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Oral cavity as a potential source of gastric reinfection by Helicobacter pylori.
Dig. Dis. Sci. 2002: 47 (5) s.978-986, il., tab., bibliogr. 24 poz.
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Helicobacter pylori (Hp) is a common pathogen colonizing the a gastric mucosa, but some reports indicated that it may also be found in the oral cavity, which could serve as a reservoir of the bacteria and a source of gastric reinfection. Accordingly, we aimed to study whether the oral cavity, particularly gingival pockets, are colonized by Hp and whether it could be the source of gastric reinfection. We studied 329 patients with dyspeptic symptoms (257 with chronic gastritis, 15 with gastric ulcer. and 57 with duodenal ulcer). The [**13C]urea breath test (UBT), gastroscopy, and Hp culture from gastric biopsies were carried out, and material was collected from the oral cavity (gingival pocket) for bacteriological culture and genomic DNA studies. The serum was obtained for anti-Hp IgG and anti-CagA assays and saliva for anti-Hp IgA determination using the ELISA technique. bacteria in material from gingival pockets and biopsies from the corpus and antrum of stomach of 30 DU patients before and after Hp eradication were also examined by PCR technique, using primers specific for 16S rNA. All Hp-positive patients (276) were subjected to one week of triple therapy (omeprazole 2 x 20 mg twice a day, clarithromycin 2 = 500 mg twice a day, and metronidazole 2 x 500 mg twice a day). The measurements descrived above were then repeated at four weeks and six months. Bacterkilogical culture showed the prsence of Hp in the material from oral cavity in about 50 p.c. of patients, whereas UBT, used as a gold standard, revealed gastric Hp infection in about 84 p.c. of these patients...
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