Journal of Infectious Diseases & Therapy
Open Access

About Helicobacter pylori

H. pylori are a kind of spiral, micro aerobic bacteria that requires very strict growth conditions. In 1983, it was successfully isolated from gastric mucosa biopsy tissue of patients with chronic active gastritis for the first time. It is the only microbial species that can survive in human stomach. Since 1994, Organizations like International Agency for Research on Cancer and World health Organization officially classified this Helicobacter pyroli was the class I cancer causing agent which is the major reason for the onset of gastric cancer. The colonization of gastric muscosa with Helicobacter pyroli pathogen has been experienced by nearly half of the world population where the individuals are remained asymtomatic in most of the cases [1,2].

The prevalence of the infections induced by H. pylori is estimated at 85%-95% in developing countries and approximately 30%-50% in developed countries [3,4]. The oral-to-oral and fecal-to-oral routes are two major transmission routes of the bacterium. The adaptation mechanisms of H. pylori include the bacterial and environmental factors that enable its survival in the gastric microenvironment where the acidity is at pH even lower than 3.0 [5,6]. The pathogenicity of H. pylori is associated with several mechanisms, among which the alterations of the host signaling pathways, indirect inflammatory responses induced within the gastric mucosa, and direct epigenetic outcomes on gastric epithelial cells, are of major importance [7].

Diseases and symptoms caused by H. pylori

The major symptoms involved in Helicobacter pylori infection are acid regurgitation, heartburn, stomach ache and bad breath. The reason behind all these symptoms are H. pylori that induces the rapid secretion of gastrin, finally leading to heartburn. In patients with gastric ulcer disease, the main symptom would be of stomach pain and the bad breath is due to direct release of germs of H. pylori. H. pylori a pathogenic bacterium and causes gastrointestinal diseases, including chronic gastritis. The main clinical manifestations are epigastric discomfort, dull pain, sometimes belching, acid regurgitation, nausea and vomiting. The course of the disease is relatively slow but is able to relapse easily. H. pylori infection usually has no obvious symptoms. At this time, it is generally determined by inspection.

Prevention and diagnosis of H. pylori

Prevention methods: H. pylori positive patients should seek medical treatment when known. Once stomach symptoms are controlled, the chance of continuing to infect others is greatly reduced. For H. pylori positive people, it is strongly recommended that family members test to avoid cross-infection, resulting in repeated infection. To control and prevent H. pylori, it is necessary to cut off the transmission route and pay close attention to personal hygiene, oral hygiene, diet, and pay special attention to disinfection of tableware and chopsticks, and not share them. H. pylori enter the human body through the mouth as the bacteria are often present in the tartar and saliva of patients and carriers. Therefore, paying attention to oral hygiene and preventing disease from entering from the mouth are important measures to prevent H. pylori, infection, gastric disease and gastric cancer.

H. pylori diagnostic methods: H. pylori infection can be diagnosed several ways. Depending on the patient's symptoms and the timing of the doctor's visit, different diagnostic methods may be appropriate.

Breath test/urea breath test: The H. pyloriBreath test is one of the most advanced equipment for the detection of H. pylori which will detect the infectious cases of H. pylori without intubation.

Direct inspection of bacteria: The direct method to detect Helicobacter pylori is gastroscopy forceps where direct smear of gastric mucosa taken for staining, tissue section staining and bacterial culture.

Rapid chromatographic immunoassay: Here the Detection of H. pylori infection can be done by measuring H. pylori antibodies in serum. The H. pylori Antibody Rapid Test Cassette (serum/plasma) can be used for screening.

Evaluation of citest H. pylori antibody rapid test cassette (serum/plasma)

Materials and directions for use:Materials provided included a test cassette, droppers, and package insert. The qualitative membrane based immunoassay used for the detection of H. pylori antibodies in serum or plasma is H. pylori antibody rapid test cassette (serum/plasma). In this test procedure, anti-human IgG is immobilized in the test line region of the test. After specimen is added to the specimen well of the cassette, it reacts with H. pylori antigen coated particles in the test. This mixture migrates chromatographically along the length of the test and interacts with the immobilized anti-human IgG. If the specimen contains H. pylori antibodies, a colored line will appear in the test line region indicating a positive result. If the specimen does not contain H. pylori antibodies, a colored line will not appear in this region indicating a negative result. To serve as a procedural control, a colored line will always appear in the control line region, indicating that proper volume of specimen has been added and membrane wicking has occurred.In serum and plasma assays, first bring the bag to room temperature (15°C-30°C) before opening and remove the test cassette from the sealed bag and use within one hour.

For serum or plasma specimens:Remove the test cassette from the sealed foil pouch and use it as soon as possible. Best results will be obtained if the assay is performed immediately after opening the foil pouch.

Using the dropper: Hold the dropper vertically and transfer 3 drops of serum or plasma (approximately 75 μL) to the test cassette specimen well and start the timer. Avoid trapping air bubbles in the specimen well. Then wait for the colored line to appear. The result should be read at 10 minutes. Do not interpret the result after 20 minutes.

Performance characteristics:The H. pylori antibody rapid test cassette (serum/plasma) has been evaluated with serum and plasma specimens obtained from a population of symptomatic and asymptomatic individuals who presented for endoscopic examination (Table 1).

Table 1: Results obtained upon performing H. pylori antibody rapid test cassette (serum/plasma).

Relative sensitivity: 95.5% (95%CI*:91.8%-97.8%)

Relative specificity: 91.3% (95%CI*:85.7%-95.1%)

Overall sccuracy: 93.7% (95%CI*:90.8%-95.9%)

Expected values: The H. pylori antibody rapid test cassette (serum/plasma) has been compared with a leading commercial H. pylori antibody EIA test. The correlation between these two systems is 93.7%.

At present, H. pylori positive cases are closely related to the occurrence of gastric mucosa associated lymphoid tissue, upper gastrointestinal ulcer, chronic gastritis and gastric cancer. Therefore, during physical examinations, targeted treatment should be given, which is of great significance for the prevention and treatment of diseases related to H. pylori.

In the detection of H. pylori, methods include serological detection, urease antibody detection, and 14C urea breath test, which are routine methods for clinical detection of H. pylori. Compared with other conventional detection methods, the citest rapid detection kit is easy to operate and non-invasive and does not require patients to go through routine gastroscopy. Therefore, rational selection of non-invasive H. pylori detection methods according to different patients and different treatment stages can provide timely treatment and monitor the evolution of the disease course and provide timely information and services for clinical work.

The citest rapid detection kit has the characteristics of high sensitivity and good accuracy. The test has great significance for primary screening of H. pylori and has a positive impact on the prevention and control of gastrointestinal diseases. The authors conclude that it is necessary to add H. pylori testing to middle-aged people for health examination. Early detection and treatment can reduce transmission of H. pylori and improve patients’ quality of life. This practice is worth popularizing and creating awareness.

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