChiCTR2200056375). Registered on February 4, 2022, https://www.chictr.org.cn/showproj.aspx?proj=14131.</p>\u0000 </section>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Candidate Antigens and the Development of Helicobacter pylori Vaccines 候选抗原和幽门螺旋杆菌疫苗的开发。

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-08-23 DOI: 10.1111/hel.13128

Zhanhua Zhang, Man Cui, Xiaohui Ji, Guimin Su, Yi-Xuan Zhang, Lin Du

Background

Infection with Helicobacter pylori (Hp) mostly occurs during childhood, and persistent infection may lead to severe gastric diseases and even gastric cancer. Currently, the primary method for eradicating Hp is through antibiotic treatment. However, the increasing multidrug resistance in Hp strains has diminished the effectiveness of antibiotic treatments. Vaccination could potentially serve as an effective intervention to resolve this issue.

Aims

Through extensive research and analysis of the vital protein characteristics involved in Hp infection, we aim to provide references for subsequent vaccine antigen selection. Additionally, we summarize the current research and development of Hp vaccines in order to provide assistance for future research.

Materials and Methods

Utilizing the databases PubMed and the Web of Science, a comprehensive search was conducted to compile articles pertaining to Hp antigens and vaccines. The salient aspects of these articles were then summarized to provide a detailed overview of the current research landscape in this field.

Results

Several potential antigens have been identified and introduced through a thorough understanding of the infection process and pathogenic mechanisms of Hp. The conserved and widely distributed candidate antigens in Hp, such as UreB, HpaA, GGT, and NAP, are discussed. Proteins such as CagA and VacA, which have significant virulence effects but relatively poor conservatism, require further evaluation. Emerging antigens like HtrA and dupA have significant research value. In addition, vaccines based on these candidate antigens have been compiled and summarized.

Conclusions

Vaccines are a promising method for preventing and treating Hp. While some Hp vaccines have achieved promising results, mature products are not yet available on the market. Great efforts have been directed toward developing various types of vaccines, underscoring the need for developers to select appropriate antigens and vaccine formulations to improve success rates.

背景：幽门螺杆菌（Hp）感染大多发生在儿童时期，持续感染可能导致严重的胃病，甚至胃癌。目前，根除 Hp 的主要方法是通过抗生素治疗。然而，由于 Hp 菌株对多种药物的耐药性不断增强，抗生素治疗的效果大打折扣。目的：通过广泛研究和分析参与 Hp 感染的重要蛋白质特征，我们旨在为后续疫苗抗原的选择提供参考。此外，我们还总结了当前 Hp 疫苗的研究和开发情况，以便为未来的研究提供帮助：我们利用 PubMed 和 Web of Science 数据库进行了全面搜索，汇编了有关 Hp 抗原和疫苗的文章。然后对这些文章的主要内容进行了总结，以提供该领域当前研究状况的详细概述：通过对 Hp 感染过程和致病机制的深入了解，发现并引入了几种潜在的抗原。本文讨论了 Hp 中保守且分布广泛的候选抗原，如 UreB、HpaA、GGT 和 NAP。CagA和VacA等蛋白质具有显著的毒力作用，但保守性相对较差，需要进一步评估。HtrA 和 dupA 等新出现的抗原具有重要的研究价值。此外，还对基于这些候选抗原的疫苗进行了整理和总结：疫苗是一种很有前景的预防和治疗甲型肝炎的方法。虽然一些甲型肝炎疫苗取得了可喜的成果，但成熟的产品尚未上市。人们已在开发各种类型的疫苗方面付出了巨大努力，这也说明开发人员需要选择合适的抗原和疫苗配方来提高成功率。

{"title":"Candidate Antigens and the Development of Helicobacter pylori Vaccines","authors":"Zhanhua Zhang, Man Cui, Xiaohui Ji, Guimin Su, Yi-Xuan Zhang, Lin Du","doi":"10.1111/hel.13128","DOIUrl":"10.1111/hel.13128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Infection with <i>Helicobacter pylori</i> (Hp) mostly occurs during childhood, and persistent infection may lead to severe gastric diseases and even gastric cancer. Currently, the primary method for eradicating Hp is through antibiotic treatment. However, the increasing multidrug resistance in Hp strains has diminished the effectiveness of antibiotic treatments. Vaccination could potentially serve as an effective intervention to resolve this issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Through extensive research and analysis of the vital protein characteristics involved in Hp infection, we aim to provide references for subsequent vaccine antigen selection. Additionally, we summarize the current research and development of Hp vaccines in order to provide assistance for future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Utilizing the databases PubMed and the Web of Science, a comprehensive search was conducted to compile articles pertaining to Hp antigens and vaccines. The salient aspects of these articles were then summarized to provide a detailed overview of the current research landscape in this field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several potential antigens have been identified and introduced through a thorough understanding of the infection process and pathogenic mechanisms of Hp. The conserved and widely distributed candidate antigens in Hp, such as UreB, HpaA, GGT, and NAP, are discussed. Proteins such as CagA and VacA, which have significant virulence effects but relatively poor conservatism, require further evaluation. Emerging antigens like HtrA and dupA have significant research value. In addition, vaccines based on these candidate antigens have been compiled and summarized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vaccines are a promising method for preventing and treating Hp. While some Hp vaccines have achieved promising results, mature products are not yet available on the market. Great efforts have been directed toward developing various types of vaccines, underscoring the need for developers to select appropriate antigens and vaccine formulations to improve success rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to Pingping Yang et al. 对 Pingping Yang 等人的回应

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter

Pub Date : 2024-08-21 DOI: 10.1111/hel.13132

Yongkang Lai, Yi Hu, Zhaoshen Li

引用次数: 0