Türkiye’nin Doğusunda Gastrointestinal Şikayeti Olan Erişkinlerde Helicobacter pylori Prevalansının Yaş Gruplarına Göre Dağılımı

Abstract

Helicobacter pylori (H. pylori), yaygın bir bakteri olup yaklaşık olarak Dünya nüfusunun %50’sinin bu bakteri ile infekte olduğu tahmin edilmektedir. Esas rezervuarı insandır. H. pylori, kronik antral gastritin sebebi olan peptik ülserlerin önemli bir etkeni olarak bilinmektedir. Bu nedenle çalışmada Türkiye’nin doğusunda gastrointestinal şikayetler ile hastaneye başvuran erişkin bireylerde H. pylori seroprevalansını ve yaş ile ilişkisini saptamak amaçlanmıştır. Bu amaçla hastanemize karın ağrısı, dispeptik yakınmalar, epigastrik hassasiyet, üst abdomende ağrı veya sızı, şişlik ve reflü gibi gastroentestinal şikayetler ile başvuran toplam 993 erişkin yaş grubundaki hastalar çalışma kapsamına alındı. On altı yaş ve üzeri hastalardan alınan kan örneklerinde H. pylori IgG seroprevalansı araştırıldı. Hastalardan alınan serum örnekleri H. pylori IgG kitleri ve TKA 4HD EIA cihazı kullanılarak değerlendirildi. Başvuran hastaların 539 (%54.3)’u kadın, 454 (%45.7)’ü de erkek olup yaş ortalamaları da 39.2 ± 14.0 (16-92) idi. H.Pylori pozitif olan hastaların yaş ortalaması ise 39.7 ± 13.9 (16-92) olarak saptandı. H.pylori IgG total seropozitiflik oranı %67.7 olup bu oran kadınlarda %66.6, erkeklerde ise %68.1 idi. İstatistik! olarak yaş ve cins arasındaki ilişki değerlendirildiğinde anlamlı bir fark saptanmadı (p> 0.05). Muhammet Güzel KURTOĞLU, Hamza BOZKURT, Gülhan ARVAS, Mustafa BERKTAŞ,

Distrubution of Helicobacter pylori Prevalence in Adults with Gastrointestinal Complaints According to Age Levels in Eastern Turkey

Abstract

H.pylori is a common bacterium, and approximately 50 percent of the world’s population has been estimated to be infected. Human are the principal reservoir. H.pylori is known as one of important factors in the peptic ulcer, causing antral type chronic gastritis. So, it was aimed in the study to determine the relationship of the gastrointestinal complaints witnessed in Eastern Turkey with H.pylori seroprevalance in adults applying to the hospitals and the age level. A total of 993 adults applying to Medical School Hospital of Van Yüzüncü Yıl University and Van Training and Research Hospital between July 2002 and December 2003 with the complaints of abdominal pain, dis-peptic symptoms, epigastric tenderness, pain or epigastric burning in the upper abdomen, meteorism and other gastrointestinal (GI) complaints such as reflux were enrolled into the study. H.pylori IgG seroprevalance was investigated in the blood samples isolated from the adults at and over 16 years of age. Serum samples obtained from the patients were examined by using TKA 4HD EIA device and H.pylori IgG kits. Of the patients, 539 were females (54.3%) and 454 were males (45.7%). Average age rate was 39.7 ± 13.9 (16-92) in the patients with H.pylori positive. Average age rate was detected as 39.2 ± 14.0 (16-92) in all patients. Total seropositivity rate of H.pylori IgG was 67.7%, and this rate was 66.6 % in men and 68.1 % in women. Evaluating the scores related to the age and sex, no statistically significant difference could be determined according to the age or sex (p> 0.05). Muhammet Güzel KURTOĞLU, Hamza BOZKURT, Gülhan ARVAS, Mustafa BERKTAŞ,

Keywords

• H.pylori
• seroprevalance
• dispeptic complaints

References

1. 1. Blaser MJ, Chyou PA, Nomura A. Age at establishment of H.pylori infection and gastric carcinoma, gastric ulcer and duodenal ulcer risk. Cancer Res 1995; 55: 562-5.
2. 2. Megraud F. Advantages and disadvantages of current diagnostic test for the detection of H.pylori. Scand J Gastroenterol 1996; 31:57-62.
3. 3. Deschryver AA, Van Winckel MA. H.pylori infection: Epidemiology and occupational risk for healthcare. Ann Acad Med 2001; 30:457-63.
4. 4. Goodman KJ, Cockburn M. The role of epidemiology in understanding the health effects of H.pylori. Epidemiology 2001; 12:266-71.
5. 5. Park SR, Mackay WG, Reid DC. Helicobacter sp. recovered from drinking water biofilm sampled from a water distribution system. Water Res 2001; 35:1624-6.
6. 6. Horiuchi T, Ohkusa T, Watanabe M, Kobayashi D, Miwa H, Eishi Y. H.pylori DNA in drinking water in Japan. Microbiol Immunol 2001; 45: 515-9.
7. 7. Lu YZ, Redlinger TE, Avitia R, Galindo A, Goodman K. Isolation and genotyping of H.pylori from untreated municipal wastewater. Appl Environ Microbiol 2002; 68: 1436-9.
8. 8. Yamashita Y, Fujisawa T, Kimura A, Kato H. Epidemiology of H.pylori infection in children: a serologic study of the Kyushu region in Japan. Ped Int 2001; 43:4-7.

9. 9. Fernando N, Perera N, Vaira D, Holton J. H.pylori in school children from the Western province of Sri Lanka. Helicobacter 2001; 6: 169-74.
10. 10. Brown LM, Thomas TL, Ma JL, Chang YS, Yo-u WC, Liu WD, et al. H.pylori infection in rural China: exposure to domestic animals during childhood and adulthood. Scand J Infect Dis 2001; 33: 686-91.
11. 11. Dore MP, Sepulveda AR, El-Zimaity H, Yamaoka Y, Osato MS, Mototsugu K et al. Isolation of H.pylori from sheep implications for transmission to humans. Am J Gastroenterol 2001; 96:1396-401.
12. 12. Morad M, Merrick J, Nasri Y. Prevalence of H.pylori in people with intellectual disability in a residential care centre in Israel. J Intel Dis-abil Res 2002; 46:141-3.
13. 13. Wallace RA, Webb PM, Schluter PJ. Environmental, medical, behavioral and disability factors associated with H.pylori infection in adults with intellectual disability. J Intell Disabil Res 2002; 46:51-60.
14. 14. Hazel Mitchell and Francis Megraud. Epidemiology and diagnosis of H.pylori infection. Helicobacter 2002; 7: 8-16.
15. 15. Park IS, Lee YC, Park HJ, Kim Tl, Lee SI, Kim H, et al. H.pylori infection in Korea. Yonsei Med J 2001; 42: 457-70.
16. 16. Torres J, Perez P Guillermo, Goodman KJ, Atherton JC, Gold BD, Harris PR, et al. A comprehensive review of the natural history of H.pylori infection in children. Arch Med Research 2000; 31:431-69.
17. 17. Goossens H, Glupezynski Y, Burette A, Van den Borre C, Butzler JP. Evaulation of a commercially available second generation immun-globulin G enzyme immuno assay for detection of H.pylori infection. J Clin Microbiol 1992; 30: 176-80.
18. 18. Erdem B. Campylobacter ve Helicobacter. In: Mutlu G, İmirT, eds. Temel ve Klinik Mikrobiyoloji. Chapter 14. Vol. 5. Ankara: Güneş Kita-bevi; 1999. p.531-40.
19. 19. Guillermo I, Perez-Perez, Rothenbacher D, Brenner H. Epidemiology of H.pylori Infection. Helicobacter 2004; 9:1-6.
20. 20. Rothenbacher D, Brenner H. Burden of H.pylori and H. pylori-related diseases in developed countries: recent developments and future implications. Microbes Infect 2003; 5: 693-703.
21. 21. Frenck RW Jr, Clemens J. Helicobacter in the developing world. Microbes Infect 2003; 5: 705-13.
22. 22. Pounder RE, Ng D. The prevalence of H.pylori infection in different countries. Aliment Pharmacol Ther 1995; 9:33-9.
23. 23. Lin DB, Lin JB, Chen CY, Chen SC, Chen WK. Seroprevalence of H.pylori infection among schoolchildren and teachers in Taiwan. Helicobacter 2007; 812(3): 258-64.
24. 24. Teh BH, Lin JT, Pan WH, Lin SH, Wang LY, Lee TJ, et al. Seroprevalence and associated risk factors of H.pylori infection in Taiwan. Anticancer Res 1994; 14(3B): 1389-92.
25. 25. Nurgalieva ZZ, Malaty HM, Graham DY, Al-muchambetova R, Machmudova A, Kapsulta-nova D, et al. H.pylori infection in Kazakhstan: effect of water source and household hygiene. Am J Trop Med Hyg 2002; 67(2): 201-6.
26. 26. Breuer T, Sudhop T, Hoch J, Sauerbruch T, Malfertheiner P. Prevalence of and risk factors for H.pylori infection in the western part of Germany. Eur J Gastroenterol Hepatol 1996; 8(1): 47-52.
27. 27. Camargo MC, Lazcano-Ponce E, Torres J, Velasco-Mondragon E, Quiterio M, Correa P. Determinants of H.pylori seroprevalence in Mexican adolescents. Helicobacter 2004; 9(2): 106-14.
28. 28. Murray LJ. McCrum EE, Evans AE, Bamford KB. Epidemiology of H.pylori infection among 4742 randomly selected subjects from Northern Ireland. Int J Epidemiol 1997; 26(4): 880-7.
29. 29. Kumar A, Levinson JR, Sharma T. Seroepi-demiology of H.pylori in immigrants from the former Soviet Union to the United States. Am J Gastroenterol 1994; 89(8): 1307.
30. 30. Reshetnikov OV, Haiva VM, Granberg C, Ku-rilovich SA, Babin VP. Seroprevalence of H.pylori Infection in Siberia. Helicobacter 2001; 6: 331-6.
31. 31. Us D, Hasçelik G. Seroprevalence of H.pylori infection in an asymptomatic Turkish population. J Infect 1998; 37(2): 148-50.
32. 32. Altındiş M. Afyon bölgesinde H.pylori enfeksiyon sıklığı, Genel Tıp Derg 2001; 11:109-13.
33. 33. Doğan ÜB, Tunçer C, Dursun A, Kandilci U. Türkiye'de H.pylori'nin Yaş Gruplarına Göre Dağılımı. Gastroenteroloji 1996; 7:49.
34. 34. Kalkan A, Bulut V, Bahçecioğlu İH, Demirdağ K, Aral M. Elazığ yöresinde H.pylori enfeksiyon Seroprevalansı, Türk Mikrobİyol Cem Derg 1997; 27: 28-32.