Thesis (M.D.) -- University of Adelaide, Dept. of Medicine, 2000. / Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.

Thesis (doctoral)--Lund University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Lund University, 1998. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (Ph. D.)--University of Oregon, 2006. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 80-91). Also available for download via the World Wide Web; free to University of Oregon users.

Contexte : Amélioration de la prise en charge de l’infection à H. pylori. Matériels et Méthodes : Détection de H. pylori, la résistance à la clarithromycine, la tétracycline, la lévofloxacine, et la détermination des gènes de pathogénicité ont été réalisées par PCR en temps réel, du gène de l’ARNr 23 S, de l’ARNr 16S, PCR classique et séquençage. L’évaluation de la stabilité du mutant résistant par rapport à l’isolat sensible était obtenue par compétition en culture sur cellules gastriques AGS sur une longue période, suivie du séquençage du génome entier. L’évaluation de l’effet de l’extrait de Ceiba pentandra sur H. pylori était réalisée par la détermination de la concentration minimale inhibitrice. Résultats : Prévalence de l’infection à H. pylori : 75.52%, résistance à la clarithromycine et tétracycline : 4,2% et 1,2%, résistance à la lévofloxacine : 57%. Gène CagA : 92,2%. Gène Vac As1m1 : 82%. Absence de stabilité du mutant résistant dans le couple de souches 3695 R/S (ratio R / S 0,1), à 30 jours de la co-culture (p <0.05) ; ce mutant présentait la mutation A2142G, conférant la résistance à la clarithromycine. On notait la stabilité du mutant résistant dans l’autre couple de souches 3657R/S (ratio R / S ratio : 1,7) à 40 jours de la co-culture (p <0.05), avec développement des mutations compensatoires ; ce mutant présentait la mutation A2143G. L’activité modérée à faible était notée avec les extraits hydroéthanolique et butanolique de Ceiba pentandra, avec une concentration minimale inhibitrice de 50 à 80 μg / ml.Conclusion : il est possible de traiter l’infection à H. pylori avec une thérapie à base de clarithromycine au Congo. L’absence d’une activité forte ne permet pas de recommander Ceiba pentandra dans le traitement de l’infection à H. pylori . La réversion de la résistance dans le cas de H. pylori peut être envisagée. / Context: The objective of this work was to improve Helicobacter pylori infection management. Materials and methods: H. pylori detection, it’s resistance to clarithromycine, tetracyclin, levofloxacin, and determination pathogenic genes were done by real-time PCR on 23 S rRNA, on 16 S rRNA gene, classic PCR, sequencing. Evaluation of the resistant mutant stability to its sensitive isolate was carried out by competing them over a long period in culture on AGS gastric cells and whole sequencing genome. The evaluation of Ceiba pentandra extract effect on H. pylori was carried out by determining the minimum inhibitory concentration. Results: Prevalence of H. pylori infection: 75.52%, resistance to clarithromycin and tetracycline: 4.2% and 1.2%, levofloxacin resistance: 57%. CagA gene: 92.2%. Vac As1m1 gene: 82%. Lack of stability of the resistant mutant in a 3695 R/S pair of isolates (R/S ratio 0.1), at the 30 day of the co-culture (p <0.05); this mutant had an A2142G mutation conferring resistance to clarithromycin. Stability of the resistant mutant in the other 3657 pair of isolates (R/S ratio of 1.7) at the 40 day of the co-culture (p <0.05), with development of compensatory mutations; this mutant had an A2143G mutation conferring resistance to clarithromycin. The moderate to low activity was noted with the hydroethanol extract and the butanol extract: minimum inhibitory concentration: 50 to 80 μg / ml. Conclusion: It’s possible to treat H. pylori infection with therapy based on clarithromycin in Congo. The absence of a strong activity does not make it possible to recommend Ceiba pentandra in the treatment of H. pylori infection. Reversion resistance is possible with H. pylori.

Introdução: Helicobacter pylori é uma bactéria que infecta aproximadamente metade da população mundial e é considerada uma importante causa de câncer gástrico. A terapia de erradicação nem sempre é eficaz, pois pode ocorrer a resistência aos antimicrobianos. Objetivo: Determinar o perfil de sensibilidade de isolados de H. pylori frente aos antibióticos amoxicilina, claritromicina e ciprofloxacina na população do Rio Grande do Sul empregando distintas padronizações. Material e Métodos: Estudo transversal. Avaliaram-se 54 amostras de H. pylori obtidas através de cultivo de biópsias gástricas em Agar Belo Horizonte e incubação a 37°C em microaerofilia, durante cinco dias. A sensibilidade aos antibióticos foi determinada segundo as orientações das padronizações britânica (BSAC) e australiana (CDS Method) (quantitativas), além da francesa (CA-SFM) (qualitativa). Resultados e discussão: Sete (13%) isolados de H. pylori foram resistentes à claritromicina, um (1,9%) à amoxicilina e três (5,5%) à ciprofloxacina. Estes índices de resistência são considerados satisfatórios e demonstram que todos esses antibióticos podem ser utilizados na terapia empírica na população local, sobretudo a amoxicilina e a claritromicina como primeira linha de tratamento. As metodologias quantitativas BSAC e CDS Method revelaram concordância muito semelhante nos resultados de sensibilidade, sendo a interpretação mais facilitada na técnica CDS Method. A padronização CA-SFM parece ser mais atrativa sob o aspecto econômico, mas fornece resultados apenas qualitativos. Conclusão: Os antibióticos amoxicilina e claritromicina ainda são uma boa opção no tratamento anti-H. pylori na população do Rio Grande do Sul. / Introduction: Helicobacter pylori is a bacteria which infects nearly half the world population and it is considered an important cause of gastric cancer. The eradication therapy is not always effective because resistance to antimicrobials may occur. Objective: To determine the susceptibility profile of H. pylori isolates to the antibiotics amoxicillin, clarithromycin and ciprofloxacin in the population of Rio Grande do Sul using different standardizations. Material and Methods: Transversal study. Were evaluated 54 samples of H. pylori obtained by gastric biopsies which were cultured on Belo Horizonte agar and incubated at 37°C in a microaerophilic environment for five days. The antibiotics susceptibility was determined according to the guidelines of the British Society for Antimicrobial Chemotherapy (BSAC), the Australian (CDS Method) (quantitative) and the French (CA-SFM) (qualitative). Results and discussion: Seven (13%) H. pylori isolates were resistant to clarithromycin, one (1,9%) to amoxicillin and three (5,5%) to ciprofloxacin. These indices of resistance are considered satisfactory and show that all of these antibiotics can be used in the empirical therapy of the local population, especially amoxicillin and clarithromycin as a first line treatment. The quantitative methodologies BSAC and CDS Method revealed very similar agreement in the susceptibility results. Moreover, the CDS method had an easier interpretation technique. The CA-SFM standards seem to be more attractive on the economic aspect but they only provide qualitative results. Conclusion: The antibiotics amoxicillin and clarithromycin are still a good option for anti-H. pylori treatment in the population of Rio Grande do Sul.

Made available in DSpace on 2014-06-11T19:23:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T19:30:03Z : No. of bitstreams: 1 souza_ml_me_botfm.pdf: 633844 bytes, checksum: fe0b935ff3a3529cee98b24f3b1e8d82 (MD5) / O presente trabalho foi delineado para investigar a freqüência de infecção pelo Helicobacter em cães oriundos do Biotério Central da UNESP – Campus de Botucatu - e a incidência da espécie Helicobacter pylori(Hp) nos animais. Os animais utilizados foram capturados em várias cidades, desconhecendo-se seus hábitos alimentares até a captura, mas é provável que foram pertencentes ou conviveram com pessoas de classe sócio-econômica de baixo poder aquisitivo, onde a incidência de Hp em seres humanos é mais elevada. Foram utilizados os métodos de teste rápido da urease, teste imunocromatográfico (kit H. pylori one step teste) e o método histoquímico de coloração pelo Giemsa. A coleta de material foi feita em 109 caninos sem raça definida, sendo 49 machos e 60 fêmeas. O sangue foi retirado da veia jugular e as amostras gástricas e duodenais foram obtidas por endoscopia (61/109) e pela técnica aberta (48/109). As análises, pelo teste rápido da urease e coloração pelo Giemsa, mostraram que, em 97,96% dos machos (48/49) e em 100% das fêmeas (60/60), foi detectada reação positiva para Helicobacter, sendo 99,08% (108/109) na totalidade dos animais. Não foram observadas alterações estatisticamente significativas entre os dois sexos... / The present work was delineated to investigate the infection frequency for Helicobacter in dogs originating from Central Animal House of UNESP - Campus of Botucatu - and the incidence of the species pylori in the animals. The used animals were captured in several towns, being ignored their alimentary habits until the capture, but it is probable that they belonged or they lived together with people of socioeconomic class of low purchasing power, where the incidence of H. pylori in humans is higher. The methods used were of fast urease test, immunocromatograph test (kit H. pylori one step test) and histochemical coloration method for Giemsa. The material collection was made in 109 mongrel dogs, being 49 males and 60 females. The blood was removed of the jugular vein and the gastric and duodenal samples were obtained by endoscopy (61/109) and by the open technique (48/109). The analyses for the fast test of the urease and coloration for Giemsa showed that, in 97,96% of the males (48/49) and in 100% of the females (60/60), positive reaction was detected for Helicobacter, being 99,08% (108/109) in the totality of the animals. No statistically significant alterations significant were observed between the two sexes... (Complete abstract, click electronic address below)

Introdução: Helicobacter pylori é uma bactéria que infecta aproximadamente metade da população mundial e é considerada uma importante causa de câncer gástrico. A terapia de erradicação nem sempre é eficaz, pois pode ocorrer a resistência aos antimicrobianos. Objetivo: Determinar o perfil de sensibilidade de isolados de H. pylori frente aos antibióticos amoxicilina, claritromicina e ciprofloxacina na população do Rio Grande do Sul empregando distintas padronizações. Material e Métodos: Estudo transversal. Avaliaram-se 54 amostras de H. pylori obtidas através de cultivo de biópsias gástricas em Agar Belo Horizonte e incubação a 37°C em microaerofilia, durante cinco dias. A sensibilidade aos antibióticos foi determinada segundo as orientações das padronizações britânica (BSAC) e australiana (CDS Method) (quantitativas), além da francesa (CA-SFM) (qualitativa). Resultados e discussão: Sete (13%) isolados de H. pylori foram resistentes à claritromicina, um (1,9%) à amoxicilina e três (5,5%) à ciprofloxacina. Estes índices de resistência são considerados satisfatórios e demonstram que todos esses antibióticos podem ser utilizados na terapia empírica na população local, sobretudo a amoxicilina e a claritromicina como primeira linha de tratamento. As metodologias quantitativas BSAC e CDS Method revelaram concordância muito semelhante nos resultados de sensibilidade, sendo a interpretação mais facilitada na técnica CDS Method. A padronização CA-SFM parece ser mais atrativa sob o aspecto econômico, mas fornece resultados apenas qualitativos. Conclusão: Os antibióticos amoxicilina e claritromicina ainda são uma boa opção no tratamento anti-H. pylori na população do Rio Grande do Sul. / Introduction: Helicobacter pylori is a bacteria which infects nearly half the world population and it is considered an important cause of gastric cancer. The eradication therapy is not always effective because resistance to antimicrobials may occur. Objective: To determine the susceptibility profile of H. pylori isolates to the antibiotics amoxicillin, clarithromycin and ciprofloxacin in the population of Rio Grande do Sul using different standardizations. Material and Methods: Transversal study. Were evaluated 54 samples of H. pylori obtained by gastric biopsies which were cultured on Belo Horizonte agar and incubated at 37°C in a microaerophilic environment for five days. The antibiotics susceptibility was determined according to the guidelines of the British Society for Antimicrobial Chemotherapy (BSAC), the Australian (CDS Method) (quantitative) and the French (CA-SFM) (qualitative). Results and discussion: Seven (13%) H. pylori isolates were resistant to clarithromycin, one (1,9%) to amoxicillin and three (5,5%) to ciprofloxacin. These indices of resistance are considered satisfactory and show that all of these antibiotics can be used in the empirical therapy of the local population, especially amoxicillin and clarithromycin as a first line treatment. The quantitative methodologies BSAC and CDS Method revealed very similar agreement in the susceptibility results. Moreover, the CDS method had an easier interpretation technique. The CA-SFM standards seem to be more attractive on the economic aspect but they only provide qualitative results. Conclusion: The antibiotics amoxicillin and clarithromycin are still a good option for anti-H. pylori treatment in the population of Rio Grande do Sul.