Prevalence of helicobacter Pyloriamongdyspeptic Patients Attending Bir Hospital, Nepal

Abstract

Helicobacter pylori is the causative agent of chronic gastritis, peptic ulcer and gastriccancer.The purpose of this study was todetermine the prevalence ofH. pyloriamongdyspeptic patients in Bir Hospital. A total of 110 dyspeptic patients attending theGastroenterologyDepartment for upper gastrointestinalendoscopyfromJuneto August,2008wereenrolled. Two antral biopsy samples were collected from each patient. Oneofthesampleswasusedforrapid urease test (RUT)and the other for culture.Bacterialisolates were identified by standard microbiological techniquesand biochemical tests.The confirmed H. pylori isolates were subcultured and subjected to antibioticsusceptibility test by disk diffusion method. The sensitivity, specificity, PredictiveValue Positive (PVP)andPredictive Value Negative(PVN)of RUT weredeterminedusing culture as reference (gold standard).15 (13.6%) cases were positive by cultureand 28(25.5%) by RUT. The overall prevalence of H. pylori among 110 dyspepticcases was28 (25.5%) consideringeither RUT or culture positive result. Themale tofemale ratioforH. pyloriinfection was 1.03:1.H. pyloriinfectionratewas higher in theage groupof26-35 years. H. pylori infection ratewas higher induodenal ulcer cases.Among the 15 bacterial isolates,only 13 could be maintained in subculture.7(53.8%)of the 13 isolates were resistant to metronidazole, 2 (15.38%)were resistant toamoxycillin while all were sensitive to clarithromycin.The sensitivity, specificity, PVPandPVNof RUTwere 100%, 86%, 54% and100% respectively.Key words:Helicobacter pylori,dyspeptic patients,prevalence,RUT, PVP, PVN