Characteristics of Helicobacter pylori Infection in Jamaican Adults with Gastrointestinal Symptoms

Department of Pediatrics, Emory University, Atlanta, Georgia, United States
Journal of Clinical Microbiology (Impact Factor: 3.99). 02/2001; 39(1):212-6. DOI: 10.1128/JCM.39.1.212-216.2001
Source: PubMed


Helicobacter pylori infection is common in Jamaica. Describing its epidemiology in a population-based study depends largely on serology, but serologic assays have not been validated in this population. To address this issue, we examined the presence of H. pylori infection in 30 sequential adult patients with gastroduodenal symptoms by three biopsy-based methods (rapid urease test, histology, and culture) as well as by one research and two commercial enzyme-linked immunosorbent assays (ELISAs). A patient was considered H. pylori positive if the organism was detected by at least one biopsy-based method. Eighteen (60%) of the 30 patients were H. pylori positive by these criteria, whereas 21 (70%) were seropositive for H. pylori immunoglobulin G by our research ELISA. The presence of H. pylori infection in patients with gastric cancer and those with chronic gastritis was missed by biopsy-based methods but was detected by serologic assays. This observation indicates that serologic assays may be better suited for the detection of this infection in a population in which H. pylori-associated pathology is prevalent. The performance of our research ELISA in detecting biopsy-based H. pylori-positive cases was excellent, with a sensitivity and specificity of 100% and 75%, respectively. Molecular genotyping of the isolates revealed that the predominant H. pylori genotypes in this cohort of Jamaicans were cagA(+) vacA slb-m1, and iceA2. The validated serologic assay enables us to interpret epidemiologic data from population-based studies in Jamaica by comparison to those from other populations.

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Available from: Masayuki Hisada, Feb 03, 2015
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    • "The epidemiology of H. pylori infection in the Caribbean islands remains an important concern for public health investigation because of the high prevalence of this infection and its association with gastric cancer. In Jamaica a high prevalence of 70% has been described (Hisada et al., 2001). "
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    ABSTRACT: Helicobacter pylori induces chronic gastritis, the strongest known risk factor for peptic ulcer disease, distal gastric cancer and a number of extra gastric related morbidity. More than 50% of the world's population is infected with this organism lifelong without effective bacterial eradication. Clinical sequelae are dependent upon bacterial virulence factors and host genetic diversity, particularly within immune response genes. The organism is able to evade the harsh acidic environment in the gastric mucosa and host immune response by elaborating a number of factors that aid in the achievement of its persistent colonization. H. pylori possess numerous virulence proteins (cagA, vacA and iceA) and enzymes (urease, catalase, lipase, phospholipase and proteases) with substantial genotypic diversity, which engenders differential host inflammatory responses that influence the pathologic outcome. The hallmark of H. pylori infection is a marked inflammatory response with the infiltration of various immune cells into the infected gastric mucosa; with a polarized Th1 immune response which further attracts inflammatory cells to the gastric mucosa leading to damage. Knowledge on H. pylori reservoirs and transmission remains elusive. However, studies have described the gastro-oral, oral-oral and faecal-oral as possible routes of acquisition and transmission. This paper provides an understanding of H. pylori persistence and pathogenesis as well as its route of transmission.
    African journal of microbiology research 03/2010; 4(6). · 0.54 Impact Factor
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    • "The epidemiology of H. pylori infection in the Caribbean islands remains an important concern for public health investigation because of the high prevalence of this infection and its association with gastric cancer. In Jamaica a high prevalence of 70% has been described (Hisada et al., 2001). "
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    ABSTRACT: Since Marshall and Warren reported the first isolation of Helicobacter pylori basic and clinical research on pathogenesis and epidemiology of Helicobacter pylori infection have been tremendous. Childhood is clearly established as the period of major risk for Helicobacter pylori acquisition. The transmission pathways may be several including the oral-oral, the gastro-oral or the fecal-oral transmission route. The colonization of Helicobacter pylori occurs exclusively in the gastric mucosa or in areas of gastric metaplasia especially in the duodenum. Helicobacter pylori possesses several factors to adhere to the epithelial cells and to cause mucosal damage. The acquisition of Helicobacter pylori always induces a chronic gastritis. The development to clinical manifestations (peptic ulcer or gastric cancer) are further dependent on specific bacterial strain virulence factors as well as on host and environment factors. The mechanisms involved in the inflammatory process have been elucidated in great detail and will further be focused and related to specific associated disease development.
    Wiener Medizinische Wochenschrift 02/2002; 152(5-6):117-22.
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    ABSTRACT: A number of scientific breakthroughs since H pylori first became recognized as a human pathogen have increased our understanding of the pathogenesis of gastroduodenal disease. In particular, advances in molecular bacteriology and the complete sequencing of the H pylori genome in 1999, and soon thereafter the human genome, provide tools allowing better delineation of the pathogenesis of disease. These molecular tools for both bacteria and host should now be applied to multicenter pediatric studies that evaluate disease outcome. More recent developments indicate that a better understanding of the microbial-host interaction is critical to furthering knowledge with respect to H pylori-induced diseases. Studies are needed to evaluate either DNA-based or more traditional protein-based vaccines, to evaluate more specific antimicrobials that confer minimal resistance, and to evaluate probiotics for the management of H pylori infection. Multicenter multinational studies of H pylori infection in the pediatric population, which include specific, randomized controlled eradication trials, are essential to extend current knowledge and develop better predictors of disease outcome.
    Current Problems in Pediatric and Adolescent Health Care 09/2001; 31(8):247–266. DOI:10.1067/mps.2001.118485
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