Helicobacter Pylori – howMed

Helicobacter pylori is a gram- negative rod, curved in shape and motile with the help of flagellum.

Pathogenesis

Route of Entry

  • Person to person transmission
  • Ingested
  • Not isolated from food, water, stool or animals

The organism usually colonies the stomach.
Chronic information
B-cell proliferation may lead to B-cell lymphoma.

Virulence factors

  • Urease
  • Enterotoxins
  • Flagellum

Predisposing factors

  • Cancers
  • Chronic NSAID’s users
  • Bad hygiene
  • Malnutrition
  • Use of proton pump inhibitors

Clinical Symptoms

  • Gastritis
  • Peptic ulcers
  • Recurrent upper abdominal pain
  • No bacteremia or disseminated  disease
  • MALT ( mucosal associated lymphyd tissues )

Lab-Diagnosis

Specimen •    Stool -antigens are detected

•    Gastric biopsy

Microscopy

Following features are observed under microscope: •    Gram- negative rods •    Curved in shape •    Flagellum present

•    Motile

Culture

  • Microaerophilic organisms
  • Gram – stain is used for gastric biopsy
  • Gastric mucosa is cultured on improved perston blood-free medium. They are urease positive and show grey colonies.
  • Blood agar -slightly beta hemolytic colonies are formed.

Biochemical Tests

  • Catalase              Positive
  • Oxidase               Positive
  • Urease                 Positive
  • Urea breath test

Serologic Test

  • Latex agglutination test
  • PCR

Treatment

Two antibiotics plus an agent to lower acidity.

  • Amoxicillin
  • Metronidazole
  • Bismuth salts (Pepto – Bismol)