Results of Helicobacter pylori infection treatment in medical and non-medical workers in Trans-Baikal territory

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The efficacy of Helicobacter pylori eradication varies in different regions. Lower success rates of therapy are observed in medical personnel.

The aim: to analyze the results of H. pylori treatment in residents of Trans-Baikal territory, as well as in the professional community of health workers (HW) of this region.

Material and methods. 148 H. pylori-infected individuals were surveyed about their readiness to undergo anti-Helicobacter treatment. Eradication was performed in 133 of them – 67 HW and 66 non-health workers (NW). For 14 days, were used regimens that included a proton pump inhibitor (PPI), bismuth tripotassium dicitrate (B) and three combinations of antibiotics: clarithromycin and amoxicillin (PPI-BCA; n = 111), tetracycline and metronidazole (PPI-BTM; n = 9), levofloxacin and amoxicillin (PPI-BLA) as second-line therapy (n = 13) in recommended doses. H. pylori was diagnosed by determining the antigen in feces using immunochromatographic analysis. Eradication control was performed 6–8 weeks after the end of the treatment.

Results. In the questionnaire, 74.3% of HWs and 89.2% of NWs expressed their willingness to undergo eradication (p = 0.020). The treatment regimen was violated by 11 people, of whom H. pylori was eradicated only in 18.2%. When the treatment regimen was followed, the eradication efficacy was 76.0% with PPI-BCA, 44.4% with PPI-BTM, and 92.3% with PPI-BLA. The efficacy of all regimens was 64.9% for HWs and 84.6% for NWs (p = 0.012). The probability of effect absence among physicians was 2.97 times higher (odds ratio 2.973; 95% confidence interval: 1.251–7.068; p = 0.012). Adverse events developed against the background of PPI-VCA in 78.6% of MR and 56.7% of NR (p = 0.022), against the background of PPI-VLA – in 62.5 and 0% (p = 0.119), respectively.

Conclusion. PPI-BCA and PPI-BLA regimens for H. pylori eradication among residents of Trans-Baikal territory who are not involved in medical activities exceed the minimum level of efficacy and can be recommended for use in the region. The probability of failure of therapy in MW is 2.97 times higher. The worst result was obtained when using PPI-BTM (44.4%).

Full Text

Restricted Access

About the authors

Elena V. Luzina

Chita State Medical Academy of the Ministry of Healthcare of Russia

Author for correspondence.
Email: el.luz@list.ru
ORCID iD: 0000-0002-8282-3056
SPIN-code: 6748-9361

MD, PhD (Medicine), associate professor, associate professor of the Department of therapy of the Faculty of continuing professional education, chairman of the Transbaikal Scientific Society of Gastroenterologists

Russian Federation, Chita

Leonid B. Lazebnik

Russian University of Medicine of the Ministry of Healthcare of Russia

Email: leonid.borisl@gmail.com
ORCID iD: 0000-0001-8736-5851

MD, Dr. Sci. (Medicine), professor, professor of the Department of therapy and preventive medicine, vice-president of the Russian Scientific Medical Society of Internal Medicine (RSMSIM)

Russian Federation, Moscow

Natalia V. Lareva

Chita State Medical Academy of the Ministry of Healthcare of Russia

Email: larevanv@mail.ru
ORCID iD: 0000-0001-9498-9216
SPIN-code: 1228-6205

MD, Dr. Sci. (Medicine), professor, acting rector, vice-rector for scientific and international work, head of the Department of therapy of the Faculty of continuing professional education, chairman of the Transbaikal regional branch of the Russian Scientific Medical Society of Internal Medicine (RSMSIM)

Russian Federation, Chita

Zinaida M. Zhigula

Chita State Medical Academy of the Ministry of Healthcare of Russia

Email: pustotinazm@yandex.ru
ORCID iD: 0000-0002-8762-9914
SPIN-code: 4820-0122

MD, PhD (Medicine), associate professor of the Department of therapy of the Faculty of continuing professional education

Russian Federation, Chita

Sofya Y. Znamenshchikova

Trans-Baikal Regional Clinical Hospital

Email: kaayka@mail.ru
ORCID iD: 0009-0001-7733-9569

MD, gastroenterologist

Russian Federation, Chita

References

  1. Ивашкин В.Т., Лапина Т.Л., Маев И.В., Драпкина О.М., Козлов Р.С., Шептулин А.А. с соавт. Клинические рекомендации Российской гастроэнтерологической ассоциации, Научного сообщества по содействию клиническому изучению микробиома человека, Российского общества профилактики неинфекционных заболеваний, Межрегиональной ассоциации по клинической микробиологии и антимикробной химиотерапии по диагностике и лечению H. pylori у взрослых. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2022;32(6):72–93. [Ivashkin VT, Lapina TL, Maev IV, Drapkina OM, Kozlov RS, Sheptulin AA et al. Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for Н. pylori Diagnostics and Treatment in Adults. Rossijskiy zhurnal gastroenterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(6):72–93 (In Russ.)]. EDN: QRQFTQ. https://doi.org/10.22416/1382-4376-2022-32-6-72-93
  2. Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou J-M, Schulz C et al.; European Helicobacter and Microbiota Study group. Management of Helicobacter pylori infection: The Maastricht VI / Florence consensus report. Gut. 2022;gutjnl-2022-327745. PMID: 35944925. https://doi.org/10.1136/gutjnl-2022-327745
  3. Лазебник Л.Б., Дехнич Н.Н., Ситкин С.И., Атрушевич В.Г., Авалуева Е.Б., Бакулин И.Г. с соавт. Helicobacter pylori, хеликобактериоз и ассоциированные заболевания (VIII Московские соглашения по диагностике и лечению хеликобактериоза у взрослых и детей). Руководство для врачей. Экспериментальная и клиническая гастроэнтерология. 2024;(12):49–145. [Lazebnik LB, Dekhnich NN, Sitkin SI, Atrushevich VG, Avalueva EB, Bakulin IG et al. Helicobacter pylori, helicobacteriosis and associated diseases (VIII Moscow Agreements on the diagnosis and treatment of helicobacteriosis in adults and children). A Clinical Guide for Physicians. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2024;(12):49–145 (In Russ.)]. EDN: KTVUAA. https://doi.org/10.31146/1682-8658-ecg-232-12-49-145
  4. Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC et al. ACG Clinical Guideline: Treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024;119(9):1730–53. PMID: 39626064. https://doi.org/10.14309/ajg.0000000000002968
  5. Андреев Д.Н., Дичева Д.Т., Маев И.В. Возможности оптимизации эрадикационной терапии инфекции Helicobacter pylori в современной клинической практике. Терапевтический архив. 2017;89(2):84–90. [Andreev DN, Dicheva DT, Maev IV. Possibilities for optimization of eradication therapy for Helicobacter pylori infection in modern clinical practice. Terapevticheskiy arkhiv = Therapeutic Archive. 2017;89(2):84–90 (In Russ.)]. EDN: XXZGGL. https://doi.org/10.17116/terarkh201789284-90
  6. Megraud F, Bruyndonckx R, Coenen S, Wittkop L, Huang T-D, Hoebeke M et al.; European Helicobacter pylori Antimicrobial Susceptibility Testing Working Group. Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut. 2021;70(10):1815–22. PMID: 33837118. https://doi.org/10.1136/gutjnl-2021-324032
  7. Маев И.В., Андреев Д.Н., Бордин Д.С., Кучерявый Ю.А., Кудрявцева Л.В., Вьючнова Е.С. с соавт. Резистентность Helicobacter pylori к кларитромицину в Российской Федерации. Эффективная фармакотерапия. 2020;16(30):16–22. [Maev IV, Andreev DN, Bordin DS, Kucheryaviy YuA, Kudryavtseva LV, Vyuchnova ES et al. Helicobacter pylori resistance to clarithromycin in the Russian Federation. Effektivnaya farmakoterapiya = Effective Pharmacotherapy. 2020;16(30):16–22 (In Russ.)]. EDN: XKDIFO. https://doi.org/10.33978/2307-3586-2020-16-30-16-22
  8. Zou Y, Qian X, Liu X, Song Y, Song C, Wu S et al. The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714. PMID: 32533599. https://doi.org/10.1111/hel.12714
  9. Shah SC, Tepler А, Chung СР, Suarez G, Peek RM Jr, Hung A et al. Host genetic determinants associated with Helicobacter pylori eradication treatment failure: A systematic review and meta-analysis. Gastroenterology. 2021;161(5):1443–59. PMID: 34358488. PMCID: PMC8545829. https://doi.org/10.1053/j.gastro.2021.07.043
  10. Бакулина Н.В., Симаненков В.И., Бакулин И.Г., Ильчишина Т.А. Распространенность хеликобактерной инфекции среди врачей. Экспериментальная и клиническая гастроэнтерология. 2017;148(12):20–24. [Bakulina NV, Simanenkov VI, Bakulin IG, Ilchishina TA. Prevalence of Helicobacter pylori infection among physicians. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2017;(12):20–24 (In Russ.)]. EDN: YOFUPS.
  11. Katelaris P, Hunt R, Bazzoli F, Fock KM, Gemilyan M et al. Helicobacter pylori World Gastroenterology Organization Global Guideline. J Clin Gastroenterol. 2023;57(2):111–26. PMID: 36598803. https://doi.org/10.1097/MCG.0000000000001719
  12. Fekadu S, Engiso H, Seyfe S, Iizasa H, Godebo A, Deyno S, Yoshiyama H. Effectiveness of eradication therapy for Helicobacter pylori infection in Africa: A systematic review and meta-analysis. BMC Gastroenterol. 2023;23(1):55. https://doi.org/10.1186/s12876-023-02707-5
  13. Kiani F, Khademolhosseini S, Fathi M, Tavasol A, Mohammadi J, Dousti M, Hoseini JE. Standard triple therapy as a remedy for treatment of Helicobacter pylori infection: A systematic review and meta-analysis of randomized clinical trials. Curr Rev Clin Exp Pharmacol. 2023;18(2):167–81. PMID: 35301958. https://doi.org/10.2174/2772432817666220317152544
  14. Велиев А.М., Маев И.В., Андреев Д.Н., Дичева Д.Т., Заборовский А.В., Лобанова Е.Г., Бектемирова Л.Г. Эффективность и безопасность квадротерапии без препаратов висмута при лечении пациентов с Helicobacter pylori-ассоциированной язвенной болезнью желудка и двенадцатиперстной кишки. Терапевтический архив. 2019;91(8):28–33. [Veliev AM, Maev IV, Andreev DN, Dicheva DT, Zaborovskiy AV, Lobanova EG, Bektemirova LG. The efficacy and safety of quadruple therapy without bismuth (concomitant therapy) in the treatment of patients with Helicobacter pylori-associated gastric and duodenal peptic ulcer disease. Terapevticheskiy arkhiv = Therapeutic Archive. 2019;91(8):28–33 (In Russ.)]. EDN: ZNNREO. https://doi.org/10.26442/00403660.2019.08.000382
  15. Дехнич Н.Н., Хохлова Ю.А., Трушин И.В., Кузьменков А.Ю., Шумилов А.П., Сериков Н.А. Применение стандартной тройной терапии в лечении инфекции Helicobacter pylori у взрослых. Consilium Medicum. 2019;21(8):35–41. [Dekhnich NN, Khokhlova YuA, Trushin IV, Kuzmenkov AYu, Shumilov AP, Serikov NA. Use of standard triple therapy in the treatment of Helicobacter pylori infection in adult. Consilium Medicum. 2019;21(8):35–41 (In Russ.)]. EDN: ZXQMF. https://doi.org/10.26442/20751753.2019.8.190322
  16. Белковец А.В., Курилович С.А., Юркова Т.А., Толкачева Н.Ю., Щербакова Л.В. Сравнительное исследование двух схем эрадикации Helicobacter pylori (с висмутом трикалия дицитратом и без него). Фарматека. 2019;26(2):61–67. [Belkovets AV, Kurilovich SA, Yurkova TA, Tolkacheva NYu, Scherbakova LV. Omparative evaluation of two Helicobacter pylori eradication schemes (with and without bismuth tripotassium dicitrate). Farmateka. 2019;26(2):61–67 (In Russ.)]. EDN: YZCLNB. https://dx.doi.org/10.18565/pharmateca.2019.2.61-67
  17. Nyssen OP, Bordin D, Tepes B, Pérez-Aisa Á, Vaira D, Caldas Maria et al.; Hp-EuReg Investigators. European Registry on management (Hp-EuReg): Patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients. Gut. 2021;70(1):40–54. PMID: 32958544. https://doi.org/10.1136/gutjnl-2020-321372
  18. Serena P, Popa A, Bende R, Miutescu B, Mare R, Borlea A et al. Prevalence of Helicobacter pylori infection and efficacy of bismuth quadruple and levofloxacin triple eradication therapies: A retrospective analysis. Life (Basel). 2024;14(7):885. PMID: 39063638. PMCID: PMC11278125. https://doi.org/10.3390/life14070885
  19. Chen P-Y, Wu M-S, Chen C-Y, Bair M-J, Chou C-K, Lin J-T, Liou J-M. Systematic review with meta-analysis: The efficacy of levofloxacin triple therapy as the first- or second-line treatments of Helicobacter pylori infection. Aliment Pharmacol Ther. 2016;44(5):427–37. PMID: 27363687. https://doi.org/10.1111/apt.13712
  20. de Moraes Andrade PV, Monteiro YM, Chehter EZ. Third-line and rescue therapy for refractory Helicobacter pylori infection: A systematic review. World J Gastroenterol. 2023;29(2):390–409. PMID: 36687120. PMCID: PMC9846933. https://doi.org/10.3748/wjg.v29.i2.390
  21. Alsamman MA, Vecchio EC, Shawwa K, Acosta-Gonzales G, Resnick MB, Moss SF. Retrospective analysis confirms tetracycline quadruple as best Helicobacter pylori regimen in the USA. Dig Dis Sci. 2019;64(10):2893–98. PMID: 31187323. https://doi.org/10.1007/s10620-019-05694-4
  22. Zagari RM, Dajti E, Cominardi A, Frazzoni L, Fuccio L, Eusebi LH et al. Standard bismuth quadruple therapy versus concomitant therapy for the first-line treatment of Helicobacter pylori infection: A systematic review and meta-analysis of randomized controlled trials. J Clin Med. 2023;12(9):3258. PMID: 37176698. PMCID: PMC10179629. https://doi.org/10.3390/jcm12093258
  23. De Francesco V, Zullo A, Manta R, Gatta L, Fiorini G, Saracino IM, Vaira D. Helicobacter pylori eradication following first-line treatment failure in Europe: What, how and when chose among different standard regimens? A systematic review. Eur J Gastroenterol Hepatol. 2021;33(1S Suppl 1):e66–e70. PMID: 33741798. https://doi.org/10.1097/MEG.0000000000002100
  24. Бордин Д.С., Плавник Р.Г., Невмержицкий В.И., Буторова Л.И., Абдулхаков Р.А., Абдулхаков С.Р. с соавт. Распространенность Helicobacter pylori среди медицинских работников Москвы и Казани по данным ¹³С-уреазного дыхательного теста. Альманах клинической медицины. 2018;46(1):40–49. [Bordin DS, Plavnik RG, Nevmerzhitskiy VI, Butorova LI, Abdulkhakov RA, Abdulkhakov SR et al. Prevalence of Helicobacter pylori among medical workers in Moscow and Kazan according to ¹³С-urease breath test. Al’manakh klinicheskoy meditsiny = Almanac of Clinical Medicine. 2018;46(1):40–49 (In Russ.)]. EDN: YVSHHC. https://doi.org/10.18786/2072-0505-2018-46-1-40-49
  25. Лузина Е.В., Дутова А.А., Лазебник Л.Б., Ларева Н.В. Лечение инфекции Helicobacter pylori у медицинских работников. Экспериментальная и клиническая гастроэнтерология. 2023;(3):28–40. [Luzina EV, Dutova AA, Lazebnik LB, Lareva NV. Treatment of Helicobacter pylori infection for medical professionals. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2023;(3):28–40 (In Russ.)]. EDN: QJYRGX. https://doi.org/10.31146/1682-8658-ecg-211-3-28-40
  26. Kim BJ, Lee H, Lee YC, Jeon SW, Kim GH, Kim H-S et al.; Korean College of Helicobacter Upper Gastrointestinal Research. Ten-day concomitant, 10-day sequential, and 7-day triple therapy as first-line treatment for Helicobacter pylori infection: A nationwide randomized trial in Korea. Gut Liver. 2019;13(5):531–40. PMID: 31505907. PMCID: PMC6743805. https://doi.org/10.5009/gnl19136
  27. Jonaitis P, Nyssen OP, Saracino IM, Fiorini G, Vaira D, Pérez-Aísa Á et al.; Hp-EuReg investigators. Comparison of the management of Helicobacter pylori infection between the older and younger European populations. Sci Rep. 2023;13(1):17235. PMID: 37821503. PMCID: PMC10567783. https://doi.org/10.1038/s41598-023-43287-4

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Results of a survey of medical and non-medical workers infected with Helicobacter pylori in the Trans-Baikal Territory about their consent to undergo antihelicobacter treatment.

Download (53KB)
Indexing metadata
3. 2. The effectiveness of Helicobacter pylori eradication using all recommended treatment regimens in the studied medical and non-medical workers of the Trans-Baikal Territory

Download (56KB)
Indexing metadata
4. Fig. 3. Score assessment of tolerance of various schemes of eradication of Helicobacter pylori in the studied group

Download (55KB)
Indexing metadata

Copyright (c) 2025 Bionika Media