Helicobacter

pylori
Oleh :
Efrida Warganegara

Introduction -- Classification
Campylobacter

spp. are curved

or S-shaped, Gram negatif
rods, oxidative-positive,
nonsporeforming, microaerophilic, motile by lopotrichous
flagellum from 1950s until
1970s they not recoqnized as a
common human pathogen

Today,

Genus Campylobacter is
recoqnized as one of the causes

Introduction -- Classification
One

of species : Campylobacter
pylori, in the last 10 years then
transfferred to the new genus / now
reclassified as Helicobacter pylori
is an important cause of gastritis
and gastric/duodenal ulcers

Helicobacter

pylori was first

isolated from human gastric
mucosa in 1983

The

mechanism of pathogenicity

Pathogenesis
The

organism appears to be spread

by close familial contact but the
route of transmission is nor known.

The

incidence of infection
increases after the age of 7 years

The

pathogenic mechanism of
helicobacter pylori are as yet
poorly defined

The

organism colonized only

Pathogenesis
The

organism produces urease and it

has been postulated that this
compound acts as a protective device.

Ammonia

is a product of urease
activity and it could protect the m.o.
from stomach acidity

High

concentration of ammonia
produced by large numbers of bacteria
could also be responsible for the
inflamatory condition in the stomach

Chronic

inflammation often remains

Pathogenesis
Helicobacter

pylori can colonize the

duodenum as well as the stomach and
may be responsible for peptic ulcer.
Several studies have pointed to an
association between Helicobacter pylori
and carcinoma of the stomach

When

individuals with peptic ulcer are

treated with acid-reducing therapies,
there is temporary cure

Once

the treatment is stopped, the ulcers

reappear in about 70 percent of patients

If

these individuals are later treated with

Diagnosis
Diagnosis

is usually ;

1. made on the basis of

stained, culture, histological
examination of the biopsi
spesimen for the presence
of bacteria, or
2. detection of urease

Specimen collection and

Processing
Collection

by gastric biopsy transported

immediately to the laboratory in sterile
saline solution, processed by grinding, and
plated without delay.

If

short delayed are expected, the specimen

can be keep at 4oC without a significant loss
in viability of Helicobacter pylori.

If

more than 6 hours is required before

processing of the specimen, Stuart transport
medium has been shown to increase survival
of the organisms for up to 48 hours,
especially if storage temperatures are below
15o C

Growth Requirements
To

isolate Helicobacter pylori,

biopsy specimen should be
inoculated onto choccolate
agar, incubated as for enteric
campylobacter at 37o C, and
examined daily for 5 days.

The

ideal selective medium

not yet been develop.

Several

laboratorium have had

success utilizing Skirrow

Growth Requirements
Regardless

of the medium
utilized, Helicobacter pylori grows
best on fresh, moist media in a
humid environment

Cultures

for Helicobacter pylori

should be placed in an
environment with increased
humidity

wet paper towel added to the

jar or bag is helpful

Cultural Characteristic
Helicobacter

spp. are Gram-negative

rods, which , in addition to appearing
like campylobacters, can be straight
cells

Their

size is also similar to the

campylobacters

Two

of the spesies, H. cinaidi and

H.fennelliae, are motile by means of a
single polar flagellum, Helicobacter
pylori is usually lopotrichous

Colonies

are 1 to 2 mm in diameter,
smooth, convex, and transluscent

Biochemical Identification
Helicobacter

pylori can be identified

presumptively by oxidase activity , and
the presence of strong urease activity,
and urea hydrolysis.

The

organism produce large amounts of

urease, probably a useful strategy for
survival in the acid environment of the
gastric mucosa

In

Christensen medium a color change is

usually observed in as little as10
minutes

Serologies
Serological

diagnosis may in
future play a valuable part in
investigation of patients
thereby avoiding invasive
procedures

ELISA

is the most common

serological test and can be
used to monitor eradication of
helicobacter pylori.

Treatment
Treatment

with combination of
bismusth salts with metronidazole
or tinidazole with amoxicillin or
tetacyclin, is successful but relapse
is common

At

present the epidemiology of

Helicobacter pylori is unknown and
it is impossible to distinguish
between relaps due to the failure of
treatment to eradicate all organism

Daftar kepustakaan
Mims
Boyd
Barbara

J Howard

Terima
Kasih