Helicobacter

Dr. Nan Nwe Win

 Helicobacter pylori
• Associated with
- Antral gastritis
- Duodenal (peptic ulcer)
- Gastric ulcer
- Gastric carcinoma
AETIOLOGY
Morphology
- Spiral-shaped gram negative rod
- Multiple flagella at one pole
- Actively motile

Culture
- Skirrow’s medium
Growth characteristics
- A strong producer of urease
PATHOGENESIS
 Grows at pH of 6 - 7
 Protease - modifies the gastric mucus, reduces
ability of acid to diffuse through the mucus
 Urease - ammonia production-buffering acid
 Motility - even in mucous, finds its way to the
epithelial surface
DIAGNOSTIC LABORATORY TESTS
A. Specimens
- Blood - antibodies
- Gastric boipsy - histology and culture

B. Smear
- Histology
- Giemsa or special silver stain

C. Culture
• Selective medium – Skirrow’s medium
D. Antibodies (Serology)
- Persist even if the infection is eradicated

E. Special tests
 In vivo test

 13 C/ 14 C labled urea is ingested by patient

 If H. pylori (+) - urease activity generate labled CO2

- detected in the patient’s exhaled breath
( Urea breath test)
 TREATMENT
Triple therapy
- metronidazole
- amoxicillin or tetracycline
- bismuth subsalicylate or subcitrate
- for 14 days --- eradicates in 70-90 % of
patients

Proton pump inhibitors (potent urease

inhibitors) --- directly inhibit H. pylori
Campylobacter
Campylobacter jejuni & Campylobacter coli

Morphology
• Gram negative bacilli,
• comma, S or Gull-wing shapes
• Motile, single polar flagellum
Culture
• Skirrow’s medium
Pathogenesis
• MOT - ingestion of contaminated food & drink
• Clinical findings
- Acute onset of crampy abdominal pain
- Profuse diarrhoea - grossly bloody
THE END