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Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2014, vol. 20, issue 4
Subject Collection: Medicine
Pages: 523-525
DOI: 10.5272/jimab.2014204.523
Published online: 02 September 2014
J of IMAB 2014 Jul-Sep;20(4):523-525
MONITORING OF CASES WITH A CHRONIC PERSISTENT INFECTION WITH HELICOBACTER PYLORI.
Miglena Stamboliyska 
, Ivan Shalev, Diana Gancheva, Maria Atanasova, Violina Kaludova, Iskren Kotzev.
Clinic of Gastroenterology, Department of Microbiology, Medical University - Varna, MHAT "St. Marina" Varna, Bulgaria.
ABSTRACT:
Introduction: The patients with persistent forms of Helicobacter pylori (HP) infection are refractory to eradication treatment. They receive unsuccessful therapies, experience frequent recurrences and re-infections. One of the main reasons for the development of persistent forms is an inadequate and insufficient treatment. The persistent forms of HP infection create conditions for the maintenance of activity and for the progression of the induced chronic gastritis. In this aspect these cases will be at a higher risk for the development of gastric cancer.
The aim of this study is: to monitor and analyze the cases with persistent HP infection and to establish an approach for their management.
Clinical material and methods: The study includes 12 patients (8 female and 4 male) at a middle age of 63,7, with a persistent HP infection, who have been observed for a period of five years. Two methods for the detection of HP infection are used – one invasive and one non-invasive. Upper endoscopy with morphological examination was performed.
Results: In 9/12 patients HP was unsuccessfully treated for three times, in 2 patients – four times, and in 1 patient – five times. In all patients the initial treatment consisted of a standard triple therapy (STT). In 5 of them STT was conducted twice, with the same regimen for a period of seven days. Two patients received three courses of STT. In four patients an antibiotic resistance was established by means of a cultured assessment. In three cases an HP resistance to Clarithromycine and Metronidazole was demonstrated. Significant gastro-duodenal pathology with atrophic gastritis, intestinal metaplasia, and hyperplastic polyposis was found in all patients. The persistent clinical symptoms had 9 patients.
Conclusion: We believe that a devised and proposed step strategy which covers early detection of infection, reliable diagnosis, adequate and successful treatment, and dispensary monitoring, contributes to the prevention of gastric cancer.
Key words: HP infection, persistent forms, treatment, risk patient,
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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Stamboliyska M, Shalev I, Gancheva D, Atanasova M, Kaludova V, Kotzev I. Monitoring of cases with a chronic persistent infection with helicobacter pylori. J of IMAB. 2014 Jul-Sep;20(4):523-525. http://dx.doi.org/10.5272/jimab.2014204.523.
Correspondence to: Dr. Miglena Stamboliyska, Clinic of Gastroenterology, University Hospital "St. Marina", 1, Hristo Smirnenski str, 9002 Varna, Bulgaria; E-mail: m.stamboliyska@abv.bg
REFERENCES:
1. Moya DA, Crissinger KD. Helicobacter pylori persistence in children: distinguishing inadequate treatment, resistant organisms, and reinfection. Curr Gastroenterol Rep. 2012 Jun;14(3):236-242. [PubMed] [CrossRef]
2. Müller A, Oertli M, Arnold IC. H. pylori exploits and manipulates innate and adaptive immune cell signaling pathways to establish persistent infection. Cell Commun Signal. 2011 Nov 1;9(1):25. [PubMed] [CrossRef]
3. Luther J, Chey WD, Saad RJ. A clinician’s guide to salvage therapy for persistent Helicobacter pyloriinfection. Hosp Pract (1995). 2011 Feb;39(1):133-140. [PubMed]
4. Kim S, Ruiz VE, Carroll JD, Moss SF. Helicobacter pylori in the pathogenesis of gastric cancer and gastric lymphoma. Cancer Lett, 2011 Jun 28;305(2):228-238. [PubMed] [CrossRef]
5. Alvi A, Ansari SA, Ehtesham NZ, Rizwan M, Devi SL, Sechi A, et al. Concurrent proinflammatory and apoptotic activity of a Helicobacter pylori protein (HP986) points to its role in chronic persistence. PLoS One. 2011 Jul;6(7):e22530. [PubMed] [CrossRef]
6. Abdiev S, Ahn K, Khadjibaev A, Malikov Y, Bahramov S, Rakhimov B, et al. Helicobacter pylori infection and cytokine gene polymorphisms in Uzbeks. Nagoya J Med Sci. 2010 Aug;72(3-4):167-172. [PubMed]
7. Cervantes DT, Fischbach LA, Goodman KJ, Phillips CV, Chen CS, Broussard CS. Exposure to Helicobacter pylori-positive siblings and persistence of Helicobacter pylori infection in early childhood. J Pediatr Gastroenterol Nutr. 2010 May;50(5):481-485. [PubMed]
8. Lee YC, Liou JM, Wu MS, Wu CY, Lin JT. Eradication of Helicobacter pylori to prevent gastroduodenal diseases: hitting more than one of bird with the same stone, Ther Adv Gastroenterol. 2008 Sep;1(2):111-120. [PubMed] [CrossRef]
Received: 17 June 2014
Published online: 02 September 2014