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Helicobacter pylori infection: association with dietary habits and socioeconomic conditions
Abstract
Introduction:
Few studies have investigated factors possibly related to the source of Helicobacter pylori infection in humans.
Materials and methods:
This was a retrospective study including a population of 201 H.pylori positive patients and 259 H. pylori negative subjects observed at a tertiary referral center in Apulia. The H. pylori status was assessed by urea breath test. Data on socio-demographic characteristics and the consumption of different foods and beverages in the last year were collected by a questionnaire.
Results:
No significant relationship was found between H. pylori infection and gender or age, type of employment, working in direct contact with the public, residence, level of education or exposure to pets. No association between H.pylori status and the consumption of fish, fruits, legumes, honey, spices, meats, milk and milk products including some typical product of our area was found. The same was true for the consumption of several kind of beverage including green tea and wine. Cigarette smoking and living in the same house with H.pylori positive relatives were significantly associated with H. pylori positivity. The intake of uncooked seafood (mussels and other molluscs) as well as some uncooked vegetables such as tomatos,pepper,and chicory,municipal water and the number of cups of coffee consumed per week correlated significantly with H. pylori status. The consumption of raw vegetables purchased from street vendors and the consumption of meals outside home were also associated with H.pylori infection.
Conclusions:
Foods may represent an important route in the transmission of H. pylori among humans.
... Over the past years, epidemiological studies have found that diet plays a significant role in the development of H. pylori infection and investigated the association between the intake of certain foods and nutrients and the development of such infection [16][17][18]. Some studies have reported that salty, pickled, fermented, or smoked foods increased the risk of H. pylori infection [19,20]. ...
... Coffee consumption has been linked to several health benefits and some studies found an inverse association between coffee consumption and the systemic levels of some inflammatory markers [27]. However, it was reported that frequent consumption of coffee was associated with an increased rate of H. pylori infection and exacerbation of H. pylori-related gastritis symptoms [18,28]. Some studies did not find any association between coffee consumption and H. pylori infection [10,29,30]. ...
... Alebie et al. (2016) in a study that included 145 Ethiopian students with gastritis found that consumption of coffee exacerbates H. pylori related gastritis symptoms [28]. Monno et al. (2019) in a retrospective study conducted in Italy revealed that the frequent consumption of coffee increases the H. pylori infection rate [18], while other studies did not find any association between coffee consumption and H. pylori infection [10,29,30]. The relationship between coffee consumption and H. pylori infection might be attributed to the differences in the type of coffee consumed and preparation methods. ...
Helicobacter pylori (H. Pylori) infection is the main bacterial cause of several gastrointestinal disorders. This study aims to estimate the prevalence of H. pylori infection in a population of Bahraini adults seeking care in gastroenterology clinics in a tertiary care hospital in the Kingdom of Bahrain and examine the association between dietary habits and other factors with H. pylori infection. The study is a hospital-based retrospective, cross-sectional analytical study that included 200 participants. H. pylori infection prevalence among the studied group was 55.5%, and it was significantly higher among participants with a high school education or less (44.1%). Among dietary habits, the mean of frequency of green tea, coffee and honey intake was significantly lower among the H. pylori infected participants compared to their non-infected counterparts. H. pylori infection was significantly higher among participants with vitamin D deficiency (63.6%) compared to participants with normal vitamin D (30%) (p = 0.001) and each unit decrease in serum vitamin D was associated with an increased risk of infection by 1.1 times (OR = 1.1; 95% CI: 1.05, 1.18; p < 0.001). The study revealed that high educational levels, consumption of honey, green tea, and coffee, as well as normal serum vitamin D level, were independent protectors against H. pylori infection. Additional studies are needed to estimate the prevalence and predisposing factors of H. pylori infection in the general population.
... Literature suggested that H. pylori infection was associated with age [21], race [21], education [22], poverty [21], body mass index (BMI) [23], smoking [24], alcohol [25], caffeine [26], vitamin C [27], sources of drinking water (well or municipal) [28], home water treatment devices [29] and the amounts of lead and cadmium in blood [29]. The 1999-2000 cycle of the NHANES contains the data on these factors, and they are considered as covariates in this study. ...
... In this study, the results of the bivariate chi-square tests indicated associations between H. pylori seroprevalence and the variables of age [21], race [21], education [22], poverty [21], smoking [24] and levels of lead and cadmium in blood [29] were similar to previously published literature. Whereas, the results on BMI [23], caffeine [26], vitamin C [27], water treatment and source of ...
... Whereas, Shinchi et al. [34] found no relationship between smoking and H. pylori infection in 566 Japanese men aged 50-55 years. Another example is caffeine intake, the study of Monno et al. [26] with 580 participants between 18 and 54 years of age found that coffee consumption was positively correlated with H. pylori status, whereas Shimamoto et al. [35] showed that coffee consumption was not a risk factor for H. pylori infection in 8013 participants. The characteristics of the participants in this study were dissimilar with the above-mentioned studies, as they were female-only and most of them were 20-50 years of age. ...
Recently, the antibacterial properties of oestrogen and progestogen were discovered. The aim of this study was to find the cross-sectional association between oral contraceptive use and Helicobacter pylori seroprevalence. Data were obtained from the US National Health and Nutrition Examination Survey (NHANES). The H. pylori immunoglobulin G (IgG) enzyme-linked immunosorbent assays were used to categorise participants as seropositive or seronegative. The study population included 799 female participants who had information on H. pylori seroprevalence and all other covariates and had not been taking any medications (except oral contraceptives). The bivariate Rao–Scott chi-square test indicated a significant association between H. pylori seroprevalence and contraceptive use ( P < 0.01). The variables of race, education, poverty income ratio, smoking, and blood lead and cadmium levels were also significantly associated with H. pylori seroprevalence ( P < 0.01). Multiple logistic regression analysis of the age-adjusted model revealed that contraceptive users are 65% less likely of being H. pylori seropositive as compared to non-contraceptive users (odds ratio (OR): 0.35, 95% confidence interval (CI): 0.18–0.68). This association is stronger with the final multivariate model (OR: 0.46, 95% CI: 0.23–0.89). Conclusions : This finding reveals the potential protective effect of oral contraceptives against H. pylori infection and serves as a foundation study for further investigations.
... Although the regimens of eradication therapy have been designed and widely applied, successful eradication of H. pylori is still a global challenge. The increased risk of H. pylori infection is related to environmental factors, including living in low-income countries and having a lower socioeconomic status [4], occupation, water supply, and dietary habits [5,6]. Accordingly, to clarify such risk factors may contribute to the prevention of H. pylori-associated diseases. ...
... Although a significant difference was not found, H. pylori-positive cases showed a higher proportion of some risk factors, e.g., residence in rural areas, nonfiltered water, and smoking, compared with H. pylori-negative cases. This finding is consistent with the view that H. pylori infection is associated with dietary habits and lifestyle, as described previously [5,6]. However, >60% of both H. pylori-positive and -negative cases were categorized into a group of lower socioeconomic status in our study, probably due to local areas in low-income country. ...
Chronic infection of Helicobacter pylori represents a key factor in the etiology of gastrointestinal diseases, with high endemicity in South Asia. The present study aimed to determine the prevalence of H. pylori among dyspeptic patients in north–central Bangladesh (Mymensingh) and analyze risk factors of infection and antimicrobial resistance (AMR) determinants in the pathogen. Endoscopic gastrointestinal biopsy samples were collected from dyspeptic patients for a one-year period from March 2022 and were checked for the presence of H. pylori via the rapid urease test and PCR and further analyzed for the status of virulence factors vacA/cagA and genetic determinants related to AMR via PCR with direct sequencing or RFLP. Among a total of 221 samples collected, 80 (36%) were positive for H. pylori, with the vacA+/cagA+ genotype being detected in almost half of them. H. pylori was most prevalent in the age group of 41–50-year-olds, with it being more common in males and rural residents with a lower economic status and using nonfiltered water, though the rates of these factors were not significantly different from those of the H. pylori-negative group. Relatively higher frequency was noted for the A2147G mutation in 23S rRNA, related to clarithromycin resistance (18%, 7/39). Amino acid substitutions in PBP-1A (T556S) and GyrA (N87K and D91N) and a 200 bp deletion in rdxA were detected in samples from some patients with recurrence after treatment with amoxicillin, levofloxacin, and metronidazole, respectively. The present study describes the epidemiological features of H. pylori infection in the area outside the capital in Bangladesh, revealing the spread of AMR-associated mutations.
... A significant association between cigarette smoking and residing in the same household as H. pyloripositive families was observed in H. pylori positivity (Monno et al., 2019). Additionally, Itskoviz et al. (2017) reported that smoking was found to significantly elevate the likelihood of ineffective firstline treatment for H. pylori infection. ...
Helicobacteriosis is a common bacterial infection caused by Helicobacter pylori. It affects the stomach and small intestines, leading to inflammation. Bacteria can spread through contaminated food or water. This review explores the role of food in the transmission of H. pylori, drawing on research from the past three decades. People commonly acquire the infection during childhood, often from close family members. Crowded living conditions can also contribute to the spread. This review also discusses various risk factors and highlights the challenges of detecting H. pylori, particularly in its dormant form. Techniques like ribotyping and restriction fragment length polymorphism hold promise for tracing transmission routes, but more long-term studies are needed to account for potential confounding factors.
... HP has the capacity to form biofilms and thrive as colonies on the surfaces of vegetables, greatly extending its survival [39]. This is why frequent consumption of raw vegetables like cucumbers [40], tomatoes, and peppers [41] has been associated with an increased risk of HP infection in some studies. However, relatively speaking, groups with higher fruit and vegetable consumption are usually more affluent and better educated [42], especially since our study population came from a developed country like the United States, which typically boasts better sanitary conditions compared to many other countries. ...
Background
Diet plays an important role in Helicobacter pylori (HP) infection, and our objective was to investigate potential connections between dietary patterns, specific food groups, and HP infection status in U.S. adults.
Methods
The data for this study was obtained from the NHANES (National Health and Nutrition Survey) database for the year 1999–2000. This cross-sectional study involved the selection of adults aged 20 years and older who had undergone dietary surveys and HP testing. Factor analysis was employed to identify dietary patterns, and logistic regression models were utilized to assess the association between these dietary patterns and specific food groups with HP infection status.
Result
Based on the inclusion and exclusion criteria, our final analysis included 2,952 individuals. The median age of participants was 51.0 years, and 48.7% were male. In the study population, the overall prevalence of HP infection was 44.9%. Factor analysis revealed three distinct dietary patterns: High-fat and high-sugar pattern (including solid fats, refined grains, cheese, and added sugars); Vegetarian pattern (comprising fruits, juices, and whole grains); Healthy pattern (encompassing vegetables, nuts and seeds, and oils). Adjusted results showed that the high-fat and high-sugar pattern (OR = 0.689, 95% CI: 0.688–0.690), vegetarian pattern (OR = 0.802, 95% CI: 0.801–0.803), and healthy pattern (OR = 0.717, 95% CI: 0.716–0.718) were all linked to a lower likelihood of HP infection. Further analysis of the high-fat and high-sugar pattern revealed that solid fats (OR = 0.717, 95% CI: 0.716–0.718) and cheese (OR = 0.863, 95% CI: 0.862–0.864) were protective factors against HP infection, while refined grains (OR = 1.045, 95% CI: 1.044–1.046) and added sugars (OR = 1.014, 95% CI: 1.013–1.015) were identified as risk factors for HP infection.
Conclusion
Both the Vegetarian pattern and the Healthy pattern are associated with a reduced risk of HP infection. Interestingly, the High-fat and High-sugar pattern, which is initially considered a risk factor for HP infection when the score is low, becomes a protective factor as the intake increases. Within this pattern, animal foods like solid fats and cheese play a protective role, while the consumption of refined grains and added sugars increases the likelihood of HP infection.
... The observed regional disparities in the incidence of gender-based disparities may be attributed to changes in socioeconomic, nutritional, and cultural determinants. In contrast, (Monno et al., 2019) found no statistically significant association between H. pylori infection and gender. Also, they reported that the high prevalecne was in the age 31-50 (36.32%). ...
Introduction and Aim: Helicobacter pylori is a gram-negative bacterium that affects up to half of the world's population, particularly in poorer nations. It is the leading cause of chronic gastritis, ulcers, gastric lymphoma, and gastric cancer, with more frequent cases in children and adolescents. Transmission can occur through fecal-oral, gastro-oral, oral-oral, or sexual means. The infection is caused by H. pylori's urease activity, invasion of host gastric epithelial cells, and adherence to host cell receptors. Early treatment can enhance gastric protection. Materials and Methods: Between November 2022 and July 2023, 103 samples were collected from patients at Mihrabani Surgical Hospital in Erbil City to identify Helicobacter pylori infection. Blood samples and stool samples were used to test for antibodies. Results: The study found a relatively equal gender representation in the patient and control groups, with 48.48% of men in the patient group and 48.64% in the control group. However, there are significant differences in age distribution, with G3 of age (<35) having the highest prevalence of H.pylori (48.48%). Additionally, 62.12% of patients are rural residents, while 97.29% of the control group are urban residents. Finally, 56.07% of patients are married, indicating a significant difference. Conclusion: The study found equal gender representation in patient and control groups but significant age differences, rural residency, and marital status, with G3 under 35 having the highest H.pylori prevalence.
... 10,11 Specifically, a higher socioeconomic status has been associated with lower hospitalization rate from infections, 12 lower incidence of certain infectious diseases, such as sexually transmitted diseases, clostridium difficile infection, helicobacter pylori infection, and acute respiratory infections. [13][14][15][16][17] Indeed, socioeconomic deprivation has been associated with worse health outcomes in certain categories of patients. These factors include limited access to healthcare services, poor living conditions, educational and linguistic obstacles in understanding and adopting preventative measures, overcrowded households due to cultural reasons, socialization patterns, long-standing structural inequalities, institutional racism relating to housing, immigration, and social welfare support. ...
Introduction
SARS‐CoV‐2 infection has had a significant impact on vulnerable individuals including transplant patients. Socioeconomic deprivation negatively affects outcomes of many health conditions. The aim of this study was to evaluate the effect of socioeconomic deprivation on the incidence and severity of SARS‐CoV‐2 infection among Welsh transplant patients.
Methods
This study is a retrospective, cross‐sectional study on the transplant population of Wales. The Welsh Index of Multiple Deprivation (WIMD) was used to assess the influence of socioeconomic deprivation on outcomes of Welsh transplant patients who developed SARS‐CoV‐2 infection. Outcome measures were the incidence of SARS‐CoV‐2 infection, rates of hospital and ICU admission, development of acute kidney injury (AKI) and mortality. A logistic binomial regression analysis was used to correlate the various risk factors with the incidence of SARS‐CoV‐2 infection.
Results
Two hundred and sixty‐six (25%) of regular follow up patients had SARS‐CoV‐2 infection; of these 55 (20.7%) were admitted, 15 (5.6%) to ICU, 37 (13.9%) developed AKI, and 23 (8.6%) died. In a regression analysis, patients of younger age were associated with more ( p = .001) and those with SPK (simultaneous pancreas kidney) transplant less chance of infection ( p = .038), whereas social deprivation was not associated with the chance of infection ( p = .14). In regression analysis increased social deprivation was associated with higher chance of AKI post SARS‐CoV‐2 ( p = .049).
Conclusions
Socioeconomic deprivation did not affect the rates or severity of SARS‐CoV‐2 infection apart from the degree of AKI in Welsh Transplant patients. Adherence to the preventive measures for this high‐risk population must continue to remain a priority.
... 48 There have been conflicting results on whether smoking could increase the risk of H. pylori infection. [56][57][58][59] Nevertheless, we found no association between the two. A pooled analysis also found the same result. ...
Background Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive epidemiologic study is necessary to explore infection susceptibility by demographic characteristics, especially between Indonesia’s Eastern and Western regions. Methods We included our recent survey and data from our previous studies with 1,172 endoscopic examinations from 19 cities throughout Indonesia from January 2014 to March 2017. H. pylori infection was diagnosed based on a combination of four different tests. Using a criterion of one positive result between four tests, we found that 190 subjects (190/1,158; 16.4%) were H. pylori positive. A total of 939 subjects who has complete data were analyzed for risk factors of H. pylori infection. Results Prevalence was slightly higher in the Eastern region compared with the Western region of Indonesia (79/277; 59.4% vs. 54/529; 40.6%). Living in the Eastern region imposes a higher risk of infection (OR 5.33, 95%CI 1.17–24.26). Timor ethnicity had the highest prevalence (15/28; 53.6%), followed by Buginese ethnicity (21/74; 28.4%), and Papuan ethnicity (18/64; 28.1%) in the Eastern region. As an ethnicity with a high prevalence (37/109; 33.9%), Batak was an outlier among the low prevalence areas in the Western region. In general, age, living in the Eastern region, Batak ethnicity, Protestant, Catholic, and alcohol drinking were independent risk factors associated with H. pylori infection in Indonesia (OR 1.03, 95%CI 1.02–1.05; OR 5.33, 95%CI 1.17–24.26; OR 5.89, 95%CI 1.58–21.94; OR 5.47, 95%CI 2.16–13.86; OR 5.05, 95%CI 1.43–17.80; OR 2.30, 95%CI 1.14–4.61, respectively). Conclusions Several ethnicities and habits were concluded to increase the risk of infection as the interaction of host, agent, and environment is inseparable in affecting disease susceptibility.
... Despite the decreasing rate of Helicobacter bacteria in developed countries, the prevalence of this infection is still high in developing countries among socioeconomically deprived populations living in crowded places with poor sanitation conditions [10,11]. ...
Purpose
Helicobacter pylori (HP) is the most common human infection that has affected up to 50% of the population worldwide. The relationship between HP eradication and weight loss is under debate. The present study aimed to compare weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in HP-negative (HP−) and HP-eradicated (HPe) patients during five years follow-ups.
Methods
This retrospective cohort study was conducted on 305 patients aged 18 and more with severe obesity, who underwent primary RYGB from February 2014 to November 2017. The HP-negative and HP-eradicated patients were evaluated for weight loss outcomes during five years follow-ups.
Results
Patients' mean age, mean weight, and mean body mass index were 38.78 ± 9.9, 114.8 ± 13.6, and 43.37 ± 2.55, respectively. 27.2% of patients who were HP-positive were treated before RYGB. There was no significant difference between the HP− and HPe patients in terms of total weight loss percent (%TWL), 12 to 60 months after RYGB. Excess weight loss percent (%EWL) was higher in HPe patients compared to HP− patients (P = 0.04) at 12-month after RYGB. However, there was no difference in %EWL between these two groups of patients, 36 and 60 months after RYGB.
Conclusion
The results of the present study showed that TWL% had no significant difference in HP− and HPe groups during five years follow-ups after RYGB. The %EWL was higher in HPe patients only at 12 months after RYGB and the difference did not persist over time.
Graphical Abstract
... Helicobacter pylori is one of the bacteria in uncooked vegetables, which are quite common in street foods. 49 If atherosclerosis, mental health issues, and peptic ulcer are considered civilizational diseases, we still do not know what other civilizational diseases humans are yet to face and which alternate model systems will be sufficient and reliable enough to understand them and to identify safe and affordable drugs in a timely manner. ...
Animal‐based research and drug safety studies are essential to understanding the mysteries of nature and the long‐term survival of humans. Due to the rapid increase in the global human population, conflict‐ and economically driven human migration, tourism‐related activities, densely populated metropolitan areas, and local policies, humans will be affected by a multitude of novel disease‐causing microorganisms and civilizational diseases. Despite disparities among countries, recent and planned changes in regulations concerning animal research and drug safety studies could have detrimental effects on both the animal research community and nations lacking sufficient social support systems. Based on existing scientific literature, I argue that we need animal research encompassing aspects such as animal development, behavior, drug safety studies, and for the understanding of future civilizational diseases. Depending on the nature of the research questions and local challenges, a suitable animal model organism should be made mandatory.
... This finding is consistent with that of other research. In a retrospective study at a tertiary referral center of Apulia, HP positivity was significantly associated with HP positive relatives [42]. Further, a meta-analysis reported that HP infection was significantly correlated with having a sibling or siblings infected with HP (OR = 3.33, 95% CI: 1.53-7.26) in children aged ≤ 18 years [43]. ...
Background
Helicobacter pylori (HP) infection is associated with various diseases. Early detection can prevent the onset of illness. We constructed a nomogram to predict groups at high risk of HP infection.
Methods
Patients who underwent regular medical check-ups at hospital in Chaoshan, China from March to September 2022 were randomly allocated to the training and validation cohorts. Risk factors including basic characteristics and lifestyle habits associated with HP infection were analyzed by logistic regression analyses. The independent varieties were calculated and plotted into a nomogram. The nomogram was internally validated by receiver operating characteristic curve, calibration, and decision curve analyses (DCAs).
Results
Of the 945 patients, 680 were included in the training cohort and 265 in the validation cohort. 356 patients in training cohort with positive 13 C-UBT results served as the infected group, and 324 without infection were the control group. The multivariate regression analyses showed that the risk factors for HP infection included alcohol consumption (OR = 1.29, 95%CI = 0.78–2.13, P = 0.03), family history of gastric disease (OR = 4.35, 95%CI = 1.47–12.84, P = 0.01), living with an HP-positive individual (OR = 18.09, 95%CI = 10.29–31.82, P < 0.0001), drinking hot tea (OR = 1.58, 95%CI = 1.05–2.48, P = 0.04), and infection status of co-drinkers unknown (OR = 2.29, 95%CI = 1.04–5.06, P = 0.04). However, drinking tea > 3 times per day (OR = 0.56, 95%CI = 0.33–0.95, P = 0.03), using serving chopsticks (OR = 0.30, 95%CI = 0.12–0.49, P < 0.0001) were protective factors for HP infection. The nomogram had an area under the curve (AUC) of 0.85 in the training cohort. The DCA was above the reference line within a large threshold range, indicating that the model was better. The calibration analyses showed the actual occurrence rate was basically consistent with the predicted occurrence rate. The model was validated in the validation cohort, and had a good AUC (0.80), DCA and calibration curve results.
Conclusions
This nomogram, which incorporates basic characteristics and lifestyle habits, is an efficient model for predicting those at high risk of HP infection in the Chaoshan region.
... According to the current research, more than 75% of mothers were found to be eating from street vendors. This study's results were supported by Monno et al. 2019 [20] , who did research on H. pylori infection: connection with food habits and socioeconomic circumstances and found that eating food from street sellers and having meals away from home were strongly related to infection with H. pylori. This result was in harmony with research by Ahmed et al. 2014 [21] on the transmission of H. pylori from food cooked and consumed under sanitary and unsanitary conditions: a preliminary study employing biopsy samples found that individuals who bought and consumed food from street vendors on a daily basis had a prevalence of 90.9%, whereas those who consumed the food products once a week or once a month had a lower incidence. ...
... 27 Differences in sex in the prevalence of H. pylori infection among adults may be explained by distinct exposure to environmental factors such as smoking, which has been associated in the literature with an increased risk of H. pylori infection. 28 It has also been hypothesized that physiological differences, especially sex hormones, may affect immunity and inflammatory responses to H. pylori differently in males and females. These hormones may interfere directly or indirectly with cell receptors, thereby altering the immune response. ...
Background
Helicobacter pylori (H. pylori) is a group 1 carcinogen and the etiological agent of gastric diseases such as gastritis, ulcers, and gastric cancer. It infects approximately half of the world’s population. Risk factors associated with H. pylori infection include socioeconomic status, lifestyle, and diet.
Objectives
This study aimed to evaluate the association between eating habits and H. pylori infection in patients from a reference hospital in Central Brazil.
Design
This cross-sectional study included 156 patients from 2019 to 2022.
Methods
Data were collected using a structured questionnaire on sociodemographic and lifestyle characteristics and a validated food frequency questionnaire. The H. pylori infection status (positive versus negative) was determined using the histopathological method. After grams/day, foods were stratified into tertiles of consumption (low, medium, and high). Simple and multiple binary logistic regression models were used in the analysis of odds ratios (ORs) and their respective 95% confidence intervals (CIs), with a 5% significance level.
Results
The prevalence of H. pylori infection was 44.2% (69/156 patients). Infected individuals had a mean age of 49.6 ± 14.6 years; 40.6% were men, 34.8% were aged 60 years or older, 42.0% were unmarried, 7.2% had higher education, 72.5% were non-white, and 30.4% were obese. In the H. pylori-positive group, 55.1% were alcohol drinkers and 42.0% were smokers. The results of multiple analyses showed that the chance of H. pylori infection was higher among male participants (OR = 2.25; CI = 1.09–4.68) and individuals with obesity (OR = 2.68; CI = 1.10–6.51). Participants with moderate consumption of refined grains (bread, cookies, cakes, breakfast cereal) (OR = 2.41; CI = 1.04–5.62) and fruits (OR = 2.53; CI = 1.08–5.94) were more likely to be infected.
Conclusion
In this study, male sex, obesity, and the consumption of refined grains and fruits were positively associated with H. pylori infection. Further research is needed to investigate this association and elucidate the underlying mechanisms.
... Assaad et al. [ 16 ] found no relationship between H. pylori positivity and dietary habits in hospitalized patients. Monno et al. [ 17 ] reported in their study a significant correlation between the consumption of uncooked sea food (mussels and other mollusks), uncooked vegetables, municipal water and cups of coffee per week and H. pylori positivity. Similarly, Mard et al. [ 18 ] stated that low consumption of vegetables may increase the H. pylori positivity and infection severity. ...
The purpose of this study is to investigate the relationship between the dietary habits of obese women aged above 18 and the Helicobacter pylori (H. pylori). Five hundred and sixty-one women aged above 18 were included in the study. Patients filled in questionnaires consisting of questions regarding their sociodemographic variables, chronic diseases and dietary habits. Blood samples taken from the patients were tested according to the H. pylori kit procedures and the results were categorized as positive and negative. In the study, obese and nonobese patients were compared and then H. Pylori positive and negative groups were compared. No significant difference was found between groups in terms of H. pylori in the comparison of obese and nonobese patients (p = 0.272). When H. pylori positive and negative groups of obese patients were compared in terms of their dietary habits, consumption rates of butter, whole-fat or lowfat milk, cookies-cake etc., and chocolate-candies were detected to be higher in the H. pylori positive group (p < 0.05). Red meat consumption (p = 0.044) and smoking rates were lower (p = 0.001). There was no significant difference between groups in terms of the consumption rates of bread, rice/pasta, corn, cheese, chicken, fish, sausages, fruit, vegetables, legumes and salt. No significant difference was found between obese and nonobese women in terms of H. pylori positivity. It was observed that H. pylori positive obese women had higher consumption rates of butter, whole-fat or low-fat milk, cake-cookies etc., and chocolate-candies.
... 48 There have been conflicting results on whether smoking could increase the risk of H. pylori infection. [56][57][58][59] However, we found no association between the two. A pooled analysis also found the same result. ...
Background: Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive epidemiologic study is necessary to explore infection susceptibility by demographic characteristics, especially between Indonesia’s Eastern and Western regions.
Methods: We included our recent survey and data from our previous studies with 1,172 endoscopic examinations from 19 cities throughout Indonesia from January 2014 to March 2017. H. pylori infection was diagnosed based on the combination of four different tests. Using a criterion of one positive result between four tests, we found that 190 subjects (190/1,158; 16.4%) were H. pylori positive. A total of 939 subjects were analyzed for risk factors of sociodemographic characteristics to H. pylori infection.
Results: Prevalence was slightly higher in the Eastern region compared with the Western region of Indonesia (79/277; 59.4% vs. 54/529; 40.6%). Living in the Eastern region imposes a higher risk of infection (OR 5.33, 95%CI 1.17–24.26). Timor ethnicity had the highest prevalence (15/28; 53.6%), followed by Buginese ethnic (21/74; 28.4%), and Papuan ethnic (18/64; 28.1%) in the Eastern region. As an ethnicity with a high prevalence (37/109; 33.9%), Batak was an outlier among the low prevalence areas in the Western region. In general, age, living in the Eastern region, Batak ethnicity, Protestant, Catholic, and alcohol drinking were independent risk factors associated with H. pylori infection in Indonesia (OR 1.03, 95%CI 1.02–1.05; OR 5.33, 95%CI 1.17–24.26; OR 5.89, 95%CI 1.58–21.94; OR 5.47, 95%CI 2.16–13.86; OR 5.05, 95%CI 1.43–17.80; OR 2.30, 95%CI 1.14–4.61, respectively).
Conclusions: Several ethnicities and habits were concluded to increase the risk of infection as the interaction of host, agent, and environment is inseparable in affecting disease susceptibility.
... Unfortunately, this pathogen can survive in contaminated water and food products for long periods of time (Quaglia and Dambrosio, 2018;Ghanbari et al., 2020). In order to understand the emerging foodborne and waterborne diseases associated with H. pylori, Monno et al. (2019) investigated the relation between dietary habits and H. pylori infection status in Apulia (Southern of Italy). The authors reported that there was a significant relationship between H. pylori positivity and consumption of some foods, such as raw mussels and other molluscs, which had been extensively consumed by local people of that area. ...
Helicobacter pylori (H. pylori) is a notorious, recalcitrant and silent germ, which can cause a variety of debilitating stomach diseases, including gastric and duodenal ulcers and gastric cancer. This microbe predominantly colonizes the mucosal layer of the human stomach and survives in the inhospitable gastric microenvironment, by adapting to this hostile milieu. In this review, we first discuss H. pylori colonization and invasion. Thereafter, we provide a survey of current curative options based on polypharmacy, looking at pharmacokinetics, pharmacodynamics and pharmaceutical microbiology concepts, in the battle against H. pylori infection.
... However, the association between H. pylori infection and dietary habits remains inconsistent. It has been reported that intake of some uncooked vegetables and seafood, such as tomato, pepper, and mussels, correlates significantly with H. pylori infection (48). In contrast, no association is observed between H. pylori infection and intake of fruits, fish, legumes, honey, spices, meats, milk, and milk products. ...
Background
Helicobacter pylori (H. pylori) infection increases the risk for atherosclerosis, and ROS are critical to endothelial dysfunction and atherosclerosis. CagA is a major H. pylori virulence factor associated with atherosclerosis. The present study aimed to test the hypothesis that CagA ⁺ H. pylori effectively colonizes gastric mucosa, and CagA ⁺ H. pylori , but not CagA – H. pylori , infection impairs endothelial function through exosomes-mediated ROS formation.
Methods
C57BL/6 were used to determine the colonization ability of CagA ⁺ H. pylori and CagA – H. pylori . ROS production, endothelial function of thoracic aorta and atherosclerosis were measured in CagA ⁺ H. pylori and CagA – H. pylori infected mice. Exosomes from CagA ⁺ H. pylori and CagA – H. pylori or without H. pylori infected mouse serum or GES-1 were isolated and co-cultured with bEND.3 and HUVECs to determine how CagA ⁺ H. pylori infection impairs endothelial function. Further, GW4869 was used to determine if CagA ⁺ H. pylori infection could lead to endothelial dysfunction and atherosclerosis through an exosomes-mediated mechanism.
Results
CagA ⁺ H. pylori colonized gastric mucosa more effectively than CagA – H. pylori in mice. CagA ⁺ H. pylori , not CagA – H. pylori , infection significantly increased aortic ROS production, decreased ACh-induced aortic relaxation, and enhanced early atherosclerosis formation, which were prevented with N-acetylcysteine treatment. Treatment with CagA-containing exosomes significantly increased intracellular ROS production in endothelial cells and impaired their function. Inhibition of exosomes secretion with GW4869 effectively prevented excessive aortic ROS production, endothelial dysfunction, and atherosclerosis in mice with CagA ⁺ H. pylori infection.
Conclusion
These data suggest that CagA ⁺ H. pylori effectively colonizes gastric mucosa, impairs endothelial function, and enhances atherosclerosis via exosomes-mediated ROS formation in mice.
... The multivariate analysis results showed that the risk factors for HP infection are eating out and group dining; this is similar to previous findings. 51 52 Studies by Monno et al showed that eating food from street vendors and eating out were associated with HP infection and may be related Taking one step forward In Japan, GC screening is incorporated into the national plan. In 2000, Japan's national health insurance began supporting HP eradication in patients with peptic ulcers, and in 2013, HP-eradication treatment in patients with HP-positive chronic gastritis diagnosed by endoscopy was included in the national health insurance. ...
Objective
To evaluate the general population’s awareness of and attitudes toward Helicobacter pylori (HP) screening and health behaviours.
Design
Cross-sectional study.
Setting
Hengyang, Hunan Province, China.
Participants
Using stratified cluster random sampling, a pretested structured questionnaire was used to interview members of the general population aged ≥18 years.
Primary and secondary outcome measures
Knowledge of and attitudes toward HP screening and associated health behaviours, sociodemographic factors associated with HP knowledge, and screening behaviours.
Results
This study featured 1042 participants. The average knowledge score was 11 (Q L =4, Q U =20, range 0–29). Approximately 68.9% of the participants said they had heard of HP, but 67.5% had never had an HP test. The most common reasons for not undergoing screening were ‘no symptoms’ (55.7%) and ‘lack of knowledge regarding the benefits of the test’ (21.1%). Independent factors related to knowledge included age, education level, occupation, HP infection, frequency of drinking unboiled water (p<0.05). Factors independently associated with screening behaviour included occupation, average monthly income, presence/absence of indigestion, stomach discomfort or pain, and/or stomach disease and knowledge score (p<0.05). Overall, 941 (90.3%) participants never used anti-HP toothpaste, and 442 (40.5%) never used serving spoons or chopsticks. The risk factors for HP infection included eating out and eating in groups (p<0.05).
Conclusion
In China, the general population has poor knowledge of HP, but most people have a positive attitude towards HP screening. Being asymptomatic and lacking knowledge about testing were the main reasons for reluctance to be screened. These results highlight the urgent need for educational activities to raise awareness, enhance screening rates for HP, and encourage people to adopt a healthy lifestyle.
... The signi cantly higher rate of clarithromycin resistance in Yangzhou may be caused by the long-time and wide use in clinical practice which can promote the emergence of drug-resistant bacteria. In addition, unhealthy lifestyle (no handwashing before meals, sharing utensils, etc.) could lead to the transmission of H. pylori among the population as well [35,36]. According to consensus recommendations [7], levo oxacin-containing regimen is generally suggested to be avoided as an initial treatment, but as an alternative for rescue therapy because of the high rate of drug resistance. ...
Background: The Helicobacter pylori (H. pylori) antibiotic resistance pattern differs geographically, knowledge of local antimicrobial resistance pattern is key to successful eradication. The current study was performed to investigate the resistance of H. pylori to 5 commonly used antibiotics in Yangzhou.
Methods: A total of 461 H. pylori strains were collected from April 2018 to September 2019 in Yangzhou and tested for their susceptibility to clarithromycin, levofloxacin, metronidazole, amoxicillin, tetracycline using gene chip technology.
Results: The resistance rates of H. pylori to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline were 41.0%, 44.9%, 38.8%, 6.3% and 1.1%. In addition, sixteen multiple resistance patterns were detected, and fortunately there were no strains resistant to all five antibiotics. The vacA s1 allele was detected in each strain, 64.0% of the isolates were s1/m2 genotype, 36.0% s1/m1 genotype. In multivariate analysis, history of chronic superficial gastritis was significantly associated with clarithromycin resistance, strains isolated from subjects with gastrointestinal symptoms had a significantly higher likelihood of metronidazole resistance, and antibiotic resistance of H. pylori was independent of both sex and age.
Conclusion: The resistance rate of H. pylori to clarithromycin, levofloxacin and metronidazole were very high in Yangzhou, the results will help in selecting effective eradication regimens.
... J Gastrointestin Liver Dis, September 2020 Vol. 29 No 3: 319-327 was reported in some studies [12,13], but not others [14,15]. Although dietary factors such as vegetable and salt intake have been linked to the development of gastric cancer and may potentiate the carcinogenic effects of H. pylori [16,17], there seem to be no consistent findings on dietary factors and the prevalence of H. pylori infection. ...
Background and aims:
The prevalence of Helicobacter pylori (H. pylori) infection is higher in developing countries and is often linked to lower socioeconomic status. Few studies have investigated the association between H. pylori and individual level characteristics in Europe, where several countries have a high prevalence of H. pylori infection. The study aimed to identify risk factors for H. pylori infection among adults in a large clinical trial in Latvia.
Methods:
1,855 participants (40-64 years) of the "Multicenter randomized study of H. pylori eradication and pepsinogen testing for prevention of gastric cancer mortality" (GISTAR study) in Latvia tested for H. pylori IgG antibodies were included in a cross-sectional analysis. Sociodemographic, lifestyle and medical factors were compared for participants seropositive (H. pylori+) and seronegative. Mutually adjusted odds ratios (OR) were calculated for H. pylori+ and factors significant in univariate analysis (education, smoking, binge drinking, several dietary habits, history of H. pylori eradication and disease), adjusting for age, gender and income.
Results:
Of the participants 1,044 (55.4%) were H. pylori seropositive. The infection was associated with current (OR: 1.34, 95%CI: 1.01-1.78) and former (OR: 1.38; 95%CI: 1.03-1.85) smoking, binge drinking (OR: 1.35; 95%CI: 1.03-1.78), having ≥200g dairy daily (OR: 1.37; 95%CI: 1.11-1.69), and very hot food/drinks (OR: 1.32; 95%CI: 1.03-1.69) and inversely with ≥400g vegetables/fruit daily (OR: 0.76; 95%CI: 0.60-0.96), history of H. pylori eradication (OR: 0.57; 95%CI: 0.39-0.84), peptic ulcer (OR: 0.55; 95%CI: 0.38-0.80) and cardiovascular disease (OR: 0.78; 95%CI: 0.61-0.99).
Conclusions:
After mutual adjustment, H. pylori seropositivity was associated with lifestyle and in particular dietary factors rather than socioeconomic indicators in contrast to the majority of other studies.
The global prevalence of Helicobacter pylori (H. pylori) infection remains high, indicating a persistent presence of this pathogenic bacterium capable of infecting humans. This review summarizes the population demographics, transmission routes, as well as conventional and novel therapeutic approaches for H. pylori infection. The prevalence of H. pylori infection exceeds 30% in numerous countries worldwide and can be transmitted through interpersonal and zoonotic routes. Cytotoxin-related gene A (CagA) and vacuolar cytotoxin A (VacA) are the main virulence factors of H. pylori, contributing to its steep global infection rate. Preventative measures should be taken from people’s living habits and dietary factors to reduce H. pylori infection. Phytotherapy, probiotics therapies and some emerging therapies have emerged as alternative treatments for H. pylori infection, addressing the issue of elevated antibiotic resistance rates. Plant extracts primarily target urease activity and adhesion activity to treat H. pylori, while probiotics prevent H. pylori infection through both immune and non-immune pathways. In the future, the primary research focus will be on combining multiple treatment methods to effectively eradicate H. pylori infection.
In this study, we aimed to clarify whether H. pylori infection is associated with the prevalence of hypertension in the Inner Mongolia crowds and whether gender and age affect the relationship between helicobacter pylori and hypertension. We collected physical examination data from 10,517 people in the Second Affiliated Hospital of Baotou Medical College from January to December in 2020. The study population was divided into three layers according to blood pressure and H. pylori infection status. We found the patients that infected with H. pylori were associated with blood pressure. And the infection rate of H. pylori in patients with hypertension is higher than that in non-hypertensive individuals. Otherwise, Gender and age influence the relationship between helicobacter pylori and hypertension. In the hypertensive population, H. pylori infection rates are higher in males than in females. In additional, the hypertensive with H. pylori-infected population, the degree of H. pylori infection was lower in young adults than in middle-aged adultsand the elderly.People with established hypertension, men are more likely to be infected with H. pylori and to have more severe infections. In contrast, the degree of H. pylori infection is lower in young peoplethan in other people in people with hypertension and infected with H. pylori.
Background
Prospective studies on the association between Helicobacter pylori (H. pylori) infection and subclinical hyperthyroidism are limited. We, therefore, designed a large-scale cohort study to explore the association between H. pylori infection and the risk of subclinical hyperthyroidism in women.
Methods
This prospective cohort study investigated 2,713 participants. H. pylori infection was diagnosed with the carbon 13 breath test. Subclinical hyperthyroidism was defined as serum thyroid-stimulating hormone levels are low or undetectable but free thyroxine and tri-iodothyronine concentrations are normal. Propensity score matching (PSM) analyses and Cox proportional hazards regression models were used to estimate the association between H. pylori infection and subclinical hyperthyroidism.
Results
A total of 1,025 PS-matched pairs of H. pylori infection women were generated after PSM. During 6 years of follow-up, the incidence rate of subclinical hyperthyroidism was 7.35/1,000 person-years. After adjusting potential confounding factors (including iodine intake in food and three main dietary patterns score), the multivariable hazard ratio (HR; 95% confidence intervals) of subclinical hyperthyroidism by H. pylori infection was 2.49 (1.36, 4.56). Stratified analyses suggested a potential effect modification by age, the multivariable HR (95% confidence intervals) was 2.85 (1.45, 5.61) in participants aged ≥ 40 years and 0.70 (0.08, 6.00) in participants aged < 40 years (P for interaction = 0.048).
Conclusion
Our prospective study first indicates that H. pylori infection is significantly associated with the risk of subclinical hyperthyroidism independent of dietary factors among Chinese women, especially in middle-aged and older individuals.
Clinical Trial Registration:https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137, identifier UMIN000027174.
Aim:
Belching disorders seriously affects the quality of life, however, the prevalence and risk factors are poorly understood. The aim of our study was to determine the prevalence and associated risk factors, particularly lifestyle factors of belching disorders among university students in central China.
Methods:
A cross-sectional study was conducted in September 2019 in Huazhong University of Science and Technology, Wuhan, China. Subjects were asked to complete a self-administered questionnaire for collecting data, including sociodemographic, lifestyle factors, and digestive symptoms. The diagnosis of belching disorders was based on the Rome IV criteria. Univariate and multivariate logistic regression model analysis were used to determine risk factors for belching disorders.
Results:
A total of 3335 subjects were enrolled, and 77.93% were male. Among them, 2.0% (65/3335) subjects with belching disorders. Significant differences in Pittsburgh Sleep Quality Index (PSQI), whole grains, black tea, coffee, and Student-Life Stress Inventory (SLSI) scores were found between belching group and non-belching group. Multivariate logistic analysis demonstrated that coffee consumption ≥1 time/week and high total SLSI scores were independent risk factors for belching disorders, while intake of whole grains ≥1 time/week was a protective factor.
Conclusions:
Excessive belching is a common disorder among university students in central China. Lifestyle factors, including whole grains, coffee, and stress were associated with belching disorders. Therefore, dietary intervention may be a potential management method for belching disorders. This article is protected by copyright. All rights reserved.
Background
Stimulating food is emerging as an important modifiable factor in the development of gastrointestinal (GI) tract cancers, but the association between chili pepper consumption and the risk of GI cancers is unclear. We aimed to evaluate the direction and magnitude of the association between chili pepper consumption and the risk of GI cancers.
Methods
A literature search was performed in PubMed, Embase, and Web of Science databases from inception to 22 December 2021. Observational studies reporting the association between chili pepper consumption and the risk of gastric cancer (GC), esophageal cancer (EC), and/or colorectal cancer (CRC) in adults were eligible for inclusion. Data extraction and quality assessment were conducted independently by two reviewers for the included literature. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were also performed based on the cancer type, study design, region of the study, study quality, and adjustments.
Results
A total of 11,421 studies were screened, and 14 case-control studies were included involving 5009 GI cancers among 11,310 participants. The summary OR showed that high consumption of chili pepper was positively related to the risk of GI cancers (OR = 1.64; 95% CI: 1.00–2.70). A stronger positive relationship was observed between chili pepper consumption and EC risk (OR = 2.71; 95% CI: 1.54–4.75), but there was no statistically significant association between GC and CRC risk. In analyses stratified by geographical location, a positive association was found between chili pepper consumption and the risk of GI cancers in Asian studies (OR = 2.50; 95% CI: 1.23–5.08), African studies (OR = 1.62; 95% CI: 1.04–2.52), and North American studies (OR = 2.61; 95% CI: 1.34–5.08), but an inverse association was seen in South American studies (OR = 0.50; 95% CI: 0.29–0.87) and European studies (OR = 0.30; 95% CI: 0.15–0.61).
Conclusion
This meta-analysis suggests that chili pepper is a risk factor for certain GI cancers (e.g., EC). Geographical regions influence the risk of GI cancers, especially in Asian, African, and North American populations, which require more attention during dietary guidance.
Systematic review registration
[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022320670].
Helicobacter pylori is a widespread organism in human population and sometimes it is responsible for some of the most common chronic clinical disorders of the upper gastrointestinal tract in humans. The routes of infection have not been firmly established yet. The occurrence and survival of the microorganism in food and water, and the epidemiological data support the hypothesis that it may be a foodborne pathogen. In order to prevent contamination of food by H. pylori, it is important to apply Good Manufacturing Practices and Good Hygiene Practices throughout food chains, from primary production to the consumer's table.
(1) Background: Gastric cancer (GC) is the fourth leading cause of cancer-related deaths worldwide. Helicobacter pylori infection is a major risk factor, but other microbial species may also be involved. In the context of an earlier proteomics study of serum and biopsies of patients with gastroduodenal diseases, we explored here a simplified microbiome in these biopsies (H. pylori, Acinetobacter baumannii, Escherichia coli, Fusobacterium nucleatum, Bacteroides fragilis) on the protein level. (2) Methods: A cohort of 75 patients was divided into groups with respect to the findings of the normal gastric mucosa (NGM) and gastroduodenal disorders such as gastritis, ulcer, and gastric cancer (GC). The H. pylori infection status was determined. The protein expression analysis of the biopsy samples was carried out using high-definition mass spectrometry of the tryptic digest (label-free data-independent quantification and statistical analysis). (3) Results: The total of 304 bacterial protein matches were detected based on two or more peptide hits. Significantly regulated microbial proteins like virulence factor type IV secretion system protein CagE from H. pylori were found with more abundance in gastritis than in GC or NGM. This finding could reflect the increased microbial involvement in mucosa inflammation in line with current hypotheses. Abundant proteins across species were heat shock proteins and elongation factors. (4) Conclusions: Next to the bulk of human proteins, a number of species-specific bacterial proteins were detected in stomach biopsies of patients with gastroduodenal diseases, some of which, like those expressed by the cag pathogenicity island, may provide gateways to disease prevention without antibacterial intervention in order to reduce antibiotic resistance.
Objective
To update and evaluate the recurrence rate of Helicobacter pylori (H. pylori) eradication therapy in recent 10 years.
Methods
A systematic search of PubMed, Embase, Cochrane library, and Web of science was performed to identify the studies of recurrence rate of H. pylori published from 2010 to 2019. Stata 15.0 was used for analysis.
Results
A total of 31 studies (16,797 participants) were analyzed. The recurrence rate of H. pylori was 9% (95% CI, 8–11%), and it showed an upward trend with the time elapsed after eradication. The annual recurrence rate was 4%, and there was a stable trend with the time elapsed after eradication. Subgroup analyses showed that the recurrence rate of H. pylori eradication by triple therapy was higher than that of quadruple therapy (14% [95% CI, 9–19] vs 12% [95% CI, 7–17]); urban was higher than that of rural (8% [95% CI, 1–14] vs 5% [95% CI, 1–9]); males were higher than that of females (11% [95% CI, 8–14] vs 10% [95% CI, 7–14]); Europe had the highest recurrence rate (16% [95% CI, −1 to 42]), and Africa had the lowest (1% [95% CI, 0–2]). The recurrence rate ofH. pylori was inversely related to the human development index.
Conclusions
The recurrence rate of H. pylori showed an increasing trend in recent 10 years, and it is still a knotty public health problem worldwide. The recurrence rate of H. pylori showed an upward trend with the time elapsed after eradication, and the recurrence rate of H. pylori varies by area, gender, and eradication methods.
The Gram-negative (−) bacterium Helicobacter pylori colonizes in the mucus gel layer above the gastric epithelium and has been considered to be a major etiologic factor in several gastric health complications including peptic ulcers, gastric MALT, gastritis, and gastric cancer in approximately 50% of the world’s population. Besides inducing colon carcinogenesis, the bacterium shows to be associated with different extragastric disorders. Eradication of H. pylori is reported to reduce 33–47% of gastric cancer; however, treatment of H. pylori against colon cancer is less effective in older people. Several targets of H. pylori to induce colorectal carcinogenesis have been hypothesized, and an association of gastric H. pylori with colorectal adenomatous polyps (CAPs) has been experimentally revealed. CAPs are precancerous lesions of epithelial cells and lead to colorectal cancer (CRC) from the adenomatous stage. Pathway analysis decrypts the cascade mechanism of CAPs via inducing matrix metalloproteinase (MMP), prostaglandin-endoperoxide synthase, and mucin with other molecular targets. Several therapeutic approaches have been established to eradicate H. pylori before inoculation and during histologic progression in early stages. This book chapter explains the impact and molecular mechanism of H. pylori in colon carcinogenesis and methods of therapeutic approaches.
Abstract
Background: Helicobacter pylori is a gram-negative, spiral-shaped, a pathogenic bacterium. Almost 50% of the world population is infected by this bacterium. Obesity, diabetes, and hypertension are multifactorial diseases that have also become a major public health problem of global significance and are found associated with several risk factors like H. pylori infection. It is also considered as a major risk factor in the onset of diseases such as obesity, diabetes, and hypertension.
Methodology: The study is designed to estimate the prevalence of H. pylori infections in the Rawalpindi region and to identify “the relationship between obesity, type-2 diabetes, hypertension, and H. pylori”. A cross-sectional study was conducted including 192 subjects from Rawalpindi, Pakistan”. Samples were obtained randomly from subjects for the detection of obesity, diabetes, hypertension, and H. pylori infection. Statistical analysis was done to establish associations of obesity, diabetes, and hypertension with H. pylori infection was assessed by various statistical tests using SPSS.
Results: The incidence of H. pylori infection was 44% in the sample population. The prevalence of obesity was observed 28%, type-2 diabetes was observed by 18% and hypertension was 22%. H. pylori infections among diabetic persons were observed 35% and 48% in non-diabetic subjects. The infection rate of H. pylori is observed high among hypertensive persons.
Conclusions: There is a significant association between obesity, hypertension, and H. pylori infection. There is no relationship between” association of diabetes “and H. pylori”. Large scale studies are required to assess “the prevalence of H. pylori infection”, and metabolic diseases.
Keywords
Obesity; Diabetes; Hypertension; Association; Statistical analysis
This review summarizes recent publications on the epidemiology of Helicobacter pylori. Two major systemic analyses, from Malaysia and Ethiopia, were published. The Brazilian Consensus Conference has stated that H pylori infection is an infectious disease with an indication for antimicrobial therapy. A continuous decrease in H pylori prevalence was reported from many regions worldwide, including Korea, China, Iran, and Austria. A cross‐sectional H pylori prevalence study conducted in the United Arab Emirates found 41% prevalence in a group of healthy children and adults. Several studies from Asia addressed H pylori prevalence in adults undergoing regular checkup. The largest of such studies, performed in Korea, involved 24 471 subjects and reported 41.5% seroprevalence. A relatively smaller study from East China on 3252 subjects reported 27.5% prevalence. In contrast, a study from Spain reported 87.2% seroprevalence. A report on the association between smoking and H pylori seropositivity was published on behalf of the Stomach Cancer Pooling (StoP) Project—a consortium of epidemiological studies of gastric cancer. Also, other potential risk factors, including occupational risk factors, water supply, and food were analyzed. Gastroesophageal reflux and sexual partners has been associated with a higher risk for H pylori acquisition, and gut microbiota was suggested to play a role in intrafamilial transmission of H pylori. Finally, in a few studies (from Mexico and Japan), the catalytic model for predicting the potential risk of acquiring H pylori infection in the future was used. As anticipated, a further decline in H pylori‐related disease was demonstrated by applying the modeling.
Background:
Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection in the world. It can result in various upper gastroduodenal diseases. The prevalence varies among countries, population groups within the same country and testing methods. The aim of the study was to determine feco-prevalence and risk factors of H.pylori infection among symptomatic patients in Amhara region, Northeast Ethiopia.
Methods:
A cross sectional study was conducted in a total of 342 new consecutive outpatients with upper abdominal complaints at Dessie Referral Hospital from May to July, 2016. A structured questionnaire was used to collect the socio-demographic, lifestyle and environmental data. Stool samples were used to detect H. pylori specific antigen. Blood samples were assessed for anti-H. pylori IgG and ABO blood types. SPSS version 20.0 statistical software package was used for data analysis. Chi-square test and logistic regression were used in the analysis and P-value ≤0.05 was considered as statistically significant.
Results:
H. pylori stool antigen and serum anti-H.pylori IgG detection rate was 30.4 and 60.5% respectively with kappa measure of agreement of 0.271. Antigen detection was significantly associated with family size (> 3) [AOR = 1.83, 95% CI: 1.10-3.05, p = 0.02], more persons (> 3) sharing the same bed room in the household [AOR = 2.91, 95% CI: 1.39-6.11, p = 0.005], alcohol consumption (> once a week) [AOR = 2.70, 95% CI: 1.49-4.89, p = 0.001] and individuals' blood type: group O [AOR = 8.93, 95%CI: 1.79-44.48, p = 0.008] and group A [AOR = 5.53, 95%CI: 1.08-28.36, p = 0.040]. Gender, age, marital status, occupation, educational level, residence, smoking as well as coffee, tea, fruits and vegetables consumption were not statistically associated with H. pylori antigen detection (p > 0.05).
Conclusion:
The overall H. pylori stool antigen and anti-H. pylori IgG detection rate was 30.4 and 60.5%, respectively. The test agreement was not strongly convincing and needs further evaluation. Alcohol consumption, overcrowding and ABO blood group were significantly associated with H. pylori antigen detection.
The aim of this study was to assess the association between some dietary factors and prevalence of H. pylori infection or strain virulence in 294 adult asymptomatic blood donors. Methods . Seroprevalence was evaluated using ELISA. Logistic regression was used. Results . Anti- H. pylori IgG prevalence was 72.4%, and CagA IgG seroprevalence was 49.3%. In the multivariate analyses, the frequent (>5 days per week) honey consumption was associated with both reduced H. pylori seroprevalence OR, 0.68 with 95% confidence interval (CI), 0.473–0.967 and reduced CagA IgG seroprevalence OR, 0.65 with 95% CI, 0.486–0859. Frequent (>5 days per week) yoghurt consumption also was associated with lower H. pylori virulence of the strains (CagA IgG OR, 0.56 with 95% CI, 0.341–0.921). Smoking and consumption of the other dietary factors resulted in no significant differences in the prevalence of H. pylori IgG and CagA IgG within the subject groups. Conclusion . To the best of our knowledge, this is the first report revealing reverse associations between honey or yoghurt consumption and CagA IgG prevalence as well as between frequent honey consumption and lower prevalence of the H. pylori infection. Regular honey and yoghurt consumption can be of value as a supplement in the control of H. pylori therapy.
Background & Aims: H. pylori eradication is strongly affected by various factors, including the ongoing antibiotic resistance. We describe a “real life” scenario in patients managed for H. pylori-related conditions, living in a southern Italian region (Apulia), an area with clarithromycin resistance >15%.
Methods: 2,224 subjects were studied in two tertiary referral centers in Apulia. Analyses included: reason for referral, H. pylori infection rates (13C-urea breath test – UBT or upper endoscopy), and eradication rates following distinct regimens previously prescribed or prospectively prescribed (such as the bismuth-based quadruple therapy Pylera®, recently marketed in Italy).
Results. Over 80% of the patients were referred by family physicians (60% naïve subjects). The overall infection rate was 32.5% and it was similar in asymptomatic patients (31.1%) or with H. pylori-related symptoms/clinical conditions (34.3%). In the 987 H. pylori+ve patients receiving therapy, the overall eradication rate was 80.2% (ITT). Observed eradication rate varied greatly across different regimens: 57.1% (2nd line levofloxacin), 59.6% (unconventional), 70.7% (7-day triple), 73.2% (7-day undefined), 89% (10-day sequential) and 96.9% (ITT, 10 day Pylera®, 1st to 5th line regimens given to 227 patients).
Conclusions. A heterogeneous “real life” scenario in Southern Europe shows that H. pylori+ve patients are put at risk of poor outcomes and points to the need of a susceptibility-based therapy according to guidelines and local microbial resistance. In the present setting (i.e. high clarithromycin resistance), despite the high observed eradication rate, sequential therapy should not be recommended (absent in guidelines, unneeded antibiotic). Bismuth-based quadruple treatment (1st, 2nd or subsequent lines) yields the highest eradication rates.
To date, the exact route and mode of transmission of Helicobacter pylori remains elusive. The detection of H. pylori in food using molecular approaches has led us to postulate that the gastric pathogen may survive in the extragastric environment for an extended period. In this study, we show that H. pylori prolongs its survival by forming biofilm and micro-colonies on vegetables. The biofilm forming capability of H. pylori is both strain and vegetable dependent. H. pylori strains were classified into high and low biofilm formers based on their highest relative biofilm units (BU). High biofilm formers survived longer on vegetables compared to low biofilm formers. The bacteria survived better on cabbage compared to other vegetables tested. In addition, images captured on scanning electron and confocal laser scanning microscopes revealed that the bacteria were able to form biofilm and reside as micro-colonies on vegetable surfaces, strengthening the notion of possible survival of H. pylori on vegetables for an extended period of time. Taken together, the ability of H. pylori to form biofilm on vegetables (a common food source for human) potentially plays an important role in its survival, serving as a mode of transmission of H. pylori in the extragastric environment.
In summer 2013, an excess of paediatric cases of haemolytic uraemic syndrome (HUS) in a southern region of Italy prompted the investigation of a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections. Case finding was based on testing patients with HUS or bloody diarrhoea for STEC infection by microbiological and serological methods. A case-control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequelae. No cases in adults were detected. Molecular typing showed that two distinct STEC O26:H11 strains were involved. The case-control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates. This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.
Background: Albania is a Mediterranean, South–East Euro- pean developing country where epidemiological data on infectious diseases are scarce. In this study, the seropreva- lence of Helicobacter pylori infection in 1,088 Albanian healthy volunteers (472 females followed-up to a prenatal clinic, 173 recruits, 443 health care workers) was evaluated. Materials and Methods: Sera were tested for immunoglob- ulin-G (IgG) antibodies against H. pylori using a quantitative enzyme immunosorbent assay.
Results: The overall H. pylori seroprevalence was 70.7%. The H. pylori seroprevalence increased by age, from 60.4% in individuals younger than 20 years to 81% among those ‡ 50 years of age with a significant trend of increase by age. The overall seroprevalence was 73.9% for females and 59.5% for males. In addition the seroprevalence was 55.3% for people living in rural areas and 72.3% for people living in urban areas. No significant differences were found according to level of education except for individuals with elementary level of education. Nurses and hospital auxiliaries have significantly higher H. pylori seroprevalence when compared to other health care workers (physicians and office workers). When each variable (age, gender, area of residence, occu- pation, and education level) was adjusted for the con- founding effect of the other variables by stepwise logistic analysis, we observed that age greater than 40 years and female gender remain the only variables independently associated with the presence of H. pylori IgG antibodies. Conclusions: H. pylori is highly prevalent among the Albanian population. Improving living conditions, educa- tion in hygiene, and the supply of running water are measures to prevent the transmission of H. pylori infection and other infections spread by the fecal–oral route in Albania.
Many food and plant extracts have shown in vitro anti-Helicobacter pylori (H. pylori) activity, but are less effective in vivo. The anti-H. pylori effects of these extracts are mainly permeabilitization of the membrane, anti-adhesion, inhibition of bacterial enzymes and bacterial grown. We, herein, review treatment effects of cranberry, garlic, curcumin, ginger and pistacia gum against H. pylori in both in vitro, animal studies and in vivo studies.
Despite the clinical importance of Helicobacter pylori in human gastric disorders, its exact route of transmission is still uncertain. Based on the contentious hypothesis and findings of previous investigations, water may play an important role in the transmission of H. pylori to humans. The present study was carried out to investigate the vacA, cagA, oipA, iceA and babA2 genotype status and antimicrobial resistance properties of H. pylori strains isolated from the drinking water samples of four major provinces in Iran. A total of 400 drinking water samples were cultured and tested. H. pylori-positive strains were analyzed for the presence of various genotypes and antimicrobial resistance. Twelve out of 400 (3%) water samples were positive for H. pylori. Samples from Isfahan province had the highest, while those from Shiraz had the lowest prevalence of H. pylori. The seasonal distribution was also determined, with the highest prevalence of bacteria in the summer season (7.36%). H. pylori strains harbored the highest levels of resistance against ampicillin (100%), erythromycin (75%), clarithromycin (75%) and trimethoprim (58.3%). The most commonly detected genotypes were vacAs1a (83.3%), vacAm1a (66.6%), vacAs2 (50%) and cagA (50%). Presence of similar genotypes in the H. pylori strains of drinking water and those of human clinical samples suggest that contaminated water maybe the sources of bacteria. Spiramycin and furazolidone are suggested for treatment of cases of H. pylori infection. This article is protected by copyright. All rights reserved.
Background:
Up to now, fecal-oral and oral-oral are the most commonly known routes for transmission of H. pylori, therefore, contaminated water can play an important role in transmission of H. pylori to humans. Genotyping using virulence markers of H. pylori is one of the best approaches to study the correlations between H. pylori isolates from different samples. The present research was carried out to study the vacA, cagA, cagE, oipA, iceA and babA2 genotyping and antimicrobial resistance properties of H. pylori isolated from the bottled mineral water samples of Iran.
Results:
Of 450 samples studied, 8 samples (1.77 %) were contaminated with H. pylori. Brand C of bottled mineral water had the highest prevalence of H. pylori (3.63 %). The bottled mineral water samples of July month had the highest levels of H. pylori-contamination (50 %). H. pylori strains had the highest levels of resistance against metronidazole (62.5 %), erythromycin (62.5 %), clarithromycin (62.5 %), amoxicillin (62.5 %) and trimethoprim (62.5 %). Totally, 12.5 % of strains were resistant to more than 6 antibiotics. VvacAs1a (100 %), vacAm1a (87.5 %), cagA (62.5 %), iceA1 (62.5 %), oipA (25 %), babA2 (25 %) and cagE (37.5 %) were the most commonly detected genotypes. M1as1a (62.5 %), m1as2 (37.5 %), m2s2 (37.5 %) and S1a/cagA+/IceA2/oipA-/babA2-/cagE- (50 %) were the most commonly detected combined genotypes.
Conclusions:
Contaminated bottled mineral water maybe the sources of virulent and resistant strains H. pylori. Careful monitoring of bottled mineral water production may reduce the risk of H. pylori transmission into the human population.
According to controversial theories and results of studies, foods with animal origins play an important role in the transmission of
H. pylori
to human. The aim of this study was to determine the distribution of
vacA
genotypes of
H. pylori,
isolated from milk and meat samples of cow, sheep, goat, camel, and buffalo. Eight hundred and twenty raw milk and meat samples were collected from various parts of Iran. Samples were cultured and those found positive for
H. pylori
were analyzed for the presence of various genotypes of
vacA
gene. Out of 420 milk and 400 meat samples, 92 (21.90%) and 105 (26.25%) were positive for
H. pylori
, respectively. The most commonly detected genotypes in the
vacA
gene were
s1a
(86.80%),
m1a
(79.18%),
s1b
(69.54%), and
m1b
(63.45%) and detected combined genotypes were mostly
m1as1a
(68.52%),
m1as1b
(60.40%),
m1bs1b
(55.83%), and
m1bs1a
(53.29%). High presence of bacteria in the milk and meat samples of sheep represents that sheep may be the natural host of
H. pylori
. High presence of
H. pylori
strains in milk and meat samples similar to
vacA
genotypes in human being suggests that milk and meat samples could be the sources of bacteria for human.
Background
Despite the high clinical standing of Helicobacter pylori, its exact routes of transmission and origin have not been determined. Based on the contentious hypothesis, foods play an important roles in the transmission of H. pylori to humans. The present study was carried out to investigate the vacA, cagA, oipA and iceA genotypes status of H. pylori isolated from the various types of ready to eat foods.
Methods
A total of 550 ready to eat food samples were cultured and tested. H. pylori-positive strains were analyzed for the presence of various genotypes and antimicrobial resistance pattern.
Results
Seventy four out of 550 (13.45 %) samples were positive for H. pylori. Olvie salad (36 %), restaurant salad (30 %), fruit salad (28 %) and soup (22 %) were the most commonly contaminated. H. pylori strains harbored the highest levels of resistance against amoxicillin (94.59 %), ampicillin (93.24 %), metronidazole (89.18 %) and tetracycline (72.97 %). The most commonly detected genotypes were vacA s1a (78.37 %), vacA m2 (75.67 %), vacA m1a (51.35 %) and cagA (41.89 %). The prevalence of iceA1, iceA2 and oipA genotypes were 13.51, 4.05 and 18.91 %, respectively. S1am2 (70.27 %), s1am1a (39.18 %) and m1am2 (31.08 %) were the most commonly detected combined genotypes. Of 40 different genotypic combinations, s1a/cagA+/iceA1/oipA− (12.16 %), s1a/cagA+/iceA1/oipA+ (10.81 %) and s1a/cagA−/iceA1/oipA+ (10.81 %) were the most prevalent.
Conclusions
The present investigation showed that some types of ready to eat food samples maybe the sources of resistant and virulent strains of H. pylori. Warily use of antibiotics with respect to the results of disk diffusion method and careful health monitoring on food and staffs of food producing companies maybe reduce the risk of H. pylori in foods.
From a clinical and epidemiological perspective, it is important to know which genotypes and antibiotic resistance patterns are present in H. pylori strains isolated from salads and vegetables. Therefore, the present investigation was carried out to find this purpose. Three hundred eighty washed and unwashed vegetable samples and fifty commercial and traditional salad samples were collected from Isfahan, Iran. Samples were cultured and those found positive for H. pylori were analyzed using PCR. Antimicrobial susceptibility testing was performed using disk diffusion method. Seven out of 50 (14%) salad and 52 out of 380 (13.68%) vegetable samples harbored H. pylori. In addition, leek, lettuce, and cabbage were the most commonly contaminated samples (30%). The most prevalent virulence genes were oipA (86.44%) and cagA (57.625). VacA s1a (37.28%) and iceA1 (47.45%) were the most prevalent genotypes. Forty different genotypic combinations were recognized. S1a/cagA+/iceA1/oipA+ (33.89%), s1a/cagA+/iceA2/oipA (30.50%), and m1a/cagA+/iceA1/oipA+ (28.81%) were the most prevalent combined genotypes. Bacterial strains had the highest levels of resistance against metronidazole (77.96%), amoxicillin (67.79%), and ampicillin (61.01%). High similarity in the genotyping pattern of H. pylori among vegetable and salad samples and human specimens suggests that vegetable and salads may be the sources of the bacteria.
Helicobacter pylori infection in human is one of the most common infections worldwide. However, the origin and transmission of this bacterium has not been clearly explained. One of the suggested theories is transmission via water. This study was conducted to determine the prevalence rate of H. pylori in tap water, dental units' water, and bottled mineral water in Iran. In the present study, totally 200 water samples were collected in Isfahan province and tested for H. pylori by cultural method and polymerase chain reaction (PCR) by the detection of the ureC (glmM) gene. Using cultural method totally 5 cultures were positive. Two out of 50 tap water samples (4%), 2 out of 35 dental units' water (5.8%) samples, and 1 out of 40 (2.5% ) from water cooler in public places were found to be contaminated with H. pylori. H. pylori ureC gene was detected in 14 (7%) of water samples including 5 tap water (10%), 4 dental units' water (11.4%), 1 refrigerated water with filtration, and 4 (10%) water cooler in public places samples. This may be due to the coccoid form of bacteria which is detected by PCR method.
To determine the association of smoking, alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) use with presence and virulence of Helicobacter pylori (H. pylori) infection in a representative sample of a random adult population of asymptomatic subjects.
Non virulent 16S rRNA and virulent cag A and T genes from salivary samples of 854 asymptomatic subjects were determined using polymerase chain reaction. The presence and absence of virulent and non virulent infection was statistically compared with consumption of smoking, alcohol and NSAIDs.
The prevalence of infection in male and female subjects was found to be 69.25% and 66.90%, respectively. The prevalence of infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (31.22%), former (52.20%) and never (43.58%). The prevalence of infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (88.80%), former (57.14%) and never (33.33%). The prevalence of infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 82.75% and 21.16%, respectively. Virulence in male and female subjects was found to be 60.00% and 50.00%, respectively. The presence of virulent infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (28.57%), former (40.15%) and never (50.00%). The prevalence of virulent infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (79.32%), former (75.00%) and never (50.00%). The prevalence of virulent infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 88.23% and 66.66%, respectively.
It can be concluded that smoking and NSAIDs consumption are aggravating factors for virulence of H. pylori and alcohol can inhibit H. pylori infection in asymptomatic subjects.
The prevalence of Helicobacter pylori infection, which may increase the risk of gastritis, peptic ulcers, and cancer, has increased worldwide. This number is estimated to be around 70-90% in developing countries and 25-50% in developed countries. It is possible that the bacterium can be transmitted via food and water as well as zoonotically and iatrogenically. Because of high prevalence of this infection in Iran, the aim of this study is to examine whether H. pylori infection might be transmitted from cow's milk and faeces.
The existence of the H. pylori antibody and antigen was investigated in samples of serum, milk, and faeces from 92 lactating Holstein cows in Shahrekord, Iran. The H. pylori antigen and antibody were detected using ELISA and were confirmed by PCR.
It was found that out of 92 serum specimens, 25 (27%) of the cows were positive for the H. pylori antibody and 67 specimens were negative. From these 25 seropositive cows, 10 (40%) faeces samples and four (16%) milk samples were antigen positive for H. pylori. Four of the antigen-positive milk specimens were also antigen positive for faeces. The existence of the UreC gene was also confirmed in positive samples of milk and faeces.
There is a possibility that cow's milk is a transmission mode in H. pylori infection and faecal contamination and inappropriate management processes could transfer H. pylori to humans. The awareness of the H. pylori epidemiology and its method of distribution are necessary for public health measures and controlling the spread of this bacterium. Further investigation with a greater sample number is necessary to verify the ability of H. pylori transmission via milk consumption.
Helicobacter pylori infection remains one of the most common in humans, but the route of transmission of the bacterium is still uncertain. This study was designed to elucidate possible sources of infection in an isolated, rural population in Guatemala. A total of 242 subjects in family units participated in the study. A medical history, including a history of dyspepsia, was taken by a physician and immunoglobulin G antibodies to H. pylori were detected with the QuickVue (Quidel, San Diego, Calif.) onsite serology test. Overall, 58% of subjects were seropositive, with a positive relationship between mother and child (P = 0.02) and a positive correlation between the serostatuses of siblings (intraclass correlation coefficient = 0.63). There was no association between serostatus and gastric symptoms. Oral H. pylori was detected from periodontal pockets of various depths and the dorsum of the tongue by nested PCR. Eighty-seven percent of subjects had at least one oral site positive for H. pylori, with the majority of subjects having multiple positive sites. There was no association between periodontal pocket depth and the detection of H. pylori. Nested PCR was also used to detect H. pylori from beneath the nail of the index finger of each subject's dominant hand. Overall, 58% of subjects had a positive fingernail result, with a significant positive relationship between fingernail and tongue positivity (P = 0.002). In conclusion, the results of this study suggest that oral carriage of H. pylori may play a role in the transmission of infection and that the hand may be instrumental in transmission.
Helicobacter pylori was detected using molecular methods in untreated well water. The presence of H. pylori in the wells correlated with infection in consumers and with the presence of Escherichia coli, indicating fecal contamination. Consumption of untreated well water should be considered a risk factor for H. pylori infection.
For this study, we isolated Helicobacter pylori from wastewater by a series of steps beginning with immunomagnetic separation and cell culture. After Gram staining and three
standard microbial tests, the 16S rRNA sequences of a total of 23 out of 37 putative H. pylori isolates were verified by PCR. Eleven H. pylori isolates were genotyped and fell into four vacA classes: those with the vacA allelic variants s1a and m1, s1b and m1, s2 and m2, or s2 and m1. Most H. pylori isolates were of the vacA s1a/m1 type, which has been shown to be associated with advanced diseases based on genotyping of H. pylori from gastric cancer patients. These results demonstrated that H. pylori survives in water and may be a potential source of H. pylori transmission, especially where water is not adequately treated.
Stool antigen test for Helicobacter pylori, a noninvasive assay, is emerging as a strong competitor to urea breath test (UBT). Nevertheless, although the UBT delta value is a semiquantitative indicator of H. pylori intragastric load, until now the H. pylori stool antigen test has been used only as a qualitative investigation. We report here the results of a study performed with the aim of obtaining a semiquantitative measurement of bacterial amount in stools. We studied 15 patients with dyspepsia using H. pylori positivity at histology, the rapid urease test, UBT, and the H. pylori stool antigen test. The result of this last test was expressed by a numerical value we obtained by applying the principle of "standard points" to the absorbance units at spectrophotometric reading. This measurement was previously validated by testing probe sampling of H. pylori stool antigen with known pure and stool-mixed bacterial amounts. A numerical result for H. pylori stool antigen was correlated to UBT delta for each patient using Pearson's r test. Finally, a Student t test was performed to investigate possible differences in UBT and H. pylori stool antigen test values between anti-CagA-positive and -negative patients. We obtained a curve of saturation with both known amount of pure and stool-mixed bacteria. Pearson's r test showed a significant correlation between UBT delta value and H. pylori stool antigen measurement (r = 0.77; p < 0.001). Urea breath test delta and H. pylori stool antigen test values were significantly higher in anti-CagA-positive patients. Our data suggest that a numerical estimation of H. pylori stool antigen may be feasible. This evaluation, similarly to UBT delta, may represent a semiquantitative determination of bacterial intragastric load.
To investigate whether red wine and green tea could exert anti-H pylori or anti-VacA activity in vivo in a mouse model of experimental infection.
Ethanol-free red wine and green tea concentrates were administered orally as a mixture of the two beverages to H pylori infected mice, or separately to VacA-treated mice. Gastric colonization and gastric inflammation were quantified by microbiological, histopathological, and immunohistochemical analyses.
In H pylori-infected mice, the red wine and green tea mixture significantly prevented gastritis and limited the localization of bacteria and VacA to the surface of the gastric epithelium. Similarly, both beverages significantly prevented gastric epithelium damage in VacA-treated mice; green tea, but not red wine, also altered the VacA localization in the gastric epithelium.
Red wine and green tea are able to prevent H pylori-induced gastric epithelium damage, possibly involving VacA inhibition. This observation supports the possible relevance of diet on the pathological outcome of H pylori infection.
Background and aims:
Data regarding the impact of smoking on the success of Helicobacter pylori (H. pylori) eradication are conflicting, partially due to the fact that sociodemographic status is associated with both smoking and H. pylori treatment success. We aimed to assess the effect of smoking on H. pylori eradication rates after controlling for sociodemographic confounders.
Methods:
Included were subjects aged 15 years or older, with a first time positive C(13)-urea breath test (C(13)-UBT) between 2007 to 2014, who underwent a second C(13)-UBT after receiving clarithromycin-based triple therapy. Data regarding age, gender, socioeconomic status (SES), smoking (current smokers or "never smoked"), and drug use were extracted from the Clalit health maintenance organization database.
Results:
Out of 120,914 subjects with a positive first time C(13)-UBT, 50,836 (42.0%) underwent a second C(13)-UBT test. After excluding former smokers, 48,130 remained who were eligible for analysis. The mean age was 44.3±18.2years, 69.2% were females, 87.8% were Jewish and 12.2% Arabs, 25.5% were current smokers. The overall eradication failure rates were 33.3%: 34.8% in current smokers and 32.8% in subjects who never smoked. In a multivariate analysis, eradication failure was positively associated with current smoking (Odds Ratio {OR} 1.15, 95% CI 1.10-1.20, p<0.001), female gender (OR 1.20, 95% CI 1.14-1.25, p<0.001) and a low socioeconomic status (OR 1.24, 95% CI 1.17-1.31, p<0.001).
Conclusions:
After controlling for socio-demographic confounders, smoking was found to significantly increase the likelihood of unsuccessful first-line treatment for H. pylori infection.
In summer 2013, an excess of paediatric cases of haemolytic uraemic syndrome (HUS) in a southern region of Italy prompted the investigation of a community- wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26: H11 infections. Case finding was based on testing patients with HUS or bloody diarrhoea for STEC infection by microbiological and serological methods. A case-control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequelae. No cases in adults were detected. Molecular typing showed that two distinct STEC O26: H11 strains were involved. The case-control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26: H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates. This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.
Purpose: Real-time polymerase chain reaction (RT-PCR) is a widely used technique for bacterial and viral infection diagnosis. Herein, we report our preliminary experience in retrieving H. pylori genetic sequences in stools and analyzing genotypic clarithromycin resistance by RT-PCR (noninvasive), with the aim of comparing this procedure with that performed on biopsy samples (invasive).
Materials and methods: After ‘in vitro’ demonstration of H. pylori DNA detection from pure and stool-mixed bacteria, 52 consecutive patients at the first diagnosis of infection were investigated. DNA was extracted from biopsy tissue and stool samples (THD® Fecal Test, Italy). RT-PCR was performed to detect 23S rRNA encoding bacterial subunit gene and search A2143G, A2142C, A2142G point mutations for clarithromycin resistance assessment.
Results: RT-PCR showed H. pylori positive DNA in all infected patients with full concordance between tissue and stool detection (100%). We found A2143G mutation in 10 (19.2%), A2142G in 4 (7.7%) and A2142C in 5 (9.6%) patients; there was a full agreement between biopsy and fecal samples. A2143G was found in all the four A2142G positive cases and in three out of the five A2142C positive strains. Overall clarithromycin resistance rate in our series was 23%.
Conclusions: Despite the need of confirmation on large sample, stool RT-PCR analysis could represent a feasible tool to detect H. pylori DNA sequences and antibiotic resistance point mutations. As compared to tissue molecular analysis, this technique is noninvasive, with potential advantages such as improvement of patient compliance, reduction of diagnostic procedure time/cost and improvement of therapeutic outcome.
Helicobacter pylori infection is among the most prevalent infections in the world and a key cause of gastric diseases; however, its route of transmission remains unclear. This study aimed to assess the potential for fecal-oral transmission of H. pylori by leveraging its association with a disease with known etiology. Utilizing serology data from the National Health and Nutrition Examination Survey (NHANES 1999; N = 6,347), the association between H. pylori and hepatitis A virus (HAV), a sensitive indicator for fecal-oral exposure, was assessed. Survey-weighted kappa and multiple logistic regression were used to quantify the association between H. pylori and HAV after controlling for age, sex, race, poverty, birthplace, crowding, smoking, and alcohol use. Concordant serological results were found among 69.8% of participants (survey-weighted κ = 0.30, 95% confidence interval [CI] = 0.26, 0.35). The adjusted odds of H. pylori seropositivity were over two times higher after adjusting for confounders (odds ratio = 2.27, 95% CI = 1.79, 2.87). Results from this study suggest H. pylori and HAV infections are strongly associated. Since HAV is primarily transmitted through the fecal-oral route, fecal-oral transmission may be an important pathway for H. pylori spread.
This study evaluated the diagnostic performances of an ELISA method and a molecular method for the detection of verotoxin in faecal samples during an outbreak of haemolytic-uraemic syndrome (HUS) occurring in Apulia, Southern Italy. Two of the 16 faecal samples were positive for verotoxin when analysed by ELISA and resulted PCR positive for stx1, stx2, eaeA and serogroup O26. The other 14 faecal samples resulted negative with both tests. The detection of verotoxin in faecal samples by ELISA is a simple, sensitive, specific and rapid method (2 hours) of considerable utility for routine clinical testing laboratories without access to more specialized diagnostic procedures.
Editor—Brenner et al conclude that alcohol consumption may have a protective effect against infection with Helicobacter pylori.1 H pylori infection is commonly acquired during childhood and spontaneous elimination may occur, usually in young children and elderly people, but it may be acquired and eliminated spontaneously throughout adulthood.2 Drinking alcohol is usually an adult habit, and if alcohol does have a protective effect against infection with H pylori we can assume that it eradicates the infection rather than prevents it. Alcohol consumption may therefore have a role only in those few people in whom spontaneous elimination of the bacterium is thought to have occurred.2
If alcohol does protect against H pylori infection then the number of years for which it has been consumed is probably important, and not just the amount consumed, particularly when overall consumption is low. Brenner et al do not, however, give data on lifetime alcohol consumption in their series. Finally, socioeconomic factors in childhood, such as low social class, manual occupation of the parents, and measures of crowding have been consistently identified as major risk factors for infection with H pylori,3 but they were not adjusted for in the multivariate analysis in the authors’ study.
We recently conducted a seroepidemiological study of H pylori infection in 705 residents in the rural town of Ciro, a wine producing centre in southern Italy.4 A structured questionnaire was administered to all subjects. The table shows data on alcohol consumption and its relation to H pylori seropositivity. The seroprevalence of infection was 63% (446/705) overall and was slightly higher in wine drinkers (70% (58/83) than in non-drinkers (62% (388 of 622)). By contrast, H pylori seropositivity was reduced in subjects who reported a lifetime alcohol consumption higher than 456 kg ethanol (64%, (27/42) v 76% (31 of 41)). The differences were not significant in a univariate or a multivariate analysis.
Serological testing for H pylori has been validated, with tests indicating active infection being used as a reference.5 Since spontaneous elimination of the bacterium is uncommon,2 a positive result of a serological test for H pylori should be considered as evidence of active infection when no specific antimicrobial treatment has been given. We believe that wine consumption is not a protective factor against H pylori. Different demographic and clinical variables may account for discrepancies in findings.
Background
Helicobacter pylori is one of the most common causes of chronic bacterial infection in humans, directly related to peptic ulcer and gastric cancer. It has been suggested that H. pylori can be acquired through different transmission routes, including water. In this study, culture and qPCR were used to detect and identify the presence of H. pylori in drinking water. Furthermore, the combined techniques PMA-qPCR and DVC-FISH were applied for detection of viable cells of H. pylori.ResultsAmong 24 drinking water samples, 16 samples were positive for the presence of H. pylori, but viable cells were only detected in six samples. Characteristic colonies, covered by a mass of bacterial unspecific growth, were observed on selective agar plates from an only sample, after enrichment. The mixed culture was submitted to DVC-FISH and qPCR analysis, followed by sequencing of the amplicons. Molecular techniques confirmed the growth of H. pylori on the agar plate.Conclusions
Our results demonstrate for the first time that H. pylori can survive and be potentially infective in drinking water, showing that water distribution systems could be a potential route for H. pylori transmission.
OBJECTIVES:When and how Helicobacter pylori (H. pylori) originally entered the human population as well as how the infection is transmitted in different communities is unknown. We previously showed that Sardinian shepherds had almost a 100% prevalence of H. pylori and that the prevalence was higher than that of their same-household siblings.AIM:To examine whether H. pylori infection might be transmitted from sheep.METHODS:Milk and gastric tissue were cultured and analyzed by PCR amplification using three sets of primers Helicobacter genus–specific 16S rRNA and two sets of primers specific for H. pylori vacA gene.RESULTS:Helicobacter DNA was demonstrated in 60% (38/63) of milk samples and in 30% (6/20) of sheep tissue samples. H. pylori vacA gene was amplified in five of 38 milk samples, and in two of six sheep tissue samples respectively. H. pylori were cultured from sheep milk and tissue samples and confirmed as H. pylori on the basis of colony morphology, positive biochemical reactions, and negative Gram stain. Sequence analysis of 16S rRNA PCR products from these isolates demonstrated 99% identity with H. pylori.CONCLUSIONS:Together, the presence of H. pylori in sheep stomach in the absence of associated gastritis and recovery of H. pylori from sheep milk and gastric tissue suggest that sheep may be a natural host for H. pylori.
Helicobacter pylori is a Gram-negative microaerophilic bacterium that has colonized the human gastric mucosa. This infection is very common and affects more than half of the human population. The prevalence is however unbalanced between rural developing areas (more than 80%) and urban developed areas (less than 40%). H. pylori is responsible for several pathologies, such as gastritis, peptic ulcer and gastric cancer but its transmission pathway is still not clear. The risk factors for H. pylori infection include poor social and economic development; poor hygienic practices; absence of hygienic drinking water; and unsanitary prepared food. There is evidence supporting a gastro-oral, oral-oral and faecal-oral transmission, but no predominant mechanism of transmission has been yet identified. Transmission may occur in a vertical mode (e.g. from parents to child) or in a horizontal mode (across individuals or from environmental contamination). In either case, the involvement of water and food cannot be excluded as vehicles or sources of infection. Indirect evidence of presence of H. pylori in water and food, namely the detection of its DNA and survival studies after artificial contamination of food and water has been described. This paper reviews data both favourable and against the role of water and food in the transmission of H. pylori, exploring their role as a potential transmission vehicle for person-to-person and food-chain transmission. The likelihood of the transmission pathway in developing rural and developed urban areas appears to be different. In developed areas, person-to-person transmission within families appears to be dominant, while in the rural developing areas the transmission pathway appears to be more complex. In this later case, the transmission by contaminated food, water, or via intensive contact between infants and non-parental caretakers may have a greater influence than within-family transmission.
Since hepatitis A virus (HAV) is acquired primarily through the fecal-oral pathway, several investigators have used HAV seropositivity as a proxy for exposure to this pathway. This paper is a critical review of the evidence relevant to the association between seropositivity to HAV and Helicobacter pylori, and considers the validity of comparisons for testing the hypothesis that H. pylori spreads by the fecal-oral route.
A Medline search identified reports of all types published in the English language literature that were linked to the keywords 'Campylobacter pylori', 'hepatitis A', or 'Helicobacter pylori', cross-referenced with 'seroepidemiology', 'seroprevalence', or 'seropositivity'. Studies identified by the search were included in the review if they used specific IgG antibodies to classify the serostatus of subjects for both HAV and H. pylori infection and provided an estimate of the magnitude of the association between HAV and H. pylori or information that permitted calculation of an odds ratio (OR).
Out of the 21 studies identified, 15 met the inclusion criteria. The studies showed ORs for an association of HAV and H. pylori that ranged from 0.81 to 8.4. After adjustment for potential confounders, ORs shifted toward the null. They also showed that HAV seroprevalence is lower than H. pylori seroprevalence in early life and then becomes higher in later life. Thus in most populations, the trends cross over at some point.
The observed associations between the two infections are generally overestimated by the confounding effects of age and socio-economic status-related factors, and when these factors are controlled, the association becomes weak. Moreover, HAV infection elicits a long-term antibody response, while H. pylori infection does not. Consequently, serostatus comparison does not constitute a convincing test of the fecal-oral transmission hypothesis for H. pylori.
Helicobacter pylori infection is very common in Chilean adults, but the age-related prevalence, risk factors for infection, and mode of transmission
in Chilean children are unknown. An ELISA was used to test for H. pylori antibodies in 1815 Chileans <35 years of age. Seropositivity was >60% in lower socioeconomic groups. H. pylori seropositivity correlated with increased age, low socioeconomic status, and consumption of uncooked vegetables by use of
a logistic regression analysis. Risk factors that reached marginal significance were consumption of uncooked shellfish, female
sex, and residence in Santiago. Although multiple modes of transmission for H. pylori undoubtedly exist, prior studies have suggested that contamination of irrigation water by raw sewage (and the subsequent
contamination of vegetables that are eaten uncooked) is a key factor in the transmission ofenteric pathogens in Chile; H. pylori may be transmitted by a similar route.
Alcohol has strong antimicrobial activity and stimulates gastric acid secretion. Alcohol consumption may therefore compromise the living conditions of Helicobacter pylori in the stomach. We assessed the relation of alcohol consumption with H. pylori infection among 1,785 participants ages 18-88 in the German National Health and Nutrition Survey. Detailed information on dietary and lifestyle habits was obtained in personal interviews using a standardized food frequency questionnaire. Serum samples were analyzed for H. pylori immunoglobulin G antibodies by enzyme-linked immunosorbent assay. Overall prevalence of H. pylori infection was 39.2%. There was a clear inverse dose-response-relation between reported alcohol consumption and H. pylori infection. The relation persisted after control for potential confounding factors. The adjusted prevalence ratios (95% confidence intervals) for H. pylori infection among persons who consumed up to 10, 10 to 20, and more than 20 gm of alcohol per day compared with non-drinkers were 0.93 (0.77-1.13), 0.82 (0.65-1.04), and 0.71 (0.55-0.92). The inverse relation between alcohol consumption and H. pylori infection was even stronger when individuals with an indication of a recent change of alcohol consumption were excluded from the analysis. These findings support the hypothesis that moderate alcohol consumption may facilitate spontaneous elimination of H. pylori infection among adults.
The aim of this study was to examine whether smoking or consumption of alcohol or coffee is associated with active Helicobacter pylori (H. pylori) infection.
This was a cross-sectional population study conducted as part of a randomized controlled trial of H. pylori infection eradication in southwest England. A total of 10,537 subjects, recruited from seven general practices, underwent 13C-urea breath testing for active infection with H. pylori and provided data on smoking, usual weekly consumption of alcohol, and daily intake of coffee.
Smoking or coffee consumption were not related to active H. pylori infection. Total alcohol consumption was associated with a small, but not statistically significant, decrease in the odds of infection. After adjustment for age, sex, ethnic status, childhood and adult social class, smoking, coffee consumption, and intake of alcoholic beverages other than wine, subjects drinking 3-6 units of wine/wk had an 11% lower risk of H. pylori infection compared with those who took no wine: OR = 0.89, 95% CI = 0.80-0.99. Higher wine consumption was associated with a further 6% reduction in the risk of infection: OR = 0.83, 95% CI = 0.64-1.07. Intake of 3-6 units of beer (but no greater intake) was associated with a similar reduction in the risk of infection when compared to no beer intake (OR = 0.83, 95% CI = 0.75-0.91).
This study indicates that modest consumption of wine and beer (approximately 7 units/wk) protects against H. pylori infection, presumably by facilitating eradication of the organism.
To assess the role of water in the faecal transmission of Helicobacter pylori by detecting the DNA of this pathogen in human faecal samples and environmental water samples with a range of faecal pollution from the north-east of Spain.
Semi-nested PCR was used to detect H. pylori in stools and water, both matrices with a complex biota. DNA was detected using highly specific primers of an ureA gene fragment. In addition, antigens were used to detect the bacteria in stools. Helicobacter pylori was detected in 33% of 36 human faecal samples and in 66% of wastewater samples, and 11% of river samples, but in none of the spring waters samples. Faecal pollution of the aquatic environment was tested analysing the presence of microbial indicators.
We report the presence of H. pylori DNA in stools and in aquatic environments with different levels of faecal pollution, from the north-east of Spain. In this study a higher number of positive results were obtained in the more faecally polluted waters.
These data indicate that water may be a vector of H. pylori in its faecal-oral route.
Eradication rates in Italian subjects heterogeneously managed for Helicobacter +Model CLINRE-1184
- Di Ciaula
- A Scaccianoce
- G Venerito
Di Ciaula A, Scaccianoce G, Venerito M, et al. Eradication rates
in Italian subjects heterogeneously managed for Helicobacter
+Model
CLINRE-1184; No. of Pages 5
Helicobacter pylori infection: association with dietary habits and socioeconomic conditions 5 pylori infection. Time to abandon empiric treatments in Southern Europe
Helicobacter pylori infection: association with dietary habits and socioeconomic conditions
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pylori infection. Time to abandon empiric treatments in Southern Europe. JGLD 2017;26:129-37.
Isolation of Helicobacter pylori from sheep-implications for transmission to humans
- Dore
Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study
- Brenner