Helicobacter pylori: analysis of infection, gastric injury and therapy for erradicating in a specilized outpatient center
DOI:
https://doi.org/10.59255/mmed.2023.88Keywords:
Helicobacter pylori, Eradication, Gastritis, eradication, gastritis, Helicobacter pyloriAbstract
Introduction: The infection caused by Helicobacter pylori (HP) is one of the most frequent infections. The most used methods in Brazil for its diagnosis are the endoscopic tests: urease test, histopathology, culture and polymerase chain reaction. The triple plan is highlighted for the treatment, followed by the quadruple plan with the use of bismuth, concomitant plan, hybrid plan and the sequential plan. The after-treatment tracking is carried after four weeks, considering the antibiotics sensitivity the main predictor of the eradication. Aim: To evaluate the HP eradication retrospectively in the context of the specialties medical ambulatory from Barretos region, in the State of São Paulo, identifying the endoscopic diagnosis, before and after the eradication of HP. Material and Methods: Retrospective cohort study in patients with hydrochloride peptics disease, which were ambulatorily submitted to high digestive endoscopy in the period between 2016 and 2021, proving to have HP, subdivided in groups of different therapies for HP eradication. Eradication results have been evaluated through specific statistical tests. Results: 473 electronic patient records have been analyzed, with the feminine sex being predominant (74,0%), and the positivity for HP in 102 patients (39,5%). The eradication has been endoscopically confirmed in 69,6%. In order to verify the implemented therapeutical plan, only 21 (20,79%) have had specification in the patient record. There has been verified predominance of gastritis on those HP positive patients, prevailing mild gastritis: 50 (49,0%). Conclusion: The retrospective analysis of eradication of HP has shown that triple plan was mainly adopted with considerable effectivity. Comparative analysis has not been made possible between the plans and the endoscopic diagnosis has shown mild predominancy of moderate gastritis.
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References
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Moon SW, Kim TH, Kim HS, Ju J-H, Ahn YJ, Jang HJ, et al. United Rapid Urease Test Is Superior than Separate Test in Detecting Helicobacter pylori at the Gastric Antrum and Body Specimens. Clinical Endoscopy. 2012;45(4):392.
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of Gastroenterology. fevereiro de 2017;112(2):212–39.
Wang Y-K. Diagnosis of Helicobacter pylori infection: Current options and developments. World Journal of Gastroenterology. 2015;21(40):11221.
Treatment regimens for Helicobacter pylori - UpToDate [Internet]. [citado 23 de outubro de 2018]. Disponível em: https://www.uptodate.com/contents/treatment-regimens-for-helicobacter-pylori#H1
Fallone CA, Chiba N, van Zanten SV, Fischbach L, Gisbert JP, Hunt RH, et al. The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults. Gastroenterology. julho de 2016;151(1):51-69.e14.
Venerito M, Krieger T, Ecker T, Leandro G, Malfertheiner P. Meta-Analysis of Bismuth Quadruple Therapy versus Clarithromycin Triple Therapy for Empiric Primary Treatment of Helicobacter pylori Infection. Digestion. 2013;88(1):33–45.
Luther J, Higgins PDR, Schoenfeld PS, Moayyedi P, Vakil N, Chey WD. Empiric Quadruple vs. Triple Therapy for Primary Treatment of Helicobacter pylori Infection: Systematic Review and Meta-Analysis of Efficacy and Tolerability. The American Journal of Gastroenterology. janeiro de 2010;105(1):65–73.
Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection—the Maastricht VI/ Florence Consensus Report. Gut. 2022 Aug. ;doi 10.1136/gutjnl-2022-327745.
Yuan Y, Ford AC, Khan KJ, Gisbert JP, Forman D, Leontiadis GI, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Upper GI and Pancreatic Diseases Group, organizador. Cochrane Database of Systematic Reviews [Internet]. 11 de dezembro de 2013 [citado 24 de outubro de 2018]; Disponível em: http://doi.wiley.com/10.1002/14651858.CD008337.pub2
Malfertheiner P, Bazzoli F, Delchier J-C, Celiñski K, Giguère M, Rivière M, et al. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. The Lancet. março de 2011;377(9769):905–13.
Peedikayil MC, AlSohaibani FI, Alkhenizan AH. Levofloxacin-Based First-Line Therapy versus Standard First-Line Therapy for Helicobacter pylori Eradication: Meta-Analysis of Randomized Controlled Trials. Bayer A, organizador. PLoS ONE. 21 de janeiro de 2014;9(1):e85620.
Greenberg ER, Anderson GL, Morgan DR, Torres J, Chey WD, Bravo LE, et al. 14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial. The Lancet. agosto de 2011;378(9790):507–14.
Sho Suzuki, Mitsuru Esaki, Chika Kusano, Hisatomo Ikehara, Takuji Gotoda (2018): Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance?, World J Gastroenterol 2019 April 28, DOI: 10.3748/wjg.v25.i16.1907
Graham DY, Lee Y, Wu M. Rational Helicobacter pylori Therapy: Evidence-Based Medicine Rather Than Medicine-Based Evidence. Clinical Gastroenterology and Hepatology. fevereiro de 2014;12(2):177-186.e3.
Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World Journal of Gastroenterology. 2013;19(45):8188.
Genta RM, Lash RH. Helicobacter pylori-negative Gastritis: Seek, Yet Ye Shall Not Always Find: The American Journal of Surgical Pathology. agosto de 2010;34(8):e25–34.
Atkinson NSS, Braden B. Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy. Digestive Diseases and Sciences. janeiro de 2016;61(1):19–24.
Garza-González E. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World Journal of Gastroenterology. 2014;20(6):1438.
Malfertheiner P. Diagnostic methods for H. pylori infection: Choices, opportunities and pitfalls. United European Gastroenterology Journal. outubro de 2015;3(5):429–31.
Saniee P, Shahreza S, Siavoshi F. Negative Effect of Proton-pump Inhibitors (PPIs) on Helicobacter pylori Growth, Morphology, and Urease Test and Recovery after PPI Removal - An In vitro Study. Helicobacter. abril de 2016;21(2):143–52.
Lins AK, Lima RA, Magalhães M. Clarithromycin-resistant Helicobacter pylori in Recife, Brazil, directly identified from gastric biopsies by polymerase chain reaction. Arquivos de Gastroenterologia. dezembro de 2010;47(4):379–82.
Eisig JN, Silva FM, Barbuti RC, Navarro-Rodriguez T, Moraes-Filho JPP, Pedrazzoli Jr J. Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option. Arquivos de Gastroenterologia. dezembro de 2011;48(4):261–4.
Suzuki RB, Lopes RAB, da Câmara Lopes GA, Hung Ho T, Sperança MA. Low Helicobacter pylori primary resistance to clarithromycin in gastric biopsy specimens from dyspeptic patients of a city in the interior of São Paulo, Brazil. BMC Gastroenterology [Internet]. dezembro de 2013 [citado 27 de outubro de 2018];13(1). Disponível em: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-13-164
Picoli SU, Mazzoleni LE, Fernández H, De Bona LR, Neuhauss E, Longo L, et al. Resistance to amoxicillin, clarithromycin and ciprofloxacin of Helicobacter pylori isolated from southern Brazil patients. Revista do Instituto de Medicina Tropical de São Paulo. junho de 2014;56(3):197–200.
Sanches BS, Martins GM, Lima K, Cota B, Moretzsohn LD, Ribeiro LT, et al. Detection of Helicobacter pylori resistance to clarithromycin and fluoroquinolones in Brazil: A national survey. World Journal of Gastroenterology. 2016;22(33):7587.
Martins GM, Sanches BSF, Moretzsohn LD, Lima KS, Cota BDCV, Coelho LGV. Molecular detection of clarithromycin and fluoroquinolones resistance in helicobacter pylori infection, directly applied to gastric biopsies, in an urban brazilian population. Arquivos de Gastroenterologia. junho de 2016;53(2):113–7.
Camargo MC, García A, Riquelme A, Otero W, Camargo CA, Hernandez-García T, et al. The Problem of Helicobacter pylori Resistance to Antibiotics: A Systematic Review in Latin America. The American Journal of Gastroenterology. abril de 2014;109(4):485–95.
Li B-Z, Threapleton DE, Wang J-Y, Xu J-M, Yuan J-Q, Zhang C, et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori : systematic review and network meta-analysis. BMJ. 19 de agosto de 2015;h4052.
Arama SS, Tiliscan C, Negoita C, Croitoru A, Arama V, Mihai CM, et al. Efficacy of 7-Day and 14-Day Triple Therapy Regimens for the Eradication of Helicobacter pylori : A Comparative Study in a Cohort of Romanian Patients. Gastroenterology Research and Practice. 2016;2016:1–7.
Puig I, Baylina M, Sánchez-Delgado J, López-Gongora S, Suarez D, García-Iglesias P, et al. Systematic review and meta-analysis: triple therapy combining a proton-pump inhibitor, amoxicillin and metronidazole for Helicobacter pylori first-line treatment. Journal of Antimicrobial Chemotherapy. outubro de 2016;71(10):2740–53.
Lu H, Zhang W, Graham DY. Bismuth-containing quadruple therapy for Helicobacter pylori: lessons from China. European Journal of Gastroenterology & Hepatology. junho de 2013;1.
Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut. janeiro de 2017;66(1):6–30.
Rimbara E, Fischbach LA, Graham DY. Optimal therapy for Helicobacter pylori infections. Nature Reviews Gastroenterology & Hepatology. fevereiro de 2011;8(2):79–88.
Lee S tae, Lee DH, Lim JH, Kim N, Park YS, Shin CM, et al. Efficacy of 7-Day and 14-Day Bismuth-Containing Quadruple Therapy and 7-Day and 14-Day Moxifloxacin-Based Triple Therapy as Second-Line Eradication for Helicobacter pylori Infection. Gut and Liver. 23 de julho de 2015;9(4):478.
Crowe SE & Feldman M. (2020). Treatment regimens for Helicobacter pylori. In S. Grover (Ed.), UpToDate. Retrieved March 20, 2020 from https://www.uptodate.com/contents/treatment-regimens-for-helicobacter-pylori/print
Parente JML, Silva BBD, Palha-Dias MPS, Zaterka S, Nishimura NF, Zeitune JM. HELICOBACTER PYLORI INFECTION IN CHILDREN OF LOW AND HIGH SOCIOECONOMIC STATUS IN NORTHEASTERN BRAZIL. :4.
Moon SW, Kim TH, Kim HS, Ju J-H, Ahn YJ, Jang HJ, et al. United Rapid Urease Test Is Superior than Separate Test in Detecting Helicobacter pylori at the Gastric Antrum and Body Specimens. Clinical Endoscopy. 2012;45(4):392.
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of Gastroenterology. fevereiro de 2017;112(2):212–39.
Wang Y-K. Diagnosis of Helicobacter pylori infection: Current options and developments. World Journal of Gastroenterology. 2015;21(40):11221.
Treatment regimens for Helicobacter pylori - UpToDate [Internet]. [citado 23 de outubro de 2018]. Disponível em: https://www.uptodate.com/contents/treatment-regimens-for-helicobacter-pylori#H1
Fallone CA, Chiba N, van Zanten SV, Fischbach L, Gisbert JP, Hunt RH, et al. The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults. Gastroenterology. julho de 2016;151(1):51-69.e14.
Venerito M, Krieger T, Ecker T, Leandro G, Malfertheiner P. Meta-Analysis of Bismuth Quadruple Therapy versus Clarithromycin Triple Therapy for Empiric Primary Treatment of Helicobacter pylori Infection. Digestion. 2013;88(1):33–45.
Luther J, Higgins PDR, Schoenfeld PS, Moayyedi P, Vakil N, Chey WD. Empiric Quadruple vs. Triple Therapy for Primary Treatment of Helicobacter pylori Infection: Systematic Review and Meta-Analysis of Efficacy and Tolerability. The American Journal of Gastroenterology. janeiro de 2010;105(1):65–73.
Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection—the Maastricht VI/ Florence Consensus Report. Gut. 2022 Aug. ;doi 10.1136/gutjnl-2022-327745.
Yuan Y, Ford AC, Khan KJ, Gisbert JP, Forman D, Leontiadis GI, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Upper GI and Pancreatic Diseases Group, organizador. Cochrane Database of Systematic Reviews [Internet]. 11 de dezembro de 2013 [citado 24 de outubro de 2018]; Disponível em: http://doi.wiley.com/10.1002/14651858.CD008337.pub2
Malfertheiner P, Bazzoli F, Delchier J-C, Celiñski K, Giguère M, Rivière M, et al. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. The Lancet. março de 2011;377(9769):905–13.
Peedikayil MC, AlSohaibani FI, Alkhenizan AH. Levofloxacin-Based First-Line Therapy versus Standard First-Line Therapy for Helicobacter pylori Eradication: Meta-Analysis of Randomized Controlled Trials. Bayer A, organizador. PLoS ONE. 21 de janeiro de 2014;9(1):e85620.
Greenberg ER, Anderson GL, Morgan DR, Torres J, Chey WD, Bravo LE, et al. 14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial. The Lancet. agosto de 2011;378(9790):507–14.
Sho Suzuki, Mitsuru Esaki, Chika Kusano, Hisatomo Ikehara, Takuji Gotoda (2018): Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance?, World J Gastroenterol 2019 April 28, DOI: 10.3748/wjg.v25.i16.1907
Graham DY, Lee Y, Wu M. Rational Helicobacter pylori Therapy: Evidence-Based Medicine Rather Than Medicine-Based Evidence. Clinical Gastroenterology and Hepatology. fevereiro de 2014;12(2):177-186.e3.
Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World Journal of Gastroenterology. 2013;19(45):8188.
Genta RM, Lash RH. Helicobacter pylori-negative Gastritis: Seek, Yet Ye Shall Not Always Find: The American Journal of Surgical Pathology. agosto de 2010;34(8):e25–34.
Atkinson NSS, Braden B. Helicobacter Pylori Infection: Diagnostic Strategies in Primary Diagnosis and After Therapy. Digestive Diseases and Sciences. janeiro de 2016;61(1):19–24.
Garza-González E. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World Journal of Gastroenterology. 2014;20(6):1438.
Malfertheiner P. Diagnostic methods for H. pylori infection: Choices, opportunities and pitfalls. United European Gastroenterology Journal. outubro de 2015;3(5):429–31.
Saniee P, Shahreza S, Siavoshi F. Negative Effect of Proton-pump Inhibitors (PPIs) on Helicobacter pylori Growth, Morphology, and Urease Test and Recovery after PPI Removal - An In vitro Study. Helicobacter. abril de 2016;21(2):143–52.
Lins AK, Lima RA, Magalhães M. Clarithromycin-resistant Helicobacter pylori in Recife, Brazil, directly identified from gastric biopsies by polymerase chain reaction. Arquivos de Gastroenterologia. dezembro de 2010;47(4):379–82.
Eisig JN, Silva FM, Barbuti RC, Navarro-Rodriguez T, Moraes-Filho JPP, Pedrazzoli Jr J. Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option. Arquivos de Gastroenterologia. dezembro de 2011;48(4):261–4.
Suzuki RB, Lopes RAB, da Câmara Lopes GA, Hung Ho T, Sperança MA. Low Helicobacter pylori primary resistance to clarithromycin in gastric biopsy specimens from dyspeptic patients of a city in the interior of São Paulo, Brazil. BMC Gastroenterology [Internet]. dezembro de 2013 [citado 27 de outubro de 2018];13(1). Disponível em: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-13-164
Picoli SU, Mazzoleni LE, Fernández H, De Bona LR, Neuhauss E, Longo L, et al. Resistance to amoxicillin, clarithromycin and ciprofloxacin of Helicobacter pylori isolated from southern Brazil patients. Revista do Instituto de Medicina Tropical de São Paulo. junho de 2014;56(3):197–200.
Sanches BS, Martins GM, Lima K, Cota B, Moretzsohn LD, Ribeiro LT, et al. Detection of Helicobacter pylori resistance to clarithromycin and fluoroquinolones in Brazil: A national survey. World Journal of Gastroenterology. 2016;22(33):7587.
Martins GM, Sanches BSF, Moretzsohn LD, Lima KS, Cota BDCV, Coelho LGV. Molecular detection of clarithromycin and fluoroquinolones resistance in helicobacter pylori infection, directly applied to gastric biopsies, in an urban brazilian population. Arquivos de Gastroenterologia. junho de 2016;53(2):113–7.
Camargo MC, García A, Riquelme A, Otero W, Camargo CA, Hernandez-García T, et al. The Problem of Helicobacter pylori Resistance to Antibiotics: A Systematic Review in Latin America. The American Journal of Gastroenterology. abril de 2014;109(4):485–95.
Li B-Z, Threapleton DE, Wang J-Y, Xu J-M, Yuan J-Q, Zhang C, et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori : systematic review and network meta-analysis. BMJ. 19 de agosto de 2015;h4052.
Arama SS, Tiliscan C, Negoita C, Croitoru A, Arama V, Mihai CM, et al. Efficacy of 7-Day and 14-Day Triple Therapy Regimens for the Eradication of Helicobacter pylori : A Comparative Study in a Cohort of Romanian Patients. Gastroenterology Research and Practice. 2016;2016:1–7.
Puig I, Baylina M, Sánchez-Delgado J, López-Gongora S, Suarez D, García-Iglesias P, et al. Systematic review and meta-analysis: triple therapy combining a proton-pump inhibitor, amoxicillin and metronidazole for Helicobacter pylori first-line treatment. Journal of Antimicrobial Chemotherapy. outubro de 2016;71(10):2740–53.
Lu H, Zhang W, Graham DY. Bismuth-containing quadruple therapy for Helicobacter pylori: lessons from China. European Journal of Gastroenterology & Hepatology. junho de 2013;1.
Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report. Gut. janeiro de 2017;66(1):6–30.
Rimbara E, Fischbach LA, Graham DY. Optimal therapy for Helicobacter pylori infections. Nature Reviews Gastroenterology & Hepatology. fevereiro de 2011;8(2):79–88.
Lee S tae, Lee DH, Lim JH, Kim N, Park YS, Shin CM, et al. Efficacy of 7-Day and 14-Day Bismuth-Containing Quadruple Therapy and 7-Day and 14-Day Moxifloxacin-Based Triple Therapy as Second-Line Eradication for Helicobacter pylori Infection. Gut and Liver. 23 de julho de 2015;9(4):478.
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Published
2023-12-27
How to Cite
Fernandes, A. L., Costa, R. F. A., & Brisotti, J. L. (2023). Helicobacter pylori: analysis of infection, gastric injury and therapy for erradicating in a specilized outpatient center. Manuscripta Medica, 6, 31–40. https://doi.org/10.59255/mmed.2023.88
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