Antimicrobial resistance, bacterial density, and eradication outcomes of Helicobacter pylori infection in Egyptian patients: A prospective cohort study
Abstract
BACKGROUND AND STUDY AIMS
Helicobacter pylori is a widespread pathogen linked to gastritis, peptic ulcers, and gastric cancer. Increasing antimicrobial resistance is making eradication more difficult. The aim is tostudy how clinical symptoms, endoscopic and histopathological findings, bacterial density, and antimicrobial resistance patterns of H. pylori are related in Egyptian patients.
PATIENTS AND METHODS
In our study, 100 treatment-naïve patients with gastrointestinal symptoms suggestive of H. pylori infection and positive stool antigen tests underwent endoscopy, gastric biopsy, histopathology, and culture with antimicrobial susceptibility testing. All patients received 14-day levofloxacin-based triple therapy. Treatment response was assessed clinically and by stool antigen testing..
RESULTS
Epigastric pain was the most common symptom, reported by 83% of patients, followed by nausea and vomiting in 58%. Weight loss and pallor were less frequent, at 24% and 18%, respectively. Abnormal upper gastrointestinal endoscopy findings were present in 97% of patients, with 53% showing erosive or ulcerative lesions, indicating significant mucosal involvement. Higher H. pylori bacterial density was associated with gastric ulcers, erosions, mucosal atrophy, and duodenal lesions (p < 0.001). Higher bacterial density was significantly associated with severe mucosal lesions and increased the risk of ulcerative disease, resulting in more severe epigastric pain and gastrointestinal…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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