H Pylori
Prevalence of clarithromycin resistance in H.pylori patients with failure of treatment
Introduction;
The H.pylori is a gram negative bacterium that colonizes the stomach has a high prevalence; more than 50 percent of the global population has H.pylori. It’s influenced by geography, age, gender, socioeconomic status, although it is decreasing in the developed world, it remains high in the developing world as there is less proper sanitation and hygiene, crowdedness, lack of safe water supply & poor diet, transmission is mainly oral-oral or feco-oral route(1,2,3) .The prevalence of H.pylori in 2011 in Egypt was 50% among children with age group 3 and about 90% among adult(3) .there is strong relation between H.pylori and a lot of gastro duodenal disorder. It has a rule in developing Acute and chronic gastritis, dyspepsia, peptic ulcers ,Atrophic gastritis, intestinal metaplasia &and gastric cancer(7) it is an important pathogen in the developing of gastro-duodenal ulcers(8’9) H.pylori triggers lymphoid infiltration and help in formation of Gastric MALT lymphoma(10) , although there is still controversy(11) but some studies shows a strong relation between H.pylori and GERD(12) the strongest known risk factor of H.pylori is the development of gastric adenocarcinoma. H. pylori strains that have the cag pathogenicity island induce more severe gastric injury and further augment the risk for developing cancer of the stomach (13). Iron deficiency enhances H. pylori virulence and represents a measurable biomarker to identify populations of infected persons at high risk for gastric cancer (14) .It can affect extra gastrointestinal organs as H. pylori can infect the skin, liver and heart (15).
Effective treatment leads to eradication of H.pylori and thus prevent several gastro duodenal disease(16) ,it leads to ulcer healing, decrease relapse(17) .Eradication of Helicobacter pylori may result in complete regression of low-grade lymphoma of the gastric
Introduction;
The H.pylori is a gram negative bacterium that colonizes the stomach has a high prevalence; more than 50 percent of the global population has H.pylori. It’s influenced by geography, age, gender, socioeconomic status, although it is decreasing in the developed world, it remains high in the developing world as there is less proper sanitation and hygiene, crowdedness, lack of safe water supply & poor diet, transmission is mainly oral-oral or feco-oral route(1,2,3) .The prevalence of H.pylori in 2011 in Egypt was 50% among children with age group 3 and about 90% among adult(3) .there is strong relation between H.pylori and a lot of gastro duodenal disorder. It has a rule in developing Acute and chronic gastritis, dyspepsia, peptic ulcers ,Atrophic gastritis, intestinal metaplasia &and gastric cancer(7) it is an important pathogen in the developing of gastro-duodenal ulcers(8’9) H.pylori triggers lymphoid infiltration and help in formation of Gastric MALT lymphoma(10) , although there is still controversy(11) but some studies shows a strong relation between H.pylori and GERD(12) the strongest known risk factor of H.pylori is the development of gastric adenocarcinoma. H. pylori strains that have the cag pathogenicity island induce more severe gastric injury and further augment the risk for developing cancer of the stomach (13). Iron deficiency enhances H. pylori virulence and represents a measurable biomarker to identify populations of infected persons at high risk for gastric cancer (14) .It can affect extra gastrointestinal organs as H. pylori can infect the skin, liver and heart (15).
Effective treatment leads to eradication of H.pylori and thus prevent several gastro duodenal disease(16) ,it leads to ulcer healing, decrease relapse(17) .Eradication of Helicobacter pylori may result in complete regression of low-grade lymphoma of the gastric
References: 15. Lacy BE, Rosemore J. Helicobacter pylori: ulcers and more: the beginning of an era. 2001 16 37. De Francesco V, Zullo A, Ierardi E, Giorgio F, Perna F, Hassan C, Morini S, Panella C, Vaira D. Phenotypic and genotypic Helicobacter pylori clarithromycin resistance and therapeutic outcome: benefits and limits. 2010 38 39. Hultén K, Gibreel A, Sköld O, Engstrand L. Macrolide resistance in Helicobacter pylori: mechanism and stability in strains from clarithromycin-treated patients. 1997 40 41. Kim JM, Kim JS, Kim N, Kim YJ, Kim IY, Chee YJ, Lee CH, Jung HC. Gene mutations of 23S rRNA associated with clarithromycin resistance in Helicobacter pylori strains isolated from Korean patients. 2008 42