Helicobacter最新文献

{"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 In the “treatment” domain, 16.6% of the ChatGPT responses were categorized as “mixed with correct or incorrect/outdated data.”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":"29 3","pages":""},"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}

{"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 ¹³C-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":"29 3","pages":""},"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}

{"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⁺ Th cells and CCR6⁺ 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⁺ and CD4⁺CCR6⁺CD45RO⁺ T cells, antigen-specific activation, B cell response in vitro, flow cytometry, determination of CD4⁺CD25^hiFoxP3⁺ Tregs and various groups of Th cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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. <i>H. pylori</i> 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 <i>H. pylori</i>-positive patients, circulating CD4⁺CCR6⁺ cells contained a higher proportion of <i>H. pylori</i>-specific cells compared with their CD4⁺CCR6⁻ counterparts. <i>H. pylori</i> 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 <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⁺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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 3","pages":""},"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}

{"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 × 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 <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":"29 3","pages":""},"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}

{"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":"29 3","pages":""},"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}

{"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":"29 3","pages":""},"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}

{"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":"29 3","pages":""},"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}

{"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":"29 3","pages":""},"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}

{"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":"29 3","pages":""},"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}

{"title":"In vitro efficacy of combinations of antibiotics used in clinical practice on clinical isolates of Helicobacter pylori","authors":"Zahyra Kaouah,&nbsp;Julien M. Buyck,&nbsp;Maxime Pichon,&nbsp;Christophe Burucoa,&nbsp;Laure Prouvensier,&nbsp;Jeremy Moreau,&nbsp;Sandrine Marchand,&nbsp;Julie Cremniter,&nbsp;Nicolas Grégoire","doi":"10.1111/hel.13081","DOIUrl":"10.1111/hel.13081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The main antibiotics used against <i>Helicobacter pylori</i> have been chosen empirically over time, with few preclinical studies to provide support. The rise in resistance to some of these antibiotics is prompting a reassessment of their use. This work aimed to evaluate the in vitro efficacy of 2 × 2 combinations of the most widely used antibiotics against <i>H. pylori</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>J99 reference strains and 19 clinical isolates of <i>H. pylori</i> with various antibiotic resistance phenotypes were used. Minimum inhibitory concentrations were carried out using the microdilution method in 96-well plates. The activity of 15 possible combinations of two antibiotics including amoxicillin, clarithromycin (CLA), levofloxacin, rifampicin, tetracycline, and metronidazole was determined for all strains by the checkerboard method. A mean fractional inhibitory concentration index (FIC_mean) was calculated for each combination and strain and the type of pharmacodynamic interaction was considered as synergic if FIC_mean ≤ 0.5, additive if 0.5 &lt; FIC_mean ≤ 1, indifferent if 1 &lt; FIC_mean &lt; 4 or antagonistic if FIC_mean ≥ 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most of the 285 pharmacodynamic interactions tested with clinical strains were close to additivity (average FIC_mean = 0.89 [0.38–1.28]). No interaction was found to be antagonistic. When two antibiotics to which a strain was resistant were combined, the concentrations required to inhibit bacterial growth were higher than their respective breakpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present results have shown that in vitro, the different antibiotics used in therapeutics have additive effects. The addition of the effects of two antibiotics to which a strain was resistant was not sufficient to inhibit bacterial growth. In probabilistic treatment, the choice of antibiotics to combine should therefore be based on the local epidemiology of resistance, and on susceptibility testing in the case of CLA therapy, so that at least one antibiotic to which the strain is susceptible is used.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"29 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.13081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876323","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}