Page 26 - pest-POSTEN nr 4, 1995

-pest-POSTEN Side 26

NORSKE POSTERE... - forts. grew rapidly i.e after < 5 days, than after a longer
period of incubation. Overall MTZ-resistance was
Workshop on Helicobacter pylori, 29.1%. Increased resistance rates were found for
Edinburgh: (se referat s. 10) both female sex and for younger patients (i.e. < 60
years of age) with p-values of < 0.015 and <
0.002,
and
respectively.
For
tetracycline
ampicillin, susceptibility rates were nearly 100%.
HELICOBACTER PYLORI - Conclusions: In our hands, microscopy and
EPIDEMIOLOGIC AND urease test can not replace culturing as a means of
MICROBIOLOGICAL ASPECTS IN A Hp detection. A significant number of the HP
NORWEGIAN POPULATION. culture positive cases in our study (more than 1/4)
JB Haug, F Lerang, E Ragnhildstveit, B Moum. were detected after an incubation time of 6 to 12
Østfold Gastro Group: from the Departments of days. Metronidazole resistance is highly prevalent
Microbiology and Internal Medicine, Østfold (29.1%) in our population, especially among the
Central Hospital, Fredrikstad, Norway. young and female patients. We propose that an
earlier use of metronidazole in this particular
Introduction: This study comprises 1198 gastral patient group may be one possible explanation.
antrum biopsy samples routinely cultured for Serological, histopathological and clinical
Helicobacter pylori (Hp) at a single clinical observations are pending in this ongoing study
microbiological laboratory during 27 months since and will be further commented upon.
June 1992.
Aim: To evaluate 1) diagnostic methods with ——
regard to the presence of Hp. 2) antimicrobial
susceptibility rates and 3) the epidemiology of Hp
infections in our geographical area (a county of HELICOBACTER PYLORI (HP)
Norway with ~240,000 inhabitants). INFECTION AND METRONIDAZOLE
Methods: Specimens were incubated micro-
(MTZ) RESISTANCE.
aerophilic on selective agar media for up to 12 F Lerang, B Moum, E Ragnhildstveit, JB Haug
days. using standard techniques. Microscopy was and Østfold Gastrogroup. Østfold Central
performed with the Gram and Acridin stains and Hospital, Fredrikstad,Norway.
each specimen was tested for urease production
after 1/2 and 18 hours of incubation. In the case Introduction: Bismuth triple therapy achieves
of a negative culture, one typical microscopy and 85-95% Helicobacter pylori eradication (HPE)
one positive urease test was regarded a Hp- rate, but is encumbered with side effects. MTZ
positive case (designated “indirect”criterion). resistance is reported to lower HPE rate.
Antibiotic susceptibility tests were performed with Aim: To compare two triple therapies of 14
the Epsilometer test, using a MIC > 16 mg/l as days duration in patients with HP positive
breakpoint for metronidazole (MTZ) resistance. duodenal ulcer disease and the significance of
Results: The male to female ratio in Hp positive primary MTZ susceptibility on HPE rates: 1)
cases was 1.6:1. In 64.7% of cases, the patients "BTM" (bismuth subnitrate 75mg qid,
were less than 60 years of age. Hp was present in oxytetracycline 500mg qid, metronidazole 400mg
509 (42.5%) of all specimens and of these, a bid) and 2) "OAM" omeprazole 20mg bid,
positive culture was achived in 90.2%. In 72.1% amoxicillin 750m bid, metronidazole 400mg bid).
of cases, Hp was cultured within 5 days and the Methods: HP infection was confirmed by
rest after 6-12 days of incubation. Our “indirect” biopsies cultured up to 12 days, microscopy and
criterion was not fuilfilled in 33.6% of the culture- urease test. MTZ susceptibility was determined by
positive cases, hence, the sensitivity and the Epsilometer test, and MTZ resistance defined
specificity for the urease test and was 78.7% and as MIC>16mg/l. Patients completed a self-
90.5% and for microscopy, 74.0% and 90.9%. assessment questionnaire with grading of side
respectively. Microscopy and ureaset test effects. Follow up endoscopy with HP status was
performed significantly better (p<0.001) when Hp performed 6 weeks after treatment.