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  • 1
    Electronic Resource
    Electronic Resource
    Effect of H. pylori Infection and CagA Status on Leukocyte Counts and Liver Function Tests: Extra-Gastric Manifestations of H. pylori Infection (1998)
    Cambridge, MA, USA : Blackwell Science Inc, Boston, USA
    Helicobacter 3 (1998), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It has been suggested that H. pylori infection is associated with abnormalities in total leukocyte count as well as the number of basophils and lymphocytes. In addition, CagA seropositivity has been associated with an increase in serum transaminase (SGOT) values. The aim of this study was to confirm the findings of previous subgroup analyses in patients before and after treatment for H. pylori infection and to ascertain whether the abnormalities reversed following successful treatment.〈section xml:id="abs1-2"〉〈title type="main"〉Methods.Blood counts and serum transaminase levels were obtained prior to and following treatment of H. pylori infection of H. pylori-infected duodenal ulcer patients. CagA status was assessed by Western blot of the H. pylori isolates obtained from the patients.〈section xml:id="abs1-3"〉〈title type="main"〉Results.Ninety-four ulcer patients were studied, including 77 with CagA-positive H. pylori isolates (82%) and 17 with CagA-negative H. pylori isolates. All study parameters remained within normal limits both before and after therapy. There were no significant changes in any study parameter in those who failed therapy. Successful therapy resulted in a significant fall in total white cell count (7413 ± 520 cmm to 6738 ± 410 cmm, for pretreatment vs. cured, respectively, p = 0.04) and was almost entirely accounted for by a reduction in the number of circulating polymorphonuclear leukocytes (4595 ± 370 cmm to 3855 ± 270 cmm for pretreatment vs. cured, respectively, p = 0.015). The pretreatment SGOT and basophil count were significantly higher in those with CagA-positive H. pylori (SGOT = 23 ± 1 vs. 18.5 ± 1 U). Successful or failed therapy with follow-up for 3 months post therapy did not result in a significant change of SGOT levels.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions.We confirmed an increase in total leukocyte count and number of polymorphonuclear leukocytes in those with H. pylori infection. We also confirmed higher SGOT levels with CagA-positive H. pylori infection, but the failure to resolve within 3 months of cure of the infection makes it unlikely to be a direct result of the H. pylori infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-5378.1998.08018.x
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  • 2
    Electronic Resource
    Electronic Resource
    Characterization of a Culture Method to Recover Helicobacter pylori from the Feces of Infected Patients (2000)
    Boston, MA, USA : Blackwell Science Ltd
    Helicobacter 5 (2000), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background. Helicobacter pylori is difficult to culture from stool. Multiple efforts from multiple laboratories have been unsuccessful, and the optimal conditions to recover H. pylori from stool are still not known. Recovery of H. pylori from feces of infected individuals is important for the performance of molecular epidemiological investigations, especially in children, where their symptoms do not warrant endoscopy to recover the organism.Methods. Fresh fecal specimens (noncathartic) were obtained from 19 known H. pylori–infected patients and were processed to recover the organism. Fresh fecal specimens (noncathartic) were also obtained from three known H. pylori–negative individuals (controls) to determine whether H. pylori could be isolated from stools seeded with known concentrations of the organism. Treatment of the fecal suspensions with cholestyramine, a basic anion exchange resin that binds bile acids, was used in an attempt to enhance recovery of H. pylori by sequestering bile acids that are inhibitory to H. pylori growth. H. pylori was identified based on colony morphology, cell morphology, Gram's stain, biochemical reactions, and polymerase chain reaction for two H. pylori genes.Results. Among 19 patients, H. pylori was cultured at least once from 3 and three times from 2 (5 of 19). Feces that were seeded with H. pylori and obtained from three H. pylori–negative volunteer controls yielded positive recovery in all instances.Conclusion. We have confirmed that it is possible to culture H. pylori from human stool, but the procedure for optimal recovery has still not been defined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-5378.2000.00026.x
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  • 3
    Electronic Resource
    Electronic Resource
    Development of a Murine Model of Helicobacter pylori Infection (1997)
    Cambridge, MA, USA : Blackwell Science, Inc.
    Helicobacter 2 (1997), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A murine model for Helicobacter pylori infection could facilitate vaccine development. This study was designed to determine the effect of various conditions of dose, frequency of administration, and fasting on H. pylori infection of mice.〈section xml:id="abs1-2"〉〈title type="main"〉Materials and Methods.Balb/c and C3H/HeN mice were inoculated orogastrically with clinical isolates of H. pylori grown in liquid culture. At 2-week intervals, the stomachs were removed for secondary culture on horse blood agar and for histological analysis. H. pylori from secondary cultures or homogenized stomach tissue from infected mice was inoculated a second time in naïve animals.〈section xml:id="abs1-3"〉〈title type="main"〉Results. H. pylori was cultured with high frequency only from the stomachs of C3H/HeN mice. Fasting the mice and increasing the number of organisms inoculated did not increase the rate of infection. Histological analysis detected no inflammation, but mucus depletion and erosion were present in the stomachs of C3H/HeN mice. H. pylori organisms were not observed. Secondary cultures of H. pylori or homogenized infected stomach tissue did not cause infection when inoculated in naïve mice.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions.Clinical isolates of H. pylori transiently infect C3H/HeN mice. This murine model is suitable for testing oral vaccines. Effective vaccination against H. pylori could prevent transient infection and reduce subsequent gastritis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-5378.1997.tb00062.x
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  • 4
    Electronic Resource
    Electronic Resource
    Eradication of Helicobacter pylori by 7-Day Triple-Therapy Regimens Combining Pantoprazole with Clarithromycin, Metronidazole, or Amoxicillin in Patients with Peptic Ulcer Disease: Results of Two Double-Blind, Randomized Studies (2003)
    Oxford, UK : Blackwell Science Ltd
    Helicobacter 8 (2003), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim.  To compare the short-term (7-day) safety and efficacy of two triple-therapy regimens using pantoprazole with those of two dual-therapy regimens (one with pantoprazole and one without), for Helicobacter pylori eradication in patients with peptic ulcer disease.Methods.  H. pylori infection was identified by rapid urease (CLOtest), and confirmed by histology and culture. Patients were enrolled into one of two randomized, double-blind, multicenter, parallel-group studies. In study A, patients received oral pantoprazole 40 mg, clarithromycin 500 mg, and metronidazole 500 mg (PCM); pantoprazole, clarithromycin and amoxicillin 1000 mg (PCA); or pantoprazole and clarithromycin (PC). In study B, patients received PCM, PCA, PC, or clarithromycin and metronidazole without pantoprazole (CM). Treatments were given twice daily for 7 days. H. pylori status after therapy was assessed by histology and culture at 4 weeks after completing the course of study treatment. Modified intent-to-treat (MITT; each study: n = 424, n = 512) and per-protocol (PP; each study: n = 371, n = 454) populations were analyzed. The MITT population comprised all patients whose positive H. pylori status was confirmed by culture and histology; the PP population comprised patients who also complied with ≥ 85% of study medication doses.Results.  A total of 1016 patients were enrolled. Cure rates among patients with clarithromycin-susceptible H. pylori strains were 82 and 86% for PCM, and 72 and 71% for PCA, in studies A and B, respectively. Cure rates among patients with metronidazole-susceptible H. pylori strains were 82 and 87% for PCM, and 71 and 69% for PCA, in studies A and B, respectively. The combined eradication rates observed with the PCM regimen were superior to those of all other regimens tested. Side-effects were infrequent and mild.Conclusions.  PCM had the highest overall eradication rate in these two studies examining 7-day treatment regimens. All regimens were safe and well tolerated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-5378.2003.00179.x
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  • 5
    Electronic Resource
    Electronic Resource
    Is Antrum or Corpus the Best Site for Culture of Helicobacter pylori? (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Helicobacter 1 (1996), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: BackgroundIsolating Helicobacter pylori on culture media and performing antibiotic susceptibility testing is potentially the most useful tool for guiding antibiotic therapy, especially when antimicrobial resistance is suspected. The aim of this study was to determine whether the yield of H. pylori culture was related to the site from which the gastric specimen was obtained either before or after therapy. Methods.Gastric mucosal biopsies from the antrum and the corpus of the stomach were cultured. H. pylori status was determined by histological assessment using the Genta stain. Results.Fifty-two patients with documented H. pylori infection were studied: Twenty-three were tested before antibiotic therapy and 29 after therapy had failed. In 47 patients (90%), both antral and corpus culture specimens were positive. In 5 patients (10%), only one site was positive, with three false-negative antral and two false negative corpus cultures. The overall sensitivity of culture in detecting H. pylori infection was 95% (95% confidence interval = 89–98%) and was not significantly different for the antrum or corpus, either before or after therapy. Conclusion.Culture of gastric biopsies from either the antrum or the corpus has an excellent diagnostic yield even in patients who failed antimicrobial therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-5378.1996.tb00016.x
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  • 6
    Electronic Resource
    Electronic Resource
    Culture of Helicobacter pylori: Effect of Preimmersion of Biopsy Forceps in Formalin (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Helicobacter 1 (1996), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background.Treatment of antibiotic-resistant Helicobacter pylori should be based on bacterial sensitivity testing that requires the ability to isolate the bacterium from gastric mucosal biopsies. The aim of this study was to determine whether the yield for detecting H. pylori infection by culture is reduced by immersion of biopsy forceps in formalin prior to obtaining the specimen. Materials and Methods.Gastric antral mucosal biopsies (100 specimens) from 50 patients were obtained for culture of H. pylori. An antral biopsy was taken for culture, and with the same forceps a biopsy was taken for histological examination. The biopsy specimen was removed by shaking, whereas the forceps was immersed in 10% buffered formalin for the histological investigation. The forceps was then used without rinsing to obtain a second specimen for culture from an area adjacent to the first site. H. pylori status was determined by histological assessment with the Genta stain and a rapid urease test. Results.Fifty patients with H. pylori infection documented by histological inquiry and positive rapid urease testing entered the study; 29 had duodenal ulcers, 5 had gastric ulcers, 1 had mucosal associated lymphoid tissue (MALT) lymphoma, and 15 were without ulcer disease. The results of culture both before and after immersion in formalin were identical. One patient had both cultures negative; the sensitivity of culture for detection of H. pylori infection was 98% (95% confidence interval =93%-100%). Conclusion. Preimmersion of biopsy forceps in formalin does not adversely affect the ability to culture H. pylori.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-5378.1996.tb00010.x
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  • 7
    Electronic Resource
    Electronic Resource
    Frame-shift mutations in NAD(P)H flavin oxidoreductase encoding gene (frxA) from metronidazole resistant Helicobacter pylori ATCC43504 and its involvement in metronidazole resistance (2000)
    Oxford, UK : Blackwell Publishing Ltd
    FEMS microbiology letters 188 (2000), S. 0 
    Details
    ISSN: 1574-6968
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: Metronidazole is a critical ingredient for combination therapies of Helicobacter pylori infection, the major cause of peptic ulcer and gastric cancer. It has been recently reported that metronidazole resistance from H. pylori ATCC43504 is caused by the insertion of a mini-IS605 sequence and deletion of sequences in an oxygen insensitive NAD(P)H nitroreductase encoding gene (rdxA). We also found that an additional gene (frxA) encoding NAD(P)H flavin oxidoreductase in the same strain was truncated by frame-shift mutations. To assess whether the frxA truncation is also involved in metronidazole resistance, metronidazole sensitive H. pylori strains ATCC43629 and SS1 were transformed by the truncated frxA gene cloned from strain ATCC43504. All transformed cells grew on agar plates containing 16 μg ml−1 of metronidazole. The involvement of the frxA gene in metronidazole resistance was also confirmed by insertion inactivation of frxA and/or rdxA genes from strain ATCC43629 and one metronidazole sensitive clinical isolate H. pylori 2600. In addition, the frxA gene cloned from the H. pylori 2600 showed metronidazole nitroreductase activity in Escherichia coli and rendered ordinary metronidazole resistant E. coli to metronidazole sensitive cell. These results indicate that the frxA gene may also be involved in metronidazole resistance among clinical H. pylori isolates.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1574-6968.2000.tb09193.x
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  • 8
    Electronic Resource
    Electronic Resource
    Microflora of Gastric Biopsies from Patients with Duodenal Ulcer and Gastric Cancer (A Comparative Study of Patients from Korea, Colombia, and the United States) (1998)
    Springer
    Digestive diseases and sciences 43 (1998), S. 2291-2295 
    Details
    ISSN: 1573-2568
    Keywords: GASTRIC MICROFLORA ; DUODENAL ULCER ; GASTRIC CANCER ; BACTERIAL CONTAMINATION
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It remains unclear why the spectrum of H.pylori-related diseases differs among differentgeographic regions. We examined the non-H. pyloricontamination rates of the stomach in patients withduodenal ulcer or gastric adenocarcinoma from threedifferent regions with different spectra of H.pylori-related diseases. Gastric biopsies were culturedfrom patients with duodenal ulcer or histologicallyproven gastric cancer from Seoul, Korea; Bogota,Colombia; and Houston, Texas. The frequency of non-H.pylori contamination was tallied in relation to theclinical diagnosis. Cultures from 247 duodenal ulcer patients and 165 patients with gastric cancerhad bacterial growth. H. pylori was isolated from 207(73.7%) patients with duodenal ulcer and 90 (47.1%)patients with gastric cancer (P 〈 0.001). In patients with duodenal ulcer (DU) or gastriccancer (GC), the rate of positive cultures for H. pyloriwere not statistically different (P 〉 0.143 for DU,P 〉 0.190 for GC) between regions. The frequency of isolation ranged from 69% to 79% for DUpatients and from 39% to 50% for gastric cancerpatients. Non-H. pylori bacterial contamination wasfound more frequently (63%) in Colombian duodenal ulcerpatients compared to 30% ulcer patients from the UnitedStates or Korea (P 〈 0.001). Non-H. pylori growthoccurred in 50.8-75.5% of cancer patients and wassignificantly lower in US patients than in patients from either Colombia or Korea (P 〈 0.01).The geographic location as well as disease statusaffects the rate of H. pylori recovery and non-H. pyloricontamination of the stomach and may play a role in the geographic differences in manifestationof H. pylori infection. The fact that the proportion ofgastric cancer patients in the United States with non-H.pylori contamination was significantly less than that of Korea or Colombia shows that thenotion of an almost universal increase in gastricmicrobial content in gastric adenocarcinoma should bereconsidered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026631009190
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  • 9
    Electronic Resource
    Electronic Resource
    One-Week Triple Therapy with Lansoprazole, Clarithromycin, and Metronidazole to Cure Helicobacter pylori Infection in Peptic Ulcer Disease in Korea (1998)
    Springer
    Digestive diseases and sciences 43 (1998), S. 464-467 
    Details
    ISSN: 1573-2568
    Keywords: CLARITHROMYCIN ; HELICOBACTER PYLORI ; LANSOPRAZOLE ; METRONIDAZOLE ; TRIPLE THERAPY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy and acceptability of classicalbismuth triple therapy may be limited by poor patientcompliance and adverse effects. It is widely agreed thatimproved, simpler, and reliable therapies are needed to cure Helicobacter pylori infection andfoster patient compliance. We evaluated the efficacy andside effects of a Bazzoli triple therapy substitutinglansoprazole for omeprazole for H. pylori infection in active peptic ulcer in Korea (30 mg oflansoprazole, 250 mg of clarithromycin, and 400 mg ofmetronidazole, all twice daily). H. pylori status wasevaluated by rapid urease test, histology, and culture at entry and four or more weeks after endingantimicrobial therapy. Fifty-eight patients (mean age:43 years) with gastric (N = 30) or duodenal ulcer (N =28) and H. pylori infection were studied. H. pylori was cured in 47 (81%, 95% CI 69-90%). Mild sideeffects, including vomiting, diarrhea, and itching, wereobserved in four patients (7%). Compliance averaged 95%.Fifty-five ulcers (95%) were healed. Pretreatment pylorobulbar deformity was observed in 49patients (85%), and in 43 (88%) the deformitydisappeared after treatment. Pretreatment metronidazoleand clarithromycin resistance was observed in 87% and 2% of patients, respectively. The cure rate of H.pylori infection was significantly higher in patients〉50 years of age than those 〈50. Treatment withlow-dose one-week lansoprazole, clarithromycin, and metronidazole resulted in a relatively lowcure rate, but was well tolerated. Studies to define theoptimal duration, dose, and dosing interval of thiscombination therapy in Korea are needed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018886318740
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  • 10
    Electronic Resource
    Electronic Resource
    Osmotic Effect of Honey on Growth and Viability of Helicobacterpylori (1999)
    Springer
    Digestive diseases and sciences 44 (1999), S. 462-464 
    Details
    ISSN: 1573-2568
    Keywords: Helicobacterpylori ; HONEY ; ANTIBACTERIAL ACTIVITY ; HYDROGEN PEROXIDE ; OSMOLARITY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Honey from New Zealand and Saudi Arabia atconcentrations approximating 20% (v/v) inhibit thegrowth of H. pylori in vitro. The anti-H. pylori effectinvolves both hydrogen peroxide- andnon-peroxide-mediated killing mechanisms. This study was designed todetermine wheThe r the anti-H. pylori activity of honeydiffered regionally (honey from Texas, Iowa, and NewZealand) and to determine wheThe r this activity was due to the presence of hydrogen peroxide.Broth dilution susceptibility tests were performed usingsolutions of honey prepared in BHI broth ranging inconcentration from 5 to 35% (v/v) in 5% increments. Control solutions containing glucose, fructose,and combined glucose/fructose solutions in ratios of1:1.23 were also prepared. Paired catalase controls wereincluded in all tests. Twenty-eight clinical isolates of H. pylori were tested. Growth wasdetermined on the basis of a plus/minus grading score.All of the solutions containing eiThe r fructose,glucose, glucose and fructose combinations, or honey were equally effective in inhibiting the growthof H. pylori. All of the isolates were inhibited bysolutions containing 15% (w/v) carbohydrate. Honeysolutions, with or without catalase, inhibited 24/28 isolates at a concentration of 10%, and 28/28isolates at a concentration of 15%. In conclusion,regional differences in honey activity against H. pyloriwere not detected, nor was the effect of killing related to the presence of hydrogen peroxide inthe honey samples. Osmotic effects weReshown to be themost important parameter for killing H. pylori as allcarbohydrate solutions ≥15% (v/v) inhibited 100% of the H. pylori.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026676517213
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