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Bacteriology
v
Morphology:
Ø
Spiral-shaped, unipolar
multiflagellate.
v
Virulence factors:
Ø
Produce urease,
catalase, acid secretion protein inhibitor.
v
Found in stomach &
areas of gastric metaplasia in duodenum.
Transmission
·
Intra-familial
clustering suggests person-to-person spread.
·
Poor socio-economic
groups.
·
Institutionalized
groups.
·
Gastroenterologists !
Clinical
Significance
Figure 1.
Flow diagram showing the development of gastric Ca associated
with H. pylori infection.
Diagnosis
1.
Invasive endoscopy:
a.
Rapid urease test: test
of choice for diagnosis & follow up.
b.
Gram stain / culture on special medium.
c.
Histology.
2.
Non-invasive:
a.
Urea breath test:
1.
Quick but expensive!
2.
Screening test.
3.
Demonstrates eradication.
b.
Serum Abs:
↓ Specific. Used mainly for
epidemiological studies.
Treatment
·
The best regimen for
eradication is not yet clear.
·
2 regimens are
currently used.
1.
Triple therapy: 93%
eradication.
a.
Bismuth chelate.
b.
Metronidazole.
c.
Tetracycline.
2.
Alternative therapy: 85%
eradication.
a.
Omeprazole.
b.
Amoxycillin.
c.
Clarithromycin.
written
by:
Khalid Bin Yaroof. FMHS, UAE University.
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