Maria Teresa Mascellino
Sapienza University of Rome, Italy
Title: Helicobacter Pylori Infection : Pathogenesis And Therapeutic Strategies
Biography
Biography: Maria Teresa Mascellino
Abstract
Introduction: Helicobacter pylori (Hp) is a Gram-negative mobile bacillus, difficult to be cultured, and able to cause different diseases. In fact Hp is involved in chronic active gastritis, peptic ulcer disease, gastric carcinoma and mucosa-associated lymphoid tissue lymphoma (MALT) other than in endothelial dysfunction leading to vascular diseases. Hp is increasingly difficult to treat. The treatment regimens are declining in efficacy and the therapy of this infection is bedevilled by drug-resistant strains. Aim of our research is to study a population of 50 pangastritis already undergone multiple therapies and to evaluate the eradication rates.
Methods: All patients were positive to UBT (Urease Breath Test) then surely infected by Hp. Three biopsies were taken for each patient and submitted to rapid urease test, culture and antibiotics susceptibility by E-test
Results:. Out of 50 patients, culture and susceptibility testing were obtained in 31 patients (62%) whereas in 19 (38%) no H. pylori growth was detected. The first group was treated following the scheme shown in the image whereas the second one was empirically treated with antibiotics never taken before or with rescue therapies. The eradication rates were 52% and 63% respectively.
Conclusions: No significant difference has been seen between the two groups. Probably the higher eradication rate in patients empirically treated, where no microorganisms have been isolated, can be due to the presence of bacteria not able to grow in culture then in a less virulent or dormant phase or in a very low number to be detected. Anyway, in our study the eradication rates of these pangastritis patients undergone multiple treatments are very low. The Toronto Consensus Group (2016) has proposed new treatment strategies recommending to prolong the cure from 10 to 14 days, to use bismuth quadruple therapy containing metronidazole and tetracycline as well as various rescue therapies.