Malgorzata Plonka

Detection of specific Helicobacter pylori DNA and antigens in stool samples in dyspeptic patients and healthy subjects

In this study stool samples from dyspeptic patients and healthy subjects were used for detection of specific Helicobacter pylori antigens and DNA by immunoenzymatic test (PPHpSA) and semi‐nested PCR (ureA‐PCR), respectively. The H. pylori status was estimated by invasive endoscopy‐based rapid urease test and histology or noninvasive urea breath test (UBT), and by serology (ELISA, Western blot). The coincidence of H. pylori‐negative invasive tests or UBT and negative antigen or DNA stool tests was very high (mean 95%). The PPHpSA results were found positive for 56% and ureA‐PCR for 26% of individuals with H. pylori infection confirmed by invasive tests or UBT. The detection of specific H. pylori antigens and especially DNA in feces is not sufficient as a one‐step diagnosis of H. pylori infection.

The usefulness of capsulated 13C-urea breath test in diagnosis of Helicobacter pylori infection in patients with upper gastrointestinal bleeding.

Background H. pylori infection and peptic ulcerations and their complications such as bleeding are causally related, but the available methods used in bleeding to confirm active H. pylori lack accuracy. Aim To evaluate the usefulness of 13C-urea breath test (UBT) in diagnosing of H. pylori infection in bleeding patients. Patients and Methods Eighty-one patients with upper gastrointestinal bleeding and 258 matched controls without bleeding were enrolled to the study. UBT was performed using low-dose capsulated 13C-urea and IgG antibodies to H. pylori were determined by ELISA. Results UBT performed in bleeding patients was positive in 77.7%. In this group anti Hp IgG was positive in 79% of cases and among them gastroscopy showed 40.7% of bleeding duodenal ulcer, 38% bleeding gastric ulcer, and 86% hemorrhagic gastritis. UBT was positive in 90.9%, 77.4%, and in 52.97% cases, respectively, and it was not statistically different from that in non-bleeding controls, duodenal and gastric ulcers and gastritis. All patients with blood or “coffee grounds” in the stomach had both UBT and serology positive. Conclusion The UBT is simple and non-invasive method, which can be successively applied also in patients with upper gastrointestinal bleeding to detect active H. pylori infection prior to emergency endoscopy.

Can Drinking Water Serve as a Potential Reservoir of Helicobacter pylori? Evidence for Water Contamination by Helicobacter pylori

Although the natural niche for H. pylori is the human stomach, for widespread infection to occur the organism may need to survive in the external environment [1]. Documented evidence relating to the survival of H.pylori outside the gastric niche is extremely limited. However, there are no established culture methods for the detection of viable H. pylori in the environment, in particular drinking water supplies, preventing the development of true epidemiological and risk assessments [2]. A number of drinking water studies have identified H. pylori in water preand post-chlorination [3]. Baker and colleague [4] found that H. pylori were more resistant to low levels of free chlorine than E. coli or C. jejuni. Moreno and colleagues [5] have shown that H. pylori could survive disinfection procedures that are normally used in drinking water treatment when bacterium H. pylori was found in the viable but not-culturable (VBNC) state. However, they did find that culture of H. pylori was lost after 5 min in water despite free chlorine levels of 0.96 mg/2l of water. Children born into high-income families supplied with municipal water are considered 12 times more likely to become colonized with H. pylori than those supplied from community wells. This suggests that municipal water is a possible risk factor in the transmission and acquisition of H. pylori. It is plausible to suggest that breaks in municipal pipes allow for infiltration of contaminated surface water [6].