首页 > 最新文献

Helicobacter最新文献

英文 中文
Family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are highly cost-effective in preventing multiple upper gastrointestinal diseases in Chinese population at national level 以家庭为基础的幽门螺杆菌感染控制和管理策略以及筛查和治疗策略在预防中国人群多种上消化道疾病方面具有很高的成本效益。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-06-14 DOI: 10.1111/hel.13063
Chen Zhang, Ya-Bin Qi, Ruo-Bing Hu, Lu Xu, Xiao-Ting Li, Jing Ma, Qiao-Qiao Shao, Mohammed Awadh Abdun, Ishtiaq Ur Rahman, Wen-Jun Shi, Fu-Qiang Li, Jian-Jie Yu, Ming-Kai Yuan, Qi Chen, Hong Lu, Song-Ze Ding

Background

The overall benefits of the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management (FBCM) and screen-and-treat strategies in preventing multiple upper gastrointestinal diseases at national level in China have not been explored. We investigate the cost-effectiveness of these strategies in the whole Chinese population.

Materials and Methods

Decision trees and Markov models of H. pylori infection-related non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were developed to simulate the cost-effectiveness of these strategies in the whole 494 million households in China. The main outcomes include cost-effectiveness, life years (LY), quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER).

Results

When compared with no-screen strategy, both FBCM and screen-and-treat strategies reduced the number of new cases of NUD, PUD, PUD-related deaths, and the prevalence of GC, and cancer-related deaths. The costs saved by these two strategies were $1467 million and $879 million, quality-adjusted life years gained were 227 million and 267 million, and life years gained were 59 million and 69 million, respectively. Cost-effectiveness analysis showed that FBCM strategy costs −$6.46/QALY and −$24.75/LY, and screen-and-treat strategy costs −$3.3/QALY and −$12.71/LY when compared with no-screen strategy. Compared to the FBCM strategy, the screen-and-treat strategy reduced the incidence of H. pylori-related diseases, added 40 million QALYs, and saved 10 million LYs, but at the increased cost of $588 million. Cost-effectiveness analysis showed that screen-and-treat strategy costs $14.88/QALY and $59.5/LY when compared with FBCM strategy. The robustness of the results was also verified.

Conclusions

Both FBCM and screen-and-treat strategies are highly cost-effective in preventing NUD, PUD, and GC than the no-screen strategy in Chinese families at national level. As FBCM strategy is more practical and efficient, it is expected to play a more important role in preventing familial H. pylori infection and also serves as an excellent reference for other highly infected societies.

背景:在中国,新引入的基于家庭的幽门螺杆菌感染控制与管理(FBCM)和筛查与治疗策略在全国范围内预防多种上消化道疾病的整体效益尚未得到探讨。我们研究了这些策略在全中国人群中的成本效益:建立了幽门螺杆菌感染相关的非溃疡性消化不良(NUD)、消化性溃疡病(PUD)和胃癌(GC)的决策树和马尔可夫模型,以模拟这些策略在全中国 4.94 亿家庭中的成本效益。主要结果包括成本效益、生命年(LY)、质量调整生命年(QALY)和增量成本效益比(ICER):结果:与不筛查策略相比,FBCM 和筛查-治疗策略均减少了 NUD、PUD 新发病例数、PUD 相关死亡病例数、GC 患病率以及癌症相关死亡病例数。这两种策略节省的成本分别为 1.467 亿美元和 8.79 亿美元,获得的质量调整生命年分别为 2.27 亿年和 2.67 亿年,获得的生命年分别为 5900 万年和 6900 万年。成本效益分析显示,与不筛查策略相比,FBCM 策略的成本为-6.46 美元/QALY 和-24.75 美元/LY,筛查-治疗策略的成本为-3.3 美元/QALY 和-12.71 美元/LY。与 FBCM 策略相比,筛查和治疗策略降低了幽门螺杆菌相关疾病的发病率,增加了 4000 万 QALY,节省了 1000 万 LY,但成本增加了 5.88 亿美元。成本效益分析表明,与 FBCM 策略相比,筛查和治疗策略的成本为 14.88 美元/QALY 和 59.5 美元/LY。结果的稳健性也得到了验证:结论:在全国范围内,FBCM 和筛查治疗策略在中国家庭预防 NUD、PUD 和 GC 的成本效益均高于无筛查策略。由于 FBCM 策略更实用、更高效,有望在预防家族性幽门螺杆菌感染方面发挥更重要的作用,同时也可为其他高感染社会提供很好的参考。
{"title":"Family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are highly cost-effective in preventing multiple upper gastrointestinal diseases in Chinese population at national level","authors":"Chen Zhang,&nbsp;Ya-Bin Qi,&nbsp;Ruo-Bing Hu,&nbsp;Lu Xu,&nbsp;Xiao-Ting Li,&nbsp;Jing Ma,&nbsp;Qiao-Qiao Shao,&nbsp;Mohammed Awadh Abdun,&nbsp;Ishtiaq Ur Rahman,&nbsp;Wen-Jun Shi,&nbsp;Fu-Qiang Li,&nbsp;Jian-Jie Yu,&nbsp;Ming-Kai Yuan,&nbsp;Qi Chen,&nbsp;Hong Lu,&nbsp;Song-Ze Ding","doi":"10.1111/hel.13063","DOIUrl":"10.1111/hel.13063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The overall benefits of the newly introduced family-based <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection control and management (FBCM) and screen-and-treat strategies in preventing multiple upper gastrointestinal diseases at national level in China have not been explored. We investigate the cost-effectiveness of these strategies in the whole Chinese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Decision trees and Markov models of <i>H. pylori</i> infection-related non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were developed to simulate the cost-effectiveness of these strategies in the whole 494 million households in China. The main outcomes include cost-effectiveness, life years (LY), quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>When compared with no-screen strategy, both FBCM and screen-and-treat strategies reduced the number of new cases of NUD, PUD, PUD-related deaths, and the prevalence of GC, and cancer-related deaths. The costs saved by these two strategies were $1467 million and $879 million, quality-adjusted life years gained were 227 million and 267 million, and life years gained were 59 million and 69 million, respectively. Cost-effectiveness analysis showed that FBCM strategy costs −$6.46/QALY and −$24.75/LY, and screen-and-treat strategy costs −$3.3/QALY and −$12.71/LY when compared with no-screen strategy. Compared to the FBCM strategy, the screen-and-treat strategy reduced the incidence of <i>H. pylori</i>-related diseases, added 40 million QALYs, and saved 10 million LYs, but at the increased cost of $588 million. Cost-effectiveness analysis showed that screen-and-treat strategy costs $14.88/QALY and $59.5/LY when compared with FBCM strategy. The robustness of the results was also verified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both FBCM and screen-and-treat strategies are highly cost-effective in preventing NUD, PUD, and GC than the no-screen strategy in Chinese families at national level. As FBCM strategy is more practical and efficient, it is expected to play a more important role in preventing familial <i>H. pylori</i> infection and also serves as an excellent reference for other highly infected societies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317075","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
Exploring the capacities of ChatGPT: A comprehensive evaluation of its accuracy and repeatability in addressing helicobacter pylori-related queries 探索 ChatGPT 的能力:全面评估其处理幽门螺旋杆菌相关查询的准确性和可重复性。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-06-13 DOI: 10.1111/hel.13078
Yongkang Lai, Foqiang Liao, Jiulong Zhao, Chunping Zhu, Yi Hu, Zhaoshen Li

Background

Educational initiatives on Helicobacter pylori (H. pylori) constitute a highly effective approach for preventing its infection and establishing standardized protocols for its eradication. ChatGPT, a large language model, is a potentially patient-friendly online tool capable of providing health-related knowledge. This study aims to assess the accuracy and repeatability of ChatGPT in responding to questions related to H. pylori.

Materials and Methods

Twenty-one common questions about H. pylori were collected and categorized into four domains: basic knowledge, diagnosis, treatment, and prevention. ChatGPT was utilized to individually answer the aforementioned 21 questions. Its responses were independently assessed by two experts on H. pylori. Questions with divergent ratings were resolved by a third reviewer. Cohen's kappa coefficient was calculated to assess the consistency between the scores of the two reviewers.

Results

The responses of ChatGPT on H. pylori-related questions were generally satisfactory, with 61.9% marked as “completely correct” and 33.33% as “correct but inadequate.” The repeatability of the responses of ChatGPT to H. pylori-related questions was 95.23%. Among the responses, those related to prevention (comprehensive: 75%) had the best response, followed by those on treatment (comprehensive: 66.7%), basic knowledge (comprehensive: 60%), and diagnosis (comprehensive: 50%). In the “treatment” domain, 16.6% of the ChatGPT responses were categorized as “mixed with correct or incorrect/outdated data.” However, ChatGPT still lacks relevant knowledge regarding H. pylori resistance and the use of sensitive antibiotics.

Conclusions

ChatGPT can provide correct answers to the majority of H. pylori-related queries. It exhibited good reproducibility and delivered responses that were easily comprehensible to patients. Further enhancement of real-time information updates and correction of inaccurate information will make ChatGPT an essential auxiliary tool for providing accurate H. pylori-related health information to patients.

背景:关于幽门螺杆菌(H. pylori)的教育活动是预防幽门螺杆菌感染和建立根除幽门螺杆菌标准化方案的一种非常有效的方法。ChatGPT 是一种大型语言模型,是一种潜在的患者友好型在线工具,能够提供与健康相关的知识。本研究旨在评估 ChatGPT 在回答幽门螺杆菌相关问题时的准确性和可重复性:收集了 21 个有关幽门螺杆菌的常见问题,并将其分为四个领域:基础知识、诊断、治疗和预防。使用 ChatGPT 单独回答上述 21 个问题。其回答由两位幽门螺杆菌专家进行独立评估。评分有分歧的问题由第三位评审员解决。科恩卡帕系数(Cohen's kappa coefficient)用于评估两位评审员评分的一致性:结果:ChatGPT 对幽门螺杆菌相关问题的回答基本令人满意,61.9% 的回答被评为 "完全正确",33.33% 的回答被评为 "正确但不充分"。ChatGPT 对幽门螺杆菌相关问题回答的重复率为 95.23%。在这些回答中,与预防相关的回答(全面:75%)最好,其次是与治疗相关的回答(全面:66.7%)、基本知识(全面:60%)和诊断(全面:50%)。在 "治疗 "领域,16.6% 的 ChatGPT 回答被归类为 "正确或不正确/过时数据混杂"。然而,ChatGPT 仍然缺乏幽门螺杆菌耐药性和敏感抗生素使用方面的相关知识:结论:ChatGPT 可以为大多数幽门螺杆菌相关查询提供正确答案。结论:ChatGPT 可以提供大多数幽门螺杆菌相关询问的正确答案,具有良好的可重复性,提供的回答也易于患者理解。进一步加强实时信息更新和纠正不准确信息将使 ChatGPT 成为向患者提供准确的幽门螺杆菌相关健康信息的重要辅助工具。
{"title":"Exploring the capacities of ChatGPT: A comprehensive evaluation of its accuracy and repeatability in addressing helicobacter pylori-related queries","authors":"Yongkang Lai,&nbsp;Foqiang Liao,&nbsp;Jiulong Zhao,&nbsp;Chunping Zhu,&nbsp;Yi Hu,&nbsp;Zhaoshen Li","doi":"10.1111/hel.13078","DOIUrl":"10.1111/hel.13078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Educational initiatives on <i>Helicobacter pylori</i> (<i>H. pylori</i>) constitute a highly effective approach for preventing its infection and establishing standardized protocols for its eradication. ChatGPT, a large language model, is a potentially patient-friendly online tool capable of providing health-related knowledge. This study aims to assess the accuracy and repeatability of ChatGPT in responding to questions related to <i>H. pylori.</i></p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty-one common questions about <i>H. pylori</i> were collected and categorized into four domains: basic knowledge, diagnosis, treatment, and prevention. ChatGPT was utilized to individually answer the aforementioned 21 questions. Its responses were independently assessed by two experts on <i>H. pylori</i>. Questions with divergent ratings were resolved by a third reviewer. Cohen's kappa coefficient was calculated to assess the consistency between the scores of the two reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The responses of ChatGPT on <i>H. pylori</i>-related questions were generally satisfactory, with 61.9% marked as “completely correct” and 33.33% as “correct but inadequate.” The repeatability of the responses of ChatGPT to <i>H. pylori</i>-related questions was 95.23%. Among the responses, those related to prevention (comprehensive: 75%) had the best response, followed by those on treatment (comprehensive: 66.7%), basic knowledge (comprehensive: 60%), and diagnosis (comprehensive: 50%). In the “treatment” domain, 16.6% of the ChatGPT responses were categorized as “mixed with correct or incorrect/outdated data.” However, ChatGPT still lacks relevant knowledge regarding <i>H. pylori</i> resistance and the use of sensitive antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ChatGPT can provide correct answers to the majority of <i>H. pylori</i>-related queries. It exhibited good reproducibility and delivered responses that were easily comprehensible to patients. Further enhancement of real-time information updates and correction of inaccurate information will make ChatGPT an essential auxiliary tool for providing accurate <i>H. pylori</i>-related health information to patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310614","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
Fourteen-Day Tegoprazan–Amoxicillin Dual Therapy as the First-Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial 十四天替戈普拉赞-阿莫西林双重疗法作为幽门螺旋杆菌感染的一线治疗方法(SHARE2301):一项多中心、非劣效性、随机临床试验。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-06-09 DOI: 10.1111/hel.13098
Qingzhou Kong, Iqtida Ahmed Mirza, Xiaoqian Zhang, Xiaohui Song, Xiaowei Li, Qiumei Zhang, Lidong Xu, Yuting Guo, Yanan Yu, Xiuli Zuo, Yanqing Li, Yueyue Li

Background

Potassium-competitive acid blockers have demonstrated enormous potential in the eradication treatment of Helicobacter pylori infection, with tegoprazan being one of the representatives. The available data on the safety and efficacy of tegoprazan in dual therapy are limited.

Materials and Methods

The multicenter, noninferiority, randomized-controlled trial was conducted from May 2023 to March 2024. Treatment-naive subjects were randomly assigned (1:1) to enter either the tegoprazan–amoxicillin (TA) group (tegoprazan 50 mg twice daily and amoxicillin 750 mg four times daily) or the esomeprazole–amoxicillin (EA) group (esomeprazole 20 mg and amoxicillin 750 mg all four times daily), with a duration for 14 days. The primary outcome was eradication rate as determined by 13C-urea breath test, including per-protocol (PP) analysis and intention-to-treat (ITT) analysis. Secondary outcomes were adverse events and compliance.

Results

A total of 368 individuals were included in the randomization. The eradication rates in the EA group and the TA group were 84.2% and 85.8%, respectively, according to an ITT analysis (p = 0.77), and 88.5% and 88.2%, respectively, according to PP analysis (p = 1.00). The eradication rates for the TA group were not inferior to those of the EA group in both PP (p = 0.0023) and ITT analyses (p = 0.0009). There were no significant statistical differences in the incidence of adverse events and compliance between the two groups. The multivariate logistic regression analysis revealed that poor compliance increased the risk of eradication failure (p < 0.001).

Conclusions

Dual therapy containing tegoprazan is safe and effective to be considered as a clinical first-line treatment option, but further optimization involving antimicrobial susceptibility testing and adjustments in dosage and frequency is warranted.

Trial Registration

ClinicalTrials.gov ID: NCT05870683.

背景:钾竞争性酸阻滞剂在根除幽门螺旋杆菌感染的治疗中表现出巨大的潜力,替戈普拉赞就是其中的代表之一。有关替戈普拉赞在双重疗法中的安全性和有效性的现有数据十分有限:多中心、非劣效、随机对照试验于 2023 年 5 月至 2024 年 3 月进行。未经治疗的受试者被随机分配(1:1)进入替戈普拉嗪-阿莫西林(TA)组(替戈普拉嗪 50 毫克,每天两次,阿莫西林 750 毫克,每天四次)或埃索美拉唑-阿莫西林(EA)组(埃索美拉唑 20 毫克,阿莫西林 750 毫克,每天四次),疗程均为 14 天。主要结果是通过13C-尿素呼气试验确定的根除率,包括每方案(PP)分析和意向治疗(ITT)分析。次要结果为不良事件和依从性:结果:共有 368 人参与了随机分组。根据 ITT 分析(p = 0.77),EA 组和 TA 组的根除率分别为 84.2% 和 85.8%;根据 PP 分析(p = 1.00),EA 组和 TA 组的根除率分别为 88.5% 和 88.2%。在 PP 分析(p = 0.0023)和 ITT 分析(p = 0.0009)中,TA 组的根除率均不低于 EA 组。两组的不良反应发生率和依从性无明显统计学差异。多变量逻辑回归分析显示,依从性差会增加根除失败的风险(p 结论:依从性差会增加根除失败的风险:含有替戈普拉赞的双重疗法安全有效,可作为临床一线治疗选择,但需要进一步优化,包括抗菌药敏感性检测以及剂量和频率的调整:试验注册:ClinicalTrials.gov ID:试验注册:ClinicalTrials.gov ID:NCT05870683。
{"title":"Fourteen-Day Tegoprazan–Amoxicillin Dual Therapy as the First-Line Treatment of Helicobacter pylori Infection (SHARE2301): A Multicenter, Noninferiority, Randomized Clinical Trial","authors":"Qingzhou Kong,&nbsp;Iqtida Ahmed Mirza,&nbsp;Xiaoqian Zhang,&nbsp;Xiaohui Song,&nbsp;Xiaowei Li,&nbsp;Qiumei Zhang,&nbsp;Lidong Xu,&nbsp;Yuting Guo,&nbsp;Yanan Yu,&nbsp;Xiuli Zuo,&nbsp;Yanqing Li,&nbsp;Yueyue Li","doi":"10.1111/hel.13098","DOIUrl":"10.1111/hel.13098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Potassium-competitive acid blockers have demonstrated enormous potential in the eradication treatment of <i>Helicobacter pylori</i> infection, with tegoprazan being one of the representatives. The available data on the safety and efficacy of tegoprazan in dual therapy are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The multicenter, noninferiority, randomized-controlled trial was conducted from May 2023 to March 2024. Treatment-naive subjects were randomly assigned (1:1) to enter either the tegoprazan–amoxicillin (TA) group (tegoprazan 50 mg twice daily and amoxicillin 750 mg four times daily) or the esomeprazole–amoxicillin (EA) group (esomeprazole 20 mg and amoxicillin 750 mg all four times daily), with a duration for 14 days. The primary outcome was eradication rate as determined by <sup>13</sup>C-urea breath test, including per-protocol (PP) analysis and intention-to-treat (ITT) analysis. Secondary outcomes were adverse events and compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 368 individuals were included in the randomization. The eradication rates in the EA group and the TA group were 84.2% and 85.8%, respectively, according to an ITT analysis (<i>p</i> = 0.77), and 88.5% and 88.2%, respectively, according to PP analysis (<i>p</i> = 1.00). The eradication rates for the TA group were not inferior to those of the EA group in both PP (<i>p</i> = 0.0023) and ITT analyses (<i>p</i> = 0.0009). There were no significant statistical differences in the incidence of adverse events and compliance between the two groups. The multivariate logistic regression analysis revealed that poor compliance increased the risk of eradication failure (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dual therapy containing tegoprazan is safe and effective to be considered as a clinical first-line treatment option, but further optimization involving antimicrobial susceptibility testing and adjustments in dosage and frequency is warranted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov ID: NCT05870683.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295964","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
CCR6+ T helper cells and regulatory T cells in the blood and gastric mucosa during Helicobacter pylori infection 幽门螺旋杆菌感染期间血液和胃黏膜中的 CCR6+ T 辅助细胞和调节性 T 细胞。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-31 DOI: 10.1111/hel.13097
Vladimir Talayev, Maria Svetlova, Irina Zaichenko, Elena Voronina, Olga Babaykina, Natalia Neumoina, Ksenia Perfilova

Background

Helicobacter pylori (H. pylori) can evade the host's immune response and persist for a long time on the gastric mucosa. T helper (Th) cells appear to be involved in the control of H. pylori bacteria but promote mucosal inflammation. In contrast, regulatory T cells (Tregs) may reduce inflammation but promote H. pylori persistence. CC motif chemokine receptor 6 (CCR6) is involved in the migration of various cells into inflamed gastric mucosa. In this study, we examined CCR6+ Th cells and CCR6+ Tregs during H. pylori infection in humans.

Materials and Methods

Isolation of cells from blood and mucosal biopsies, magnetic separation of В cells, CD4+ and CD4+CCR6+CD45RO+ T cells, antigen-specific activation, B cell response in vitro, flow cytometry, determination of CD4+CD25hiFoxP3+ Tregs and various groups of Th cells.

Results

CD4+CCR6+ blood lymphocytes from healthy donors included Th cells and Tregs. These CCR6+ Th cells produced proinflammatory cytokines and also stimulated plasma cell maturation and antibody production in vitro. H. pylori gastritis and peptic ulcer disease were associated with an increase in the number of circulate CD4+CCR6+CD45RO+ cells and the percentage of Th1, Th17 and Th1/17 cells in this lymphocyte subgroup. In H. pylori-positive patients, circulating CD4+CCR6+ cells contained a higher proportion of H. pylori-specific cells compared with their CD4+CCR6 counterparts. H. pylori infection strongly increased the content of CD4+ lymphocytes in the inflamed gastric mucosa, with the majority of these CD4+ lymphocytes expressing CCR6. CD4+CCR6+ lymphocytes from H. pylori-infected stomach included Tregs and in vivo activated T cells, some of which produced interferon-γ without ex vivo stimulation.

Conclusion

H. pylori infection causes an increase in the number of mature CD4+CCR6+ lymphocytes in the blood, with a pro-inflammatory shift in their composition and enrichment of the gastric mucosa with CD4+CCR6+ lymphocytes, including CCR6+ Th1 cells and Tregs.

背景:幽门螺杆菌(H. pylori)可以逃避宿主的免疫反应,并在胃粘膜上长期存在。T 辅助(Th)细胞似乎参与了对幽门螺杆菌的控制,但会促进粘膜炎症。与此相反,调节性 T 细胞(Tregs)可能会减轻炎症,但会促进幽门螺杆菌的持续存在。CC motif趋化因子受体 6(CCR6)参与了各种细胞向发炎胃粘膜的迁移。在这项研究中,我们检测了幽门螺杆菌感染过程中的 CCR6+ Th 细胞和 CCR6+ Tregs:从血液和粘膜活检组织中分离细胞,磁性分离В细胞、CD4+和CD4+CCR6+CD45RO+ T细胞,抗原特异性活化,体外B细胞反应,流式细胞术,测定CD4+CD25hiFoxP3+ Tregs和各种Th细胞群:结果:来自健康捐献者的 CD4+CCR6+ 血液淋巴细胞包括 Th 细胞和 Tregs。这些 CCR6+ Th 细胞能产生促炎细胞因子,还能刺激体外浆细胞成熟和抗体产生。幽门螺杆菌胃炎和消化性溃疡病与循环 CD4+CCR6+CD45RO+ 细胞数量的增加以及该淋巴细胞亚群中 Th1、Th17 和 Th1/17 细胞比例的增加有关。在幽门螺杆菌阳性患者中,循环 CD4+CCR6+ 细胞中幽门螺杆菌特异性细胞的比例高于 CD4+CCR6- 细胞。幽门螺杆菌感染大大增加了发炎胃黏膜中 CD4+ 淋巴细胞的含量,其中大部分 CD4+ 淋巴细胞表达 CCR6。幽门螺杆菌感染胃中的 CD4+CCR6+ 淋巴细胞包括 Tregs 和体内活化的 T 细胞,其中一些无需体内外刺激即可产生干扰素-γ:结论:幽门螺杆菌感染会导致血液中成熟的 CD4+CCR6+ 淋巴细胞数量增加,其组成发生促炎性变化,并使胃黏膜中的 CD4+CCR6+ 淋巴细胞富集,其中包括 CCR6+ Th1 细胞和 Tregs。
{"title":"CCR6+ T helper cells and regulatory T cells in the blood and gastric mucosa during Helicobacter pylori infection","authors":"Vladimir Talayev,&nbsp;Maria Svetlova,&nbsp;Irina Zaichenko,&nbsp;Elena Voronina,&nbsp;Olga Babaykina,&nbsp;Natalia Neumoina,&nbsp;Ksenia Perfilova","doi":"10.1111/hel.13097","DOIUrl":"10.1111/hel.13097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) can evade the host's immune response and persist for a long time on the gastric mucosa. T helper (Th) cells appear to be involved in the control of <i>H. pylori</i> bacteria but promote mucosal inflammation. In contrast, regulatory T cells (Tregs) may reduce inflammation but promote <i>H. pylori</i> persistence. CC motif chemokine receptor 6 (CCR6) is involved in the migration of various cells into inflamed gastric mucosa. In this study, we examined CCR6<sup>+</sup> Th cells and CCR6<sup>+</sup> Tregs during <i>H. pylori</i> infection in humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Isolation of cells from blood and mucosal biopsies, magnetic separation of В cells, CD4<sup>+</sup> and CD4<sup>+</sup>CCR6<sup>+</sup>CD45RO<sup>+</sup> T cells, antigen-specific activation, B cell response in vitro, flow cytometry, determination of CD4<sup>+</sup>CD25<sup>hi</sup>FoxP3<sup>+</sup> Tregs and various groups of Th cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CD4<sup>+</sup>CCR6<sup>+</sup> blood lymphocytes from healthy donors included Th cells and Tregs. These CCR6<sup>+</sup> Th cells produced proinflammatory cytokines and also stimulated plasma cell maturation and antibody production in vitro. <i>H. pylori</i> gastritis and peptic ulcer disease were associated with an increase in the number of circulate CD4<sup>+</sup>CCR6<sup>+</sup>CD45RO<sup>+</sup> cells and the percentage of Th1, Th17 and Th1/17 cells in this lymphocyte subgroup. In <i>H. pylori</i>-positive patients, circulating CD4<sup>+</sup>CCR6<sup>+</sup> cells contained a higher proportion of <i>H. pylori</i>-specific cells compared with their CD4<sup>+</sup>CCR6<sup>−</sup> counterparts. <i>H. pylori</i> infection strongly increased the content of CD4<sup>+</sup> lymphocytes in the inflamed gastric mucosa, with the majority of these CD4<sup>+</sup> lymphocytes expressing CCR6. CD4<sup>+</sup>CCR6<sup>+</sup> lymphocytes from <i>H. pylori-</i>infected stomach included Tregs and in vivo activated T cells, some of which produced interferon-γ without ex vivo stimulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>H. pylori</i> infection causes an increase in the number of mature CD4<sup>+</sup>CCR6<sup>+</sup> lymphocytes in the blood, with a pro-inflammatory shift in their composition and enrichment of the gastric mucosa with CD4<sup>+</sup>CCR6<sup>+</sup> lymphocytes, including CCR6<sup>+</sup> Th1 cells and Tregs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179195","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
Prevalence of multidrug-resistant Campylobacter species in wastewater effluents: A menace of environmental and public health concern 废水中普遍存在耐多药弯曲杆菌:环境和公共卫生问题的威胁。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-26 DOI: 10.1111/hel.13095
Olufunmilayo Modupe Oluwakoya, Anthony Ifeanyi Okoh

The prevalence of multidrug-resistant Campylobacter species in wastewater effluents presents a formidable challenge at the intersection of environmental sustainability and public health. This study examined the presence of multidrug-resistant Campylobacter in wastewater effluents in the Eastern Cape Province, South Africa, and its implications for environmental ecosystems and public health. Forty-five samples from household effluent (HHE) and wastewater treatment plant effluent (WWTPE) were collected at different geographical locations within the province between April and September 2022. The counts of the presumptive Campylobacter genus ranged from 5.2 × 103 to 6.03 × 104 CFU/mL for HHE and 4.93 × 103 to 1.04 × 104 CFU/mL for WWTPE. About 42.55% of the samples were positive for Campylobacter species. Five virulence determinants including the cadF and wlaN were detected in all the isolates; however, flgR (19.23%), ciaB, and ceuE (15.38%) were less prevalent. The antibiogram profiles of confirmed Campylobacter isolates revealed high resistance (>55%) against all tested antibiotics ranging from 55.77% (nalidixic acid) to 92.30% (erythromycin), and resistance against the other antibiotics followed the order ciprofloxacin (51.92%), azithromycin (50%), and levofloxacin (48.08%). On the contrary, gentamicin was sensitive against 61.54% of the isolates, followed by imipenem (57.69%) and streptomycin (51.92%). The WWTPE's antibiotic resistance index (ARI) was 0.19, lower than the permitted Krumperman threshold of 0.2; and HHE's ARIs were higher. The isolates' respective multiple antibiotic resistance indexes (MARI) varied between 0.08 and 1.00. Among the phenotypically resistant Campylobacter isolates examined, 21 resistance determinants encoding resistance against β-lactam, carbapenems, aminoglycosides, phenicol, quinolones, tetracyclines, and macrolides were detected, which explains the phenotypic resistance observed in the study. This study concludes that the wastewaters in the study areas are important reservoirs of multidrug-resistant and potentially pathogenic Campylobacter species, suggesting the need for proper treatment of the wastewaters to eliminate the organisms in the effluents before discharge the final effluent to the receiving watershed.

污水中普遍存在的耐多药弯曲杆菌给环境可持续性和公共卫生带来了严峻的挑战。本研究考察了南非东开普省废水中存在的耐多药弯曲杆菌及其对环境生态系统和公共卫生的影响。2022 年 4 月至 9 月期间,在该省不同地点收集了 45 份家庭污水(HHE)和污水处理厂污水(WWTPE)样本。在 HHE 和 WWTPE 中,推定弯曲杆菌属的计数范围分别为 5.2 × 103 至 6.03 × 104 CFU/mL,4.93 × 103 至 1.04 × 104 CFU/mL。约 42.55% 的样本对弯曲杆菌呈阳性。所有分离物中都检测到了五种毒力决定因子,包括 cadF 和 wlaN;然而,flgR(19.23%)、ciaB 和 ceuE(15.38%)的流行率较低。确诊弯曲杆菌分离物的抗生素图谱显示,对所有测试抗生素的耐药性都很高(>55%),从 55.77%(萘啶酸)到 92.30%(红霉素)不等,对其他抗生素的耐药性依次为环丙沙星(51.92%)、阿奇霉素(50%)和左氧氟沙星(48.08%)。相反,庆大霉素对 61.54% 的分离株敏感,其次是亚胺培南(57.69%)和链霉素(51.92%)。WWTPE 的抗生素耐药性指数(ARI)为 0.19,低于克鲁姆伯曼允许的 0.2 临界值;而 HHE 的抗生素耐药性指数较高。分离物各自的多重抗生素耐药性指数(MARI)介于 0.08 和 1.00 之间。在检测的表型耐药弯曲杆菌分离物中,发现了 21 个耐药基因,分别编码对 β-内酰胺类、碳青霉烯类、氨基糖苷类、酚类、喹诺酮类、四环素类和大环内酯类的耐药性,这也解释了本研究中观察到的表型耐药性。本研究的结论是,研究地区的废水是具有多种耐药性和潜在致病性弯曲杆菌的重要贮存地,这表明有必要对废水进行适当处理,以消除废水中的生物,然后再将最终废水排放到受纳流域。
{"title":"Prevalence of multidrug-resistant Campylobacter species in wastewater effluents: A menace of environmental and public health concern","authors":"Olufunmilayo Modupe Oluwakoya,&nbsp;Anthony Ifeanyi Okoh","doi":"10.1111/hel.13095","DOIUrl":"10.1111/hel.13095","url":null,"abstract":"<p>The prevalence of multidrug-resistant <i>Campylobacter</i> species in wastewater effluents presents a formidable challenge at the intersection of environmental sustainability and public health. This study examined the presence of multidrug-resistant <i>Campylobacter</i> in wastewater effluents in the Eastern Cape Province, South Africa, and its implications for environmental ecosystems and public health. Forty-five samples from household effluent (HHE) and wastewater treatment plant effluent (WWTPE) were collected at different geographical locations within the province between April and September 2022. The counts of the presumptive <i>Campylobacter</i> genus ranged from 5.2 × 10<sup>3</sup> to 6.03 × 10<sup>4</sup> CFU/mL for HHE and 4.93 × 10<sup>3</sup> to 1.04 × 10<sup>4</sup> CFU/mL for WWTPE. About 42.55% of the samples were positive for <i>Campylobacter</i> species. Five virulence determinants including the <i>cad</i>F and <i>wla</i>N were detected in all the isolates; however, <i>flg</i>R (19.23%), <i>cia</i>B, and <i>ceu</i>E (15.38%) were less prevalent. The antibiogram profiles of confirmed <i>Campylobacter</i> isolates revealed high resistance (&gt;55%) against all tested antibiotics ranging from 55.77% (nalidixic acid) to 92.30% (erythromycin), and resistance against the other antibiotics followed the order ciprofloxacin (51.92%), azithromycin (50%), and levofloxacin (48.08%). On the contrary, gentamicin was sensitive against 61.54% of the isolates, followed by imipenem (57.69%) and streptomycin (51.92%). The WWTPE's antibiotic resistance index (ARI) was 0.19, lower than the permitted Krumperman threshold of 0.2; and HHE's ARIs were higher. The isolates' respective multiple antibiotic resistance indexes (MARI) varied between 0.08 and 1.00. Among the phenotypically resistant <i>Campylobacter</i> isolates examined, 21 resistance determinants encoding resistance against β-lactam, carbapenems, aminoglycosides, phenicol, quinolones, tetracyclines, and macrolides were detected, which explains the phenotypic resistance observed in the study. This study concludes that the wastewaters in the study areas are important reservoirs of multidrug-resistant and potentially pathogenic <i>Campylobacter</i> species, suggesting the need for proper treatment of the wastewaters to eliminate the organisms in the effluents before discharge the final effluent to the receiving watershed.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154612","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
Vonoprazan-based therapies versus PPI-based therapies in patients with H. pylori infection: Systematic review and meta-analyses of randomized controlled trials 幽门螺杆菌感染患者中基于沃诺普拉赞的疗法与基于 PPI 的疗法:随机对照试验的系统回顾和荟萃分析。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-24 DOI: 10.1111/hel.13094
Ligang Liu, Hekai Shi, Yufei Shi, Anlin Wang, Nuojin Guo, Fang Li, Milap C. Nahata

Background

This study aims to evaluate the efficacy and safety of vonoprazan-amoxicillin (VA), vonoprazan-amoxicillin-clarithromycin (VAC), vonoprazan-based bismuth-containing quadruple therapy (VBQT), and PPI-based triple (PAC) or quadruple therapy (PBQT) for H. pylori infection with the consideration of duration of therapy and amoxicillin dose (H: high; L: low).

Materials and Methods

PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for eligible randomized controlled trials (RCTs) up to December 15, 2023. The efficacy outcome was eradication rate, and safety outcomes included the rates of adverse events and treatment discontinuation.

Results

Twenty-seven RCTs were included. The pooled eradication rates were 82.8% for VA, 89.1% for VAC, and 91.8% for VBQT, which increased with the higher amoxicillin frequency of administration and extended duration of therapy within each regimen. There were no significant differences in eradication rate when comparing 7-VA versus 7-VAC and 14-VA versus 14-VAC. VA was at least comparable to PAC. The eradication rate did not differ significantly between 10-H-VA or 14-H-VA versus 14-PBQT. 7-L-VAC demonstrated higher eradication rate versus 7-PAC and comparable rate to 14-PAC. 14-VBQT showed higher eradication rates versus 14-PBQT. The adverse events rate was 19.3% for VA, 30.6% for VAC, and 38.4% for VBQT. VA had similar risk of adverse events versus VAC and significantly fewer adverse events compared to PBQT. The treatment discontinuation rate did not differ significantly between treatments.

Conclusions

The eradication rate of VBQT was the highest at above 90% followed by VAC and VA. VA was as effective as VAC and superior to PPI-based therapies with favorable safety, highlighting the potential of VA therapy as a promising alternative to traditional PPI-based therapies. VPZ-based triple or quadruple therapies was more effective than PPI-based therapies. Further studies are needed to establish the optimal treatment regimen especially in the western countries.

研究背景本研究旨在评估冯诺普拉唑-阿莫西林(VA)、冯诺普拉唑-阿莫西林-卡里霉素(VAC)、基于冯诺普拉唑的含铋四联疗法(VBQT)以及基于PPI的三联疗法(PAC)或四联疗法(PBQT)治疗幽门螺杆菌感染的疗效和安全性,同时考虑疗程和阿莫西林剂量(H:高;L:低):检索了 PubMed、Embase 和 Cochrane 对照试验中央注册中心截至 2023 年 12 月 15 日的符合条件的随机对照试验 (RCT)。疗效结果为根除率,安全性结果包括不良事件发生率和治疗中止率:结果:共纳入 27 项随机对照试验。VA、VAC和VBQT的总根除率分别为82.8%、89.1%和91.8%。7-VA 与 7-VAC 和 14-VA 与 14-VAC 相比,根除率没有明显差异。VA 至少与 PAC 相当。10-H-VA 或 14-H-VA 与 14-PBQT 的根除率没有明显差异。7-L-VAC的根除率高于7-PAC,与14-PAC相当。14-VBQT 的根除率高于 14-PBQT。VA的不良事件发生率为19.3%,VAC为30.6%,VBQT为38.4%。与 VAC 相比,VA 的不良事件风险相似,而与 PBQT 相比,VA 的不良事件风险要低得多。不同治疗方法的治疗中断率没有明显差异:结论:VBQT的根除率最高,超过90%,其次是VAC和VA。VA的疗效与VAC相当,优于基于PPI的疗法,且安全性良好,这凸显了VA疗法作为传统PPI疗法替代品的潜力。基于 VPZ 的三联或四联疗法比基于 PPI 的疗法更有效。需要进一步研究以确定最佳治疗方案,尤其是在西方国家。
{"title":"Vonoprazan-based therapies versus PPI-based therapies in patients with H. pylori infection: Systematic review and meta-analyses of randomized controlled trials","authors":"Ligang Liu,&nbsp;Hekai Shi,&nbsp;Yufei Shi,&nbsp;Anlin Wang,&nbsp;Nuojin Guo,&nbsp;Fang Li,&nbsp;Milap C. Nahata","doi":"10.1111/hel.13094","DOIUrl":"10.1111/hel.13094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to evaluate the efficacy and safety of vonoprazan-amoxicillin (VA), vonoprazan-amoxicillin-clarithromycin (VAC), vonoprazan-based bismuth-containing quadruple therapy (VBQT), and PPI-based triple (PAC) or quadruple therapy (PBQT) for <i>H. pylori</i> infection with the consideration of duration of therapy and amoxicillin dose (H: high; L: low).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for eligible randomized controlled trials (RCTs) up to December 15, 2023. The efficacy outcome was eradication rate, and safety outcomes included the rates of adverse events and treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven RCTs were included. The pooled eradication rates were 82.8% for VA, 89.1% for VAC, and 91.8% for VBQT, which increased with the higher amoxicillin frequency of administration and extended duration of therapy within each regimen. There were no significant differences in eradication rate when comparing 7-VA versus 7-VAC and 14-VA versus 14-VAC. VA was at least comparable to PAC. The eradication rate did not differ significantly between 10-H-VA or 14-H-VA versus 14-PBQT. 7-L-VAC demonstrated higher eradication rate versus 7-PAC and comparable rate to 14-PAC. 14-VBQT showed higher eradication rates versus 14-PBQT. The adverse events rate was 19.3% for VA, 30.6% for VAC, and 38.4% for VBQT. VA had similar risk of adverse events versus VAC and significantly fewer adverse events compared to PBQT. The treatment discontinuation rate did not differ significantly between treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The eradication rate of VBQT was the highest at above 90% followed by VAC and VA. VA was as effective as VAC and superior to PPI-based therapies with favorable safety, highlighting the potential of VA therapy as a promising alternative to traditional PPI-based therapies. VPZ-based triple or quadruple therapies was more effective than PPI-based therapies. Further studies are needed to establish the optimal treatment regimen especially in the western countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092664","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
Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study 为诊断糜烂性胃炎、炎症性肠病和嗜酸性食管炎而进行上内镜检查时发现的幽门螺杆菌感染:一项欧洲多中心儿科研究。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-24 DOI: 10.1111/hel.13092
Kallirroi Kotilea, Claudio Romano, Erasmo Miele, Angelika Kindermann, Yael Dolstra, Zrinjka Misak, Vaidotas Urbonas, Josef Sykora, Pedro Urruzuno, Alexander Krauthammer, Maria Rogalidou, Konstantina Dimakou, Tsili Zangen, Eleftheria Roma, Aglaia Zellos, María Luz Cilleruelo, Meline M'Rini, Patrick Bontems, Yasin Sahin, Marta Tavares, Tatevik Shahinyan, Biljana Vuletic, Nicolas Kalach, Michal Kori, the ESPGHAN H. pylori special interest group

Background

Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment.

Materials and Methods

A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021. Data collected: age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment.

Results

H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1–14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31–10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62–11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33–3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47–7.66 p 0.004].

Conclusions

Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.

背景:为诊断糜烂性胃炎(CeD)、炎症性肠病(IBD)和嗜酸性食管炎(EoE)而进行的上消化道内窥镜检查(UGE)可能会发现幽门螺杆菌。我们旨在描述因糜烂性胃炎、炎症性肠病和嗜酸性食管炎而接受 UGE 检查的儿童中幽门螺杆菌的感染频率以及接受根除治疗的儿童人数:一项来自14个国家的回顾性多中心研究纳入了2019年1月至2021年12月期间被诊断为CeD、IBD和EoE的儿童患者,收集的数据包括:年龄、性别、血液学参数、内镜、组织学和幽门螺杆菌培养结果以及根除治疗信息:结果:349/3890(9%)名儿童中发现了幽门螺杆菌[167(48%)名男性,中位数为 12 岁(四分位数间距为 8.1-14.6)]。10%(173/1733)CeD、8.5%(110/1292)IBD 和 7.6%(66/865)EoE 患者体内存在幽门螺杆菌(p = NS)。欧洲(东部 5.2% (28/536)、南部 3.8% (78/2032)、西部 5.6% (28/513))和中东 26.6% (215/809)之间的患病率存在显著差异[比值比 (OR) 7.96 95% 置信区间 (CI) (6.31-10.1) p 结论:在对最常见的胃肠道疾病进行胃镜检查时偶然发现幽门螺杆菌,不同地区之间存在显著差异,但不同疾病之间的差异不大。建议治疗的适应症没有明确界定,只有不到 40% 的儿童接受了治疗。
{"title":"Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study","authors":"Kallirroi Kotilea,&nbsp;Claudio Romano,&nbsp;Erasmo Miele,&nbsp;Angelika Kindermann,&nbsp;Yael Dolstra,&nbsp;Zrinjka Misak,&nbsp;Vaidotas Urbonas,&nbsp;Josef Sykora,&nbsp;Pedro Urruzuno,&nbsp;Alexander Krauthammer,&nbsp;Maria Rogalidou,&nbsp;Konstantina Dimakou,&nbsp;Tsili Zangen,&nbsp;Eleftheria Roma,&nbsp;Aglaia Zellos,&nbsp;María Luz Cilleruelo,&nbsp;Meline M'Rini,&nbsp;Patrick Bontems,&nbsp;Yasin Sahin,&nbsp;Marta Tavares,&nbsp;Tatevik Shahinyan,&nbsp;Biljana Vuletic,&nbsp;Nicolas Kalach,&nbsp;Michal Kori,&nbsp;the ESPGHAN H. pylori special interest group","doi":"10.1111/hel.13092","DOIUrl":"10.1111/hel.13092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of <i>H. pylori</i> in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021. Data collected: age, gender, hematologic parameters, endoscopic, histologic, and <i>H. pylori</i> culture results, and information on eradication treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>H. pylori</i> was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1–14.6)]. <i>H. pylori</i> was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (<i>p</i> = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31–10.1) <i>p</i> &lt; 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62–11.47, <i>p</i> &lt; 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33–3.81, <i>p</i> 0.003]. Treatment rates were higher in centers with a low <i>H. pylori</i> prevalence (&lt;20%) [OR 3.36 95% CI 1.47–7.66 <i>p</i> 0.004].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Identifying <i>H. pylori</i> incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092739","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
Nationwide survey of Helicobacter pylori seropositivity and gastric atrophy in Zambia 赞比亚全国幽门螺杆菌血清阳性和胃萎缩调查。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-24 DOI: 10.1111/hel.13096
Violet Kayamba, Husna Munshi, Mutinta Nyama Hankolwe, Ciluvya Kaluba Kavimba, Gershom Chongwe, Viktoria Knaze, Jin Young Park, Paul Kelly

Background

Helicobacter pylori (H. pylori) is a common bacterial infection which predominately drives upper gastrointestinal pathology. We carried out a nationwide serological survey in response to the deficiency of robust African data on H. pylori prevalence, age of acquisition, socio-geographic determinants, and impact on gastric physiology.

Materials and Methods

This was a cross-sectional study of archival plasma samples collected during the Zambia Population-based HIV impact Assessment (ZAMPHIA) 2016 survey. ZAMPHIA used a two-stage door-to-door stratified cluster sample approach to collect samples from adults and children from age 0 to 59 years (n = 24,266). We randomly retrieved one fifth of these samples from each of Zambia's 10 provinces and used ELISA to test for H. pylori IgG antibodies, pepsinogen 1 and 2 and gastrin-17. A pepsinogen 1:2 ratio of <3 was used to define gastric atrophy.

Results

The analysis of 4050 plasma samples (30% <16 years, 53% females) revealed an overall H. pylori seroprevalence of 79%. By the age of 10 years, more than 75% of the children had H. pylori. Urban residence was associated with increased odds (OR 1.8, 95% CI 1.5–2.2, p < 0.001) and HIV infection was associated with reduced odds (OR 0.7, 95% CI 0.5–0.9, p = 0.02) of H. pylori seropositivity. Gastric atrophy was detected in 6% of H. pylori seropositive adults below 45 years of age and 9% in those between 45 and 59 years.

Conclusions

We have confirmed a high prevalence of H. pylori seropositivity in Zambia, predominantly in urban settings. The prevalence of gastric atrophy is broadly consistent with other populations around the globe, but our sample did not include adults over 60 years.

背景:幽门螺杆菌(H. pylori)是一种常见的细菌感染,主要导致上消化道病变。由于非洲缺乏有关幽门螺杆菌感染率、感染年龄、社会地理决定因素以及对胃生理影响的可靠数据,因此我们在全国范围内开展了血清学调查:这是一项横断面研究,研究对象是在 2016 年赞比亚人口艾滋病影响评估(ZAMPHIA)调查期间收集的档案血浆样本。ZAMPHIA 采用两阶段逐户分层群组抽样方法,从 0 至 59 岁的成人和儿童中收集样本(n = 24266)。我们从赞比亚 10 个省的每个省随机抽取其中五分之一的样本,并使用 ELISA 检测幽门螺杆菌 IgG 抗体、胃蛋白酶原 1 和 2 以及胃泌素-17。结果显示,胃蛋白酶原 1:2 的比例为 1:2:对 4050 份血浆样本(30%)进行了分析:我们证实了幽门螺杆菌血清阳性在赞比亚的高流行率,主要是在城市环境中。胃萎缩的发病率与全球其他人群基本一致,但我们的样本不包括 60 岁以上的成年人。
{"title":"Nationwide survey of Helicobacter pylori seropositivity and gastric atrophy in Zambia","authors":"Violet Kayamba,&nbsp;Husna Munshi,&nbsp;Mutinta Nyama Hankolwe,&nbsp;Ciluvya Kaluba Kavimba,&nbsp;Gershom Chongwe,&nbsp;Viktoria Knaze,&nbsp;Jin Young Park,&nbsp;Paul Kelly","doi":"10.1111/hel.13096","DOIUrl":"10.1111/hel.13096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori (H. pylori)</i> is a common bacterial infection which predominately drives upper gastrointestinal pathology. We carried out a nationwide serological survey in response to the deficiency of robust African data on <i>H. pylori</i> prevalence, age of acquisition, socio-geographic determinants, and impact on gastric physiology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study of archival plasma samples collected during the Zambia Population-based HIV impact Assessment (ZAMPHIA) 2016 survey. ZAMPHIA used a two-stage door-to-door stratified cluster sample approach to collect samples from adults and children from age 0 to 59 years (<i>n</i> = 24,266). We randomly retrieved one fifth of these samples from each of Zambia's 10 provinces and used ELISA to test for <i>H. pylori</i> IgG antibodies, pepsinogen 1 and 2 and gastrin-17. A pepsinogen 1:2 ratio of &lt;3 was used to define gastric atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis of 4050 plasma samples (30% &lt;16 years, 53% females) revealed an overall <i>H. pylori</i> seroprevalence of 79%. By the age of 10 years, more than 75% of the children had <i>H. pylori</i>. Urban residence was associated with increased odds (OR 1.8, 95% CI 1.5–2.2, <i>p</i> &lt; 0.001) and HIV infection was associated with reduced odds (OR 0.7, 95% CI 0.5–0.9, <i>p</i> = 0.02) of <i>H. pylori</i> seropositivity. Gastric atrophy was detected in 6% of <i>H. pylori</i> seropositive adults below 45 years of age and 9% in those between 45 and 59 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We have confirmed a high prevalence of <i>H. pylori</i> seropositivity in Zambia, predominantly in urban settings. The prevalence of gastric atrophy is broadly consistent with other populations around the globe, but our sample did not include adults over 60 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092704","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
Treatment failure is a key factor in the development of Helicobacter pylori resistance 治疗失败是幽门螺旋杆菌产生抗药性的一个关键因素。
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-23 DOI: 10.1111/hel.13091
Jinliang Xie, Jianxiang Peng, Dingwei Liu, Rong Zeng, Jiayu Qiu, Liting Shen, Xiaomin Gong, Dongsheng Liu, Yong Xie

Background

Helicobacter pylori eradication failure influences its antibiotic resistance.

Aims

This study aimed to evaluate the effect of previous treatment failures on it, including the changes in the antibiotic resistance rates, minimal inhibitory concentration (MIC) distributions, and resistance patterns.

Materials and Methods

This single-center retrospective study included 860 primary isolates and 247 secondary isolates. Antibiotic susceptibility testing was performed for amoxicillin, metronidazole, clarithromycin, levofloxacin, furazolidone, tetracycline, and rifampicin. The demographic data and detailed regimens were collected.

Results

The primary resistance rates to amoxicillin, metronidazole, clarithromycin, levofloxacin, tetracycline, rifampin, and furazolidone were 5.93%, 83.84%, 28.82%, 26.28%, 0.35%, 1.16%, and 0%, while secondary were 25.10%, 92.31%, 79.76%, 63.16%, 1.06%, 3.19%, and 0%, respectively. The resistance rates to amoxicillin, metronidazole, clarithromycin, and levofloxacin increased significantly with the number of treatment failures accumulated, and showed a linear trend. The proportion of primary and secondary multidrug-resistant (MDR) isolates were 17.79% and 63.16%, respectively. The MIC values of amoxicillin, clarithromycin, and levofloxacin were elevated significantly with medication courses increased.

Conclusion

The prevalence of amoxicillin, clarithromycin, levofloxacin, and metronidazole resistance would increase rapidly following first-line treatment failure, as well as the MIC values of them. Clinicians should pay great attention to the first-line treatment to cure H. pylori infection successfully.

背景:幽门螺杆菌根除失败会影响其抗生素耐药性:目的:本研究旨在评估以往治疗失败对幽门螺杆菌的影响,包括抗生素耐药率、最小抑菌浓度(MIC)分布和耐药模式的变化:这项单中心回顾性研究包括 860 例初次分离株和 247 例二次分离株。对阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、呋喃唑酮、四环素和利福平进行了抗生素药敏试验。收集了人口统计学数据和详细的治疗方案:阿莫西林、甲硝唑、克拉霉素、左氧氟沙星、四环素、利福平和呋喃唑酮的一级耐药率分别为5.93%、83.84%、28.82%、26.28%、0.35%、1.16%和0%,二级耐药率分别为25.10%、92.31%、79.76%、63.16%、1.06%、3.19%和0%。随着治疗失败次数的累积,阿莫西林、甲硝唑、克拉霉素和左氧氟沙星的耐药率显著增加,并呈线性趋势。原发性和继发性多重耐药(MDR)分离株的比例分别为 17.79% 和 63.16%。随着疗程的增加,阿莫西林、克拉霉素和左氧氟沙星的 MIC 值明显升高:结论:阿莫西林、克拉霉素、左氧氟沙星和甲硝唑的耐药性在一线治疗失败后会迅速增加,其 MIC 值也会增加。临床医生应高度重视一线治疗,以成功治愈幽门螺杆菌感染。
{"title":"Treatment failure is a key factor in the development of Helicobacter pylori resistance","authors":"Jinliang Xie,&nbsp;Jianxiang Peng,&nbsp;Dingwei Liu,&nbsp;Rong Zeng,&nbsp;Jiayu Qiu,&nbsp;Liting Shen,&nbsp;Xiaomin Gong,&nbsp;Dongsheng Liu,&nbsp;Yong Xie","doi":"10.1111/hel.13091","DOIUrl":"10.1111/hel.13091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> eradication failure influences its antibiotic resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the effect of previous treatment failures on it, including the changes in the antibiotic resistance rates, minimal inhibitory concentration (MIC) distributions, and resistance patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This single-center retrospective study included 860 primary isolates and 247 secondary isolates. Antibiotic susceptibility testing was performed for amoxicillin, metronidazole, clarithromycin, levofloxacin, furazolidone, tetracycline, and rifampicin. The demographic data and detailed regimens were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The primary resistance rates to amoxicillin, metronidazole, clarithromycin, levofloxacin, tetracycline, rifampin, and furazolidone were 5.93%, 83.84%, 28.82%, 26.28%, 0.35%, 1.16%, and 0%, while secondary were 25.10%, 92.31%, 79.76%, 63.16%, 1.06%, 3.19%, and 0%, respectively. The resistance rates to amoxicillin, metronidazole, clarithromycin, and levofloxacin increased significantly with the number of treatment failures accumulated, and showed a linear trend. The proportion of primary and secondary multidrug-resistant (MDR) isolates were 17.79% and 63.16%, respectively. The MIC values of amoxicillin, clarithromycin, and levofloxacin were elevated significantly with medication courses increased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of amoxicillin, clarithromycin, levofloxacin, and metronidazole resistance would increase rapidly following first-line treatment failure, as well as the MIC values of them. Clinicians should pay great attention to the first-line treatment to cure <i>H. pylori</i> infection successfully.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081265","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
Antibiotic susceptibility pattern of Helicobacter pylori against eight antibiotics: A study from North India 幽门螺杆菌对八种抗生素的敏感性模式:印度北部的一项研究
IF 4.4 2区 医学 Q1 Medicine Pub Date : 2024-05-16 DOI: 10.1111/hel.13093
Safiya Arfi, Prateek Sharma, Mithun Kumar, Shubham Mehra, Kunal Das, Rajashree Das, Ashwini Setya

Background

The purpose of this analysis is to evaluate the antimicrobial susceptibility of eight drugs effective against Helicobacter pylori (H. pylori) strains and the genetic diversity of H. pylori virulence genes to foresee clinical outcomes in North India.

Materials and Methods

Fifty-eight H. pylori strains isolated from patients suffering from various gastrointestinal (GI) diseases were included in the study. MICs of various antibiotics were determined by the agar dilution method. The chi-squared test and Fisher exact test were used to determine the p-value, which was considered significant at p-value ≤ 0.05. RStudio 4.0 was used to for the data visualization.

Results

The prevalence of drug resistance was found to be: cefixime (CFM) (41.3%), furazolidone (FZD) (34.4%), amoxicillin (AMX) (20.7%), levofloxacin (LVFX) (70.7%), metronidazole (MTZ) (39.6%), tetracycline (TET) (20.7%), clarithromycin (CLA) (17.2%), and rifabutin (RIF) (17.2%). Out of 58 H. pylori strains, 3 were pan susceptible. There were H. pylori strains with single-drug resistance (21.8%, 12/55), dual resistance (30.9%, 17/55), triple resistance (20%, 11/55), and multidrug resistance (27.3%, 15/55). The resistance rate in MTZ, CLA and RIF were found to be significantly higher in females as compared to males (p = 0.005, p = 0.002, and p = 0.02), respectively. The resistance to TET exhibited significantly higher levels in gastritis compared to GERD, DU, and other disease groups (p = 0.04) respectively.

Conclusion

TET, AMX, CLA, and RIF were found to be more effective antibiotics against H. pylori infections, whereas more studies are required to provide evidence on increasing resistance rate of LVFX.

背景 本分析的目的是评估对幽门螺旋杆菌(H. pylori)菌株有效的八种药物的抗菌敏感性以及幽门螺旋杆菌毒力基因的遗传多样性,以预测北印度的临床结果。 材料和方法 研究对象包括从各种胃肠道疾病患者体内分离出的 58 株幽门螺杆菌。采用琼脂稀释法测定了各种抗生素的 MICs。采用卡方检验和费舍尔精确检验来确定 p 值,当 p 值≤0.05 时视为显著。数据可视化使用 RStudio 4.0。 结果 发现耐药率为:头孢克肟(CFM)(41.3%)、呋喃唑酮(FZD)(34.4%)、阿莫西林(AMX)(20.7%)、左氧氟沙星(LVFX)(70.7%)、甲硝唑(MTZ)(39.6%)、四环素(TET)(20.7%)、克拉霉素(CLA)(17.2%)和利福布汀(RIF)(17.2%)。在 58 株幽门螺杆菌中,有 3 株对泛敏感。幽门螺杆菌菌株中存在单耐药(21.8%,12/55)、双耐药(30.9%,17/55)、三耐药(20%,11/55)和多耐药(27.3%,15/55)。与男性相比,女性对 MTZ、CLA 和 RIF 的耐药率明显更高(分别为 p = 0.005、p = 0.002 和 p = 0.02)。与胃食管反流病、DU 和其他疾病组相比,胃炎患者对 TET 的抵抗力明显更高(p = 0.04)。 结论 TET、AMX、CLA 和 RIF 被认为是对幽门螺杆菌感染更有效的抗生素,而 LVFX 的耐药率增加还需要更多的研究来证明。
{"title":"Antibiotic susceptibility pattern of Helicobacter pylori against eight antibiotics: A study from North India","authors":"Safiya Arfi,&nbsp;Prateek Sharma,&nbsp;Mithun Kumar,&nbsp;Shubham Mehra,&nbsp;Kunal Das,&nbsp;Rajashree Das,&nbsp;Ashwini Setya","doi":"10.1111/hel.13093","DOIUrl":"https://doi.org/10.1111/hel.13093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this analysis is to evaluate the antimicrobial susceptibility of eight drugs effective against <i>Helicobacter pylori</i> (<i>H. pylori)</i> strains and the genetic diversity of <i>H. pylori</i> virulence genes to foresee clinical outcomes in North India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Fifty-eight <i>H. pylori</i> strains isolated from patients suffering from various gastrointestinal (GI) diseases were included in the study. MICs of various antibiotics were determined by the agar dilution method. The chi-squared test and Fisher exact test were used to determine the <i>p</i>-value, which was considered significant at <i>p</i>-value ≤ 0.05. RStudio 4.0 was used to for the data visualization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of drug resistance was found to be: cefixime (CFM) (41.3%), furazolidone (FZD) (34.4%), amoxicillin (AMX) (20.7%), levofloxacin (LVFX) (70.7%), metronidazole (MTZ) (39.6%), tetracycline (TET) (20.7%), clarithromycin (CLA) (17.2%), and rifabutin (RIF) (17.2%). Out of 58 <i>H. pylori</i> strains, 3 were pan susceptible. There were <i>H. pylori</i> strains with single-drug resistance (21.8%, 12/55), dual resistance (30.9%, 17/55), triple resistance (20%, 11/55), and multidrug resistance (27.3%, 15/55). The resistance rate in MTZ, CLA and RIF were found to be significantly higher in females as compared to males (<i>p</i> = 0.005, <i>p =</i> 0.002, and <i>p</i> = 0.02), respectively. The resistance to TET exhibited significantly higher levels in gastritis compared to GERD, DU, and other disease groups (<i>p =</i> 0.04) respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TET, AMX, CLA, and RIF were found to be more effective antibiotics against <i>H. pylori</i> infections, whereas more studies are required to provide evidence on increasing resistance rate of LVFX.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953096","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
期刊
Helicobacter
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1