Helicobacter Pylori

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)