Analysis of the prevalence of Helicobacter pylori infection and the effectiveness of eradication schemes in patients with the upper gastrointestinal tract disorders (according to the results of 13C-urea breath tests for 2006–2019)

Abstract

Introduction: The problem of Helicobacter pylori is relevant due to the high frequency of stomach and duodenum erosions and ulcers, as well as the possible development of metaplasia and gastric cancer. Therefore, it is especially important to study the dynamics of H. pylori infection and monitor the effectiveness of eradication schemes in different regions of Ukraine. Aim: To study the dynamics of H. pylori infection and to evaluate the effectiveness of H. pylori eradication schemes in patients with upper gastrointestinal tract disorders – residents of the Vinnytsia region. Material and methods: We retrospectively analysed 2205 results of 13C-urea breath tests, performed during 2006–2019 in the National Pirogov Memorial Medical University, Vinnytsya on an infrared analyser. Results: It was found that patients with upper gastrointestinal tract disorders since 2009 had significantly reduced primary H. pylori infection. Among the schemes designed according to the Maastricht recommendations, the most effective were as follows: proton pump inhibitor (PPI) + clarithromycin (Clar) + amoxicillin (Amox) – 81.6%, PPI + Clar + Amox + bismuth subcitrate (Bi) – 87%, and PPI + tetracycline (TC) + metronidazole derivatives (MNZ) + Bi – 83.9%. The lowest efficiency was recorded for the scheme PPI + Clar + MNZ, at 68.1%. Conclusions: Despite the gradual decrease in H. pylori infection in the general population, its prevalence remains quite high among the elderly. This dictates that a thorough examination be carried out for patients with disorders of the upper G.I. tract to detect the presence of H. pylori infection, and if infection is detected, the correct selection of eradication therapy