Management of Helicobacter pylori Infection in Spain Beyond the Data Collected in the European Registry on H. pylori Management (Hp-EuReg): Results of a Nationwide Survey

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2025-04-01 DOI:10.1111/hel.70028

Javier Tejedor-Tejada, Samuel J. Martínez-Domínguez, Luis Hernández, Anna Cano-Català, Pablo Parra, Leticia Moreira, Olga P. Nyssen, Javier P. Gisbert, the Hp-EuReg Investigators

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引用次数: 0

Abstract

Background

The management of Helicobacter pylori (H. pylori) infection encompasses different diagnostic and therapeutic procedures.

Materials and Methods

A survey was developed to investigate further factors of the clinical practice concerning the management of H. pylori infection that are currently not collected within the European Registry on H. pylori Management (Hp-EuReg). The survey was distributed among Spanish Hp-EuReg investigators, members of the Spanish Gastroenterology Association, and through social media.

Results

Overall, 128 investigators from all Spanish regions participated (79% from centers enrolling patients in the Hp-EuReg). Most participants (66%) reported having at least five diagnostic methods available. Culture was usually performed following the second-line failure (64%). Contrary to the recommendations, 17% of physicians did not investigate H. pylori infection in patients admitted for peptic ulcer bleeding, and 35% did not treat the infection right away. Furthermore, most investigators (95%) did not test for the infection in cohabitants, and 32% in gastric cancer relatives. The test-and-treat strategy was used in 84% of patients under 55 years without alarm symptoms, and in 15% of patients over 55 years. The majority (74%) did not confirm the penicillin allergy, only 26% were aware of the local clarithromycin resistance rate, and 37% periodically evaluated the efficacy of eradication treatments. Finally, most Spanish investigators (83%) followed the V Spanish Consensus, while up to 35% followed the Maastricht VI recommendation guidelines.

Conclusions

The management of H. pylori infection in Spain is suboptimal, even among Hp-EuReg investigators. We must optimize H. pylori management by implementing educational measures adapted to each setting.

Trial Registration

ClinicalTrials.gov: NCT02328131

查看原文本刊更多论文

背景幽门螺旋杆菌（H. pylori）感染的治疗包括不同的诊断和治疗程序。材料和方法为了进一步调查欧洲幽门螺杆菌管理登记处（Hp-EuReg）目前尚未收集的有关幽门螺杆菌感染管理的临床实践因素，我们开展了一项调查。调查问卷在西班牙 Hp-EuReg 调查员、西班牙消化病协会会员中进行了发放，并通过社交媒体进行了传播。结果共有来自西班牙所有地区的 128 名调查员参与了调查（79% 来自 Hp-EuReg 患者登记中心）。大多数参与者（66%）称至少有五种诊断方法可用。培养通常在二线诊断失败后进行（64%）。与建议相反，17% 的医生没有对因消化性溃疡出血入院的患者进行幽门螺杆菌感染检查，35% 的医生没有立即治疗感染。此外，大多数调查人员（95%）没有检测同居者是否感染幽门螺杆菌，32%没有检测胃癌亲属是否感染幽门螺杆菌。在 55 岁以下无报警症状的患者中，84% 采用了先检测后治疗的策略，在 55 岁以上的患者中，15% 采用了先检测后治疗的策略。大多数人（74%）没有确认青霉素过敏，只有 26% 的人知道当地克拉霉素的耐药率，37% 的人定期评估根除治疗的疗效。最后，大多数西班牙调查人员（83%）遵循第五次西班牙共识，而遵循第六次马斯特里赫特建议指南的调查人员则高达 35%。结论在西班牙，幽门螺杆菌感染的治疗效果并不理想，即使在 Hp-EuReg 研究人员中也是如此。我们必须根据不同的环境采取相应的教育措施，优化幽门螺杆菌的管理。试验注册 ClinicalTrials.gov：NCT02328131

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.