BACKGROUND Helicobacter pylori(H.pylori)is the most common chronic bacterial infection in humans.The risk of acquiring H.pylori is related to socioeconomic status and living conditions early in life.Treatment regimens...BACKGROUND Helicobacter pylori(H.pylori)is the most common chronic bacterial infection in humans.The risk of acquiring H.pylori is related to socioeconomic status and living conditions early in life.Treatment regimens must consider local antibiotic resistance patterns.Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America.Data regarding the prevalence and resistance of H.pylori in this population is scant.AIM To evaluate the prevalence and resistance of H.pylori and correlate with country of origin.METHODS All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation.RESULTS Two hundred and sixty-six patients are born in the United States,450,171,70,and 30 patients are immigrants from Mexico,Central and South America(CSA),Asia,and other countries respectively.Overall,14.65%were found to be infected with H.pylori.Rates of infection in United States-born citizens,immigrants from Mexico,CSA,and Asia are 9.02%,18.67%,13.45%,and 11.43%respectively,with Mexican immigrants having a relative risk of 2.3889[95%confidence interval(CI):1.4789-3.8588,P=0.0004]compared to those born in United States.No correlation seen between infection and length of time immigrants were in United States.Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276(95%CI:1.3562-2.7398,P=0.0003).Rates of resistance for clarithromycin and levofloxacin are 21.43%and 31.11%.CONCLUSION H.pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life.Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region,particularly in patients of Latin American origin.展开更多
目的分析并总结胃不适患者胃幽门螺旋杆菌流行病学特点。方法收集2023年4月-2023年7月期间在广州市越秀区东山街社区卫生服务中心因胃部不适来进行检测的患者312例为研究对象,分析不同年龄、不同性别幽门螺旋杆菌阳性分布特点。结果312...目的分析并总结胃不适患者胃幽门螺旋杆菌流行病学特点。方法收集2023年4月-2023年7月期间在广州市越秀区东山街社区卫生服务中心因胃部不适来进行检测的患者312例为研究对象,分析不同年龄、不同性别幽门螺旋杆菌阳性分布特点。结果312例患者中,阳性93例,阴性219例,阳性检出率为29.81%;其中,男性患者阳性28例,阴性74例,阳性检出率为27.45%;女性患者阳性65例,阴性145例,阳性检出率为30.95%。不同性别阳性率差异无统计学意义(χ^(2)=0.402,P=0.526);在男性感染者中,幽门螺旋杆菌检测DOB平均值为(23.01±26.75),在女性感染者中幽门螺旋杆菌检测DOB平均值为(17.31±11.84),其中DOB代表C13-尿素呼气试验超基准值(delta over baseline,DOB)。男性DOB值高于女性,但差异无统计学意义(t=1.430,P=0.156);不同年龄阳性率分布无明显上升或下降趋势;阳性构成比以40岁以上为主,占总阳性例数的79.57%;年龄在60岁及以下阳性感染者中,幽门螺旋杆菌检测DOB平均值为(14.95±11.87),61岁及以上阳性感染者中,幽门螺旋杆菌检测DOB平均值为(24.66±22.71)。两组差异有统计学意义(t=2.643,P=0.0097)。结论胃幽门螺旋杆菌在不同性别、年龄均可检出,是导致胃部不适的主要原因之一,社区开展C13吹气实验可以早期检测有无感染,实现尽早进行抗生素治疗,从而降低胃部肿瘤发生率,充分体现社区卫生服务中心医防融合的服务理念。展开更多
文摘BACKGROUND Helicobacter pylori(H.pylori)is the most common chronic bacterial infection in humans.The risk of acquiring H.pylori is related to socioeconomic status and living conditions early in life.Treatment regimens must consider local antibiotic resistance patterns.Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America.Data regarding the prevalence and resistance of H.pylori in this population is scant.AIM To evaluate the prevalence and resistance of H.pylori and correlate with country of origin.METHODS All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation.RESULTS Two hundred and sixty-six patients are born in the United States,450,171,70,and 30 patients are immigrants from Mexico,Central and South America(CSA),Asia,and other countries respectively.Overall,14.65%were found to be infected with H.pylori.Rates of infection in United States-born citizens,immigrants from Mexico,CSA,and Asia are 9.02%,18.67%,13.45%,and 11.43%respectively,with Mexican immigrants having a relative risk of 2.3889[95%confidence interval(CI):1.4789-3.8588,P=0.0004]compared to those born in United States.No correlation seen between infection and length of time immigrants were in United States.Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276(95%CI:1.3562-2.7398,P=0.0003).Rates of resistance for clarithromycin and levofloxacin are 21.43%and 31.11%.CONCLUSION H.pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life.Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region,particularly in patients of Latin American origin.
文摘目的分析并总结胃不适患者胃幽门螺旋杆菌流行病学特点。方法收集2023年4月-2023年7月期间在广州市越秀区东山街社区卫生服务中心因胃部不适来进行检测的患者312例为研究对象,分析不同年龄、不同性别幽门螺旋杆菌阳性分布特点。结果312例患者中,阳性93例,阴性219例,阳性检出率为29.81%;其中,男性患者阳性28例,阴性74例,阳性检出率为27.45%;女性患者阳性65例,阴性145例,阳性检出率为30.95%。不同性别阳性率差异无统计学意义(χ^(2)=0.402,P=0.526);在男性感染者中,幽门螺旋杆菌检测DOB平均值为(23.01±26.75),在女性感染者中幽门螺旋杆菌检测DOB平均值为(17.31±11.84),其中DOB代表C13-尿素呼气试验超基准值(delta over baseline,DOB)。男性DOB值高于女性,但差异无统计学意义(t=1.430,P=0.156);不同年龄阳性率分布无明显上升或下降趋势;阳性构成比以40岁以上为主,占总阳性例数的79.57%;年龄在60岁及以下阳性感染者中,幽门螺旋杆菌检测DOB平均值为(14.95±11.87),61岁及以上阳性感染者中,幽门螺旋杆菌检测DOB平均值为(24.66±22.71)。两组差异有统计学意义(t=2.643,P=0.0097)。结论胃幽门螺旋杆菌在不同性别、年龄均可检出,是导致胃部不适的主要原因之一,社区开展C13吹气实验可以早期检测有无感染,实现尽早进行抗生素治疗,从而降低胃部肿瘤发生率,充分体现社区卫生服务中心医防融合的服务理念。
