Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in the world, and it is currently estimated that approximately half of the world’s population is infected with the bacterium. The correct diagnosis and effective treatment of H. pylori gastric infection are essential in controlling this condition. The available diagnostic methods have advantages and limitations related to factors such as age of patients, technical difficulty level, costs and extensive accessibility in hospitals. The eradication therapy of H. pylori infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is antibiotic resistance. Biopsy cultures are the most widely used methods among the antimicrobial susceptibility tests. In case of a negative culture, H. pylori can be clearly recognised in histological sections. The sensitivity and specificity of histology for the diagnosis depend on clinical settings, density of colonisation and the experience of the histopathologist. A prospective study was performed in order to analyse patients with H. pylori gastric infection with positive histology and positive culture versus positive histology and negative culture.
Part of the book: Histology
The current gold standard for the detection of Helicobacter pylori in children remains upper endoscopy plus mucosal biopsies. Endoscopy has the advantage of being able to detect complications of Helicobacter pylori infection and to rule out other upper gastro-intestinal pathologies. An additional advantage of endoscopy with gastric biopsy is that it allows physicians to obtain mucosa for urease testing, histological examination and bacterial culture. In children, there is a high correlation between antral nodularity at endoscopy and the presence of Helicobacter pylori infection. The authors have proposed to investigate the correlations between macroscopic aspects during endoscopy and histological findings, in order to identify those endoscopic and histopathological features that can help the clinician in clinical practice.
Part of the book: Helicobacter Pylori