Micro| Helicobacter Pylori

3.21 H. Pylori Microbiology review for the USMLE Step 1 exam Helicobacter Pylori (H. Pylori) is a gram-negative, comma-shaped bacteria that causes chronic gastritis Estimated that 50% of people worldwide are infected with H. Pylori; higher in developing countries, lower in developed countries More common in populations with lower socioeconomic status and in crowded conditions with poor hygiene Spread through oral-oral or fecal-oral routes Colonizes the antrum of the stomach Produces urease that converts urea into carbon dioxide and ammonia, helping it survive in the acidic environment of the stomach Secretes toxins that cause inflammation of the gastric epithelium and lead to gastritis and ulcer formation Most people with H. Pylori never have symptoms, but some may present with dyspepsia, abdominal pain, nausea, vomiting, gastritis, or peptic ulcer disease Duodenal ulcers often associated with H. Pylori or heavy NSAID use Diagnosis can be made through urea breath test, stool antigen test, or endoscopy with gastric biopsy Treated with a triple drug regimen of a proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole (triple therapy) PCAM