Prevalence of Helicobacter pylori among patients with different gastrointestinal disorders in Saudi Arabia
Background: Helicobacter pylori is an important gastrointestinal pathogen associated with gastritis, peptic ulcers, and an increased risk of gastric carcinoma. The present study was carried out to determine the relationship between this organism with different gastrointestinal ailments.
Methods: 150 outpatients referrals to Saudi Arabian Medical City, Riyadh, Kingdom of Saudi Arabia was recruited in January to June 2015. Each patient was subjected to endoscopic examination. Biopsy specimens were taken from the stomach for rapid urease test and culture. Suspected H. pylori colonies were subjected to colony morphology identification, microscopical examination and biochemical reactions. The samples were also subjected to PCR to detect ureA subunit of urease gene.
Results: The endoscopic examination of patients revealed normal, gastric ulcer, duodenal ulcer, gastritis, and gastric cancer with a rate of 20.7%, 20%, 24%, 33.3%, and 2%, respectively. Direct smear exam revealed that 52% of patients were H. pylori positive while culture and rapid urease test showed a prevalence of 71.33%. Fifty four biopsies (36%) were urease positive after 1 hour at room temperature, 39 (62%) after 1 hour incubation at 37°C and 14 (71.33%) after 24 hours incubation. Isolated H. pylori showed that they were catalase, oxidase, and urease positive. PCR results showed 411-bp fragment, which is indicative for the ureA subunit of urease gene.
Conclusion: The prevalence of H. pylori infection was high among tested population. Strong association between H. pylori and duodenal ulcer was noticed. A 411-bp fragment indicative of the ureA subunit of urease gene was detected in all the tested isolates.
Duck WM, Jeremy S, Janet MP, Qunsheng S, David S, Friedman C, et al. Antimicrobial resistance incidence and risk factors among Helicobacter pylori-infected persons, United States. Emerg Infect Dis. 2004;10(6):1088–94. https://doi.org/10.3201/eid1006.030744
Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1(8390):1311–5. https://doi.org/10.1016/S0140-6736(84)91816-6
Forman D, Newell DG, Fullerton F, Yarnell JW, Stacey AR, Wald N, et al. Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. BMJ. 1991;302(6788):1302–5. https://doi.org/10.1136/bmj.302.6788.1302
Omunakwe HE, Madubuike OC, Nwosu SO, Pughikumo CO, Nwauche CA. Gastric mucosa-associated lymphoid tissue: The need for prompt histologic diagnosis. Ann Trop Med Public Health. 2011;4(2):113–5. https://doi.org/10.4103/1755-6783.85764
Das JC, Paul N. Epidemiology and pathophysiology of Helicobacter pylori infection in children. Indian J Pediatr. 2007;74(3):287–90. https://doi.org/10.1007/s12098-007-0046-6
Malfertheiner P, Megraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, et al. Current concepts in the management of Helicobacter pylori infection: The Maastricht III Consensus Report. Gut. 2007;56(6):772–81. https://doi.org/10.1136/gut.2006.101634
Brooks HJ, Ahmed D, McConnell MA, Barbezat GO. Diagnosis of helicobacter pylori infection by polymerase chain reaction: is it worth it? Diagn Microbiol Infect Dis. 2004;50(1):1–5. https://doi.org/10.1016/j.diagmicrobio.2003.11.010
Goodwin CS, Armstrong JA. Microbiological aspects of Helicobacter pylori (Campylobacter pylori). Eur J Clin Microbiol Infect Dis. 1990;9(1):1–13. https://doi.org/10.1007/BF01969526
Mégraud F. How should Helicobacter pylori infection be diagnosed? Gastroenterology. 1997;113(6 Suppl):S93–8. https://doi.org/10.1016/S0016-5085(97)80020-0
Vinette KM, Gibney KM, Proujansky R, Fawcett PT. Comparison of PCR and clinical laboratory tests for diagnosing H. pylori infection in pediatric patients. BMC Microbiol. 2004;4:5. https://doi.org/10.1186/1471-2180-4-5
Huang JQ, Sridhar S, Chen Y, Hunt RH. Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. Gastroenterology. 1998;114(6):1169–79. https://doi.org/10.1016/S0016-5085(98)70422-6
Matsukura N, Tajiri T, Kato S, Togashi A, Masuda G, Tokunaga A, et al. Diagnostic value of culture, histology and PCR for Helicobacter pylori in the remnant stomach after surgery. Aliment Pharmacol Ther. 2004;20Suppl1:33–8. https://doi.org/10.1111/j.1365-2036.2004.01989.x
Han SW, Flamm R, Hachem CY, Kim HY, Clarridge JE, Evans DG, et al. Transport and storage of Helicobacter pylori from gastric mucosal biopsies and clinical isolates. Eur J Clin Microbiol Infect Dis. 1995;14(4):349–52. https://doi.org/10.1007/BF02116531
Lu JJ, Perng CL, Shyu RY, Chen CH, Lou Q, Chong SK, et al. Comparison of five PCR methods for detection of Helicobacter pylori DNA in gastric tissues. J Clin Microbiol. 1999;37(3):772–4.
He Q, Wang JP, Osato M, Lachman LB. Real-time quantitative PCR for detection of Helicobacter pylori. J Clin Microbiol. 2002;40(10):3720–8. https://doi.org/10.1128/JCM.40.10.3720-3728.2002
Franzin L, Pennazio M, Cabodi D, Paolo Rossini F, Gioannini P. Clarithromycin and amoxicillin susceptibility of Helicobacter pylori strains isolated from adult patients with gastric or duodenal ulcer in Italy. Curr Microbiol. 2000;40(2):96–100. https://doi.org/10.1007/s002849910018
Maii AMA. Prevalence of Helicobacter pylori in saliva of patients with chronic gastritis disease as detected by PCR [thesis]. Egypt: Suez Canal University; 2003. p. 85–96.
Suzan GW. Comparison of serological detection of IgG, culture and rapid urease test for detection of Helicobacter pylori [thesis]. Egypt: Suez Canal University; 2000. p. 45–74.
Ashton-Key M, Diss TC, Isaacson PG. Detection of Helicobacter pylori in gastric biopsy and resection specimens. J Clin Pathol. 1996;49(2):107–11. https://doi.org/10.1136/jcp.49.2.107
Calvet X, Sanfeliu I, Musulen E, Mas P, Dalmau B, Gil M, et al. Evaluation of Helicobacter pylori diagnostic methods in patients with liver cirrhosis. Aliment Pharmacol Ther. 2002;16(7):1283–9. https://doi.org/10.1046/j.1365-2036.2002.01293.x
Li YY, Hu PO, Hazel SL. H. pylori and peptic ulcer disease. Am J Gastroentrol. 1991; 86(4):446–9.
Laura F, Peitnazio M, Cabodi D, Rossini F, Gioannini P. Clarithromycin and Amoxicillin susceptibility of Helicobacter pylori strains isolated from adult patients with gastric or duodenal ulcer in Italy. Current Microbiol. 2000;40:96–100. https://doi.org/10.1007/s002849910018
Oyedeji KS, Smith SI, Arigbabu AO, Coker AO, Ndububa DA, Agbakwuru EA, et al. Use of direct Gram stain of stomach biopsy as a rapid screening method for detection of Helicobacter pylori from peptic ulcer and gastritis patients. J Basic Microbiol. 2002;42(2):121–5. https://doi.org/10.1002/1521-4028(200205)42:2<121::AID-JOBM121>3.0.CO;2-#
Dunn BE, Vakil NB, Schneider BG, Miller MM, Zitzer JB, Peutz T, et al. Localization of Helicobacter pylori urease and heat shock protein in human gastric biopsies. Infect Immun. 1997;65(4):1181–8.
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