Prevalence and resistance of Helicobacter pylori in a predominantly Hispanic population

doi:10.4253/wjge.v16.i9.526

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. Sep 16, 2024; 16(9): 526-532
Published online Sep 16, 2024. doi: 10.4253/wjge.v16.i9.526

Prevalence and resistance of Helicobacter pylori in a predominantly Hispanic population

Alireza Tabesh, Ricardo Alberto Antillon, Manvel Kondradzhyan, Ann Zera Tan

Alireza Tabesh, Manvel Kondradzhyan, Internal Medicine, Adventist Health White Memorial, Los Angeles, CA 90033, United States

Ricardo Alberto Antillon, Family Medicine, UCLA, Los Angeles, CA 90024, United States

Ann Zera Tan, Department of Pathology, Adventist Health White Memorial, Los Angeles, CA 90033, United States

Author contributions: Tabesh A, Kondradzhyan M, and Tan AZ designed the research study; Tabesh A enrolled patients, performed all endoscopies, and gathered data; Antillon RA was in charge of data analysis; Kondradzhyan M did preliminary research and presentations necessary to obtain funding and IRB; Tan AZ oversaw microbiology and pathology department and management of specimen; and all authors have read and approved the final manuscript.

Institutional review board statement: Institutional review board approval was obtained via WCG for the study, consent form and questionnaire as well as their Spanish translation effective September 1, 2017 (Approval No. 1177305).

Informed consent statement: An informed signed written consent was obtained from each patient in either English or Spanish, depending on the patient preference, prior to their enrollment.

Conflict-of-interest statement: None of the authors of this manuscript have any conflicts-of-interest that need to be disclosed.

Data sharing statement: All data, analytic methods, and study materials will be available upon request.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Corresponding author: Ricardo Alberto Antillon, MS, Researcher, Family Medicine, UCLA, 885 Tiverton Dr, Los Angeles, CA 90024, United States. rantillon@mednet.ucla.edu

Received: March 28, 2024
Revised: May 29, 2024
Accepted: July 30, 2024
Published online: September 16, 2024
Processing time: 167 Days and 3.9 Hours

Abstract

BACKGROUND

Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in humans. The risk of acquiring H. pylori is related to socioeconomic status and living conditions early in life. Treatment regimens must consider local antibiotic resistance patterns. Adventist Health White Memorial Hospital serves a predominantly indigent population in east Los Angeles with a large number of immigrants from South and Central America. Data regarding the prevalence and resistance of H. pylori in this population is scant.

AIM

To evaluate the prevalence and resistance of H. pylori and correlate with country of origin.

METHODS

All gastric biopsies were obtained by a single gastroenterologist at the hospital in a consecutive manner from patients with gastritis from 2017 to 2022 and sent to various labs for evaluation.

RESULTS

Two hundred and sixty-six patients are born in the United States, 450, 171, 70, and 30 patients are immigrants from Mexico, Central and South America (CSA), Asia, and other countries respectively. Overall, 14.65% were found to be infected with H. pylori. Rates of infection in United States-born citizens, immigrants from Mexico, CSA, and Asia are 9.02%, 18.67%, 13.45%, and 11.43% respectively, with Mexican immigrants having a relative risk of 2.3889 [95% confidence interval (CI): 1.4789-3.8588, P = 0.0004] compared to those born in United States. No correlation seen between infection and length of time immigrants were in United States. Relative risk of infection in patients with no proton pump inhibitor use within the past 30 days found to be 1.9276 (95%CI: 1.3562-2.7398, P = 0.0003). Rates of resistance for clarithromycin and levofloxacin are 21.43% and 31.11%.

CONCLUSION

H. pylori infection appears to be associated with low socioeconomic status and poor living conditions early in life. Clarithromycin and levofloxacin based treatment regimens should be avoided as first line therapy in this region, particularly in patients of Latin American origin.

Keywords: Hispanic; Proton pump inhibitors; Gastritis; Disparity; Race/racial; Helicobacter pylori; Prevalence; Resistance

Core Tip: Gastric biopsies obtained from patients with gastritis in a predominantly indigent immigrant community in Los Angeles were tested for Helicobacter pylori in order to better understand its prevalence and resistance. Immigrants from Mexico found to have a significantly higher risk of infection regardless of length of time in the United States. Infection is significantly higher in those who did not take a proton pump inhibitor. Clarithromycin and levofloxacin should be avoided as first line therapy in this region, particularly in patients of Latin American origin. Infection appears to be associated with low socioeconomic status and poor living conditions early in life.