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[afro-nets] Open Learning Web site on Enteric pathogens

  • From: Salvatore Rubino <rubino@uniss.it>
  • Date: Wed, 13 Sep 2006 09:14:14 +0200

Open Learning Web site on Enteric pathogens

Dear Friends of the Open Learning Web site on Enteric pathogens

A new lecture is available at the new web site

Helicobacter pylori infection in Bulgarian patients

Lyudmila Boyanova
Department of Microbiology,
Medical University of Sofia, Bulgaria

The presentation aims to show the characteristics of H. pylori
in Bulgaria as a country with a high seroprevalence of the
infection. In 2003- June 2006, 78% of the non-treated adults and
72.8% of the non-treated children were H. pylori positive. The
infection was most common (>83%) in patients with peptic ulcers
and stomach cancer. Resistance rates in non-treated and treated
patients were: metronidazole 21.8 and 46.2 %, clarithromycin
16.7 and 42.6%, amoxicillin 1.1 and 3.2%, and tetracycline 4.7
and 8.9%. Treated patients harbored three-fold more resistant
strains (21.5 %) to both metronidazole and clarithromycin than
the non-treated ones (7%). The prevalence of infection was high
in all age groups involving even the youngest children (62.5%).
This can suggest an early acquisition of the infection in
Bulgaria. The culture was the most accurate diagnostic method.
In adults, a high density of colonization was found
significantly more common (44.2%) in peptic ulcers than in
chronic gastritis (27.9%) or other diseases (17%). Primary
metronidazole resistance in adults was slightly more common than
in children (p >0.05), and the differences for other agents were
comparable in both groups. The frequent resistance to
metronidazole and clarithromycin in treated patients strongly
suggests a need for H. pylori susceptibility testing in this
group. There was a significant increase in clarithromycin
resistance rates in all patients from 1996-1999 (10%) to 2003-
June 2006 (16.7%). In conclusion, H. pylori infection was common
in both Bulgarian children and adult patients. Primary
resistance rates of H. pylori were in the range of those in
other countries with a relatively more common resistance to
amoxicillin and tetracycline and a lower resistance rate to
metronidazole in children. Alarming appearance of triple
resistance to amoxicillin, metronidazole and clarithromycin was
found in 3 non-treated and one treated patients. There is an
imperative and constant need for monitoring H. pylori resistance
in Bulgaria and worldwide.

Ciao, Salvatore Rubino

Prof. Salvatore Rubino
Dip. di Scienze Biomediche
V.le San Pietro 43/b
07100 Sassari (Italy)
Tel: +39-079-228302
Fax: +39-079-212345