Attached
Introduction
Prevalence of Helicobacter pylori (H. pylori) in patients
presenting with dyspeptic sym ptom s varies between
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countries. In contrast to the early studies done in Sri
Lanka, recent stu d ies sh o w very low prevalences of
H. pylori. Primary resistance to clarithromycin is a problem
worldwide.
Objective
To determine the proportion of H. pylori and the proportion
of resistance to clarithromycin in isolates of H. pylori in
patients presenting with dyspeptic sym ptom s to a tertiary
care hospital in Sri Lanka.
Design, setting and methods
A cross sectional, descriptive, prospective study w as
carried out in the Departm ents of Microbiology, Surgery
and Pathology of a University and E ndoscopy unit in a
tertiary care hospital from March 2014 to February 2016.
Ethical approval w a s obtained by the Ethics Committee
of the University.
Hundred and thirty eight sym ptom atic patients w ho
required endoscopic examination, (as decided by the
surgeon) were included in the study after obtaining
informed written consent. Patients less than 18 years
old were excluded.
A questionnaire w as filled by an investigator to gather
de m o graph ic data. B io p sy sp e cim e n s from all the
patients were tested for the presence of H. pylori by rapid
in-house biopsy urease test and culture. Fifty eight
specim ens were tested by histology.
Results
Six of the 138 biopsies were positive by in-house biopsy
urease test (4.3%). Unfortunately, w e were unable to
isolate H. pylori from any of the specim ens. O nly 3
biopsies show ed histological ch ange s compatible with
H. pylori infection (5.2%), of which only 1 w as positive by
in-house biopsy urease test.
Conclusions
O ur study sh ow s very low proportions of H. pylori by
culture, biopsy urease test and histology, which is in line
with the recent studies done in Sri Lanka and other Asian
countries. Further studies are warranted to find out the
aetiology in patients with dyspeptic sym ptom s, a s
unnecessary u sage of antibiotics in the m anagem ent of
patients m ay increase the risk of drug resistance.
