Is Helicobacter pylori a problem in patients with dyspeptic symptoms in Sri Lanka

Abstract

Attached

Introduction Prevalence of Helicobacter pylori (H. pylori) in patients presenting with dyspeptic sym ptom s varies between 24 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.