Helicobacter pylori感染症の診断と疫学的研究

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  • Clinical Diagnosis and Epidemiological Study of Helicobacter pylori Infection

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Abstract

It has been recognized that Helicobacter pylori (H. pylori) correlates well with chronic gastritis, peptic ulcer disease, and gastric cancer. Although the mode of transmission is still not clearly understood, current evidence suppots fecal-oral and oral-oral transmission. Several methods were developed for diagnosis of H. pylori infection. Among 39 biopsy samples, 35 (90%) were positive by PCR, and 73%, 71%, 69% were also positive by culture, CLO-test, ^<13>C-UBT, respectively. The concordance rate (diagnostic accuracy) between culture and PCR, CLO-test, 13C-UBT, serum anti H. pylori IgG antibody were 82%, 85%, 89%, 90%, respectively. H. pylori could not isolated from dental plaque, but 9 of 28 patients (32%) were positive by PCR. The prevalence of H. pylori infection in Niigata was investigated by serum anti H. pylori IgG antibody. Seven percent of children under 10 years old was infected, and, after age 10, the prevalence increased with age (30% in 10～19, 39% in 20～29, 67% in 30～39, 78% in 40～49, 77% in 50～59, 79% in 60～69, 87% in after age 70). The prevalence in dentists was high in 20's male, and 30's female. The successful eradication of H. pylori greatly reduces the incidence of ulcer recurrence. We have used dual (PPI+AMPC) and triple (PPI+AMPC+MNZ) therapy, and eradication rates ranged from 97～100%. In 78 strains, resistance to metronidazole was detected in 11 strains (14%), while four stains were resistant to clarithromycin and none to amoxicillin.

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