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Türkiye'de Helicobacter pylori Pozitifliğinin Prevalansı ve Sosyodemografik Dağılımı: 2018-2023 Yılları Arasında Retrospektif Bir Analiz ve COVID-19 Tedbirlerinin Etkisi

Year 2025, Volume: 15 Issue: 2, 288 - 293, 22.05.2025
https://doi.org/10.33631/sabd.1558324

Abstract

Amaç: Helicobacter pylori, mide mukozasında yaşayan gram-negatif, çok kamçılı bir bakteridir ve kronik antral gastrit, peptik ülser, mide lenfoması ve mide adenokarsinomu gibi ciddi mide hastalıklarının oluşumuna katkıda bulunur. Bu bakterinin dünya genelindeki yaygınlığı ülkelerin gelişmişlik düzeyiyle ters orantılı olup, düşük sosyoekonomik koşullarda daha sık görülmektedir. Yayılma yolları kesin olarak bilinmemekle birlikte, fekal-oral ve oral-oral yollarla bulaştığı düşünülmektedir. Küresel enfeksiyon oranı %50 civarındadır.
Gereç ve Yöntemler: Bu çalışmada, 2018-2023 yılları arasında hastanemize başvuran 40784 hastadan alınan dışkı örneklerindeki H. pylori antijen varlığı retrospektif olarak incelenmiştir. Testler, MICROCULT (Biotech, China) kitleri kullanılarak gerçekleştirilmiş ve sonuçlar yaş, cinsiyet ve coğrafi bölgelere göre analiz edilmiştir.
Bulgular: Sonuçlara göre genel H. pylori pozitiflik oranı %14,47 olarak tespit edilmiştir. Kadınlarda (%16,73) pozitiflik oranı erkeklere (%11,64) göre daha yüksek bulunmuştur. Ayrıca çocuklarda pozitiflik oranı %6,46, yetişkinlerde ise %16,77 olarak kaydedilmiştir. Bölgesel analizde Güneydoğu Anadolu Bölgesi %25,71 ile en yüksek pozitiflik oranına sahipken, Karadeniz Bölgesi %11,95 ile en düşük orana sahip olmuştur. Ankara ilçelerinde Altındağ %17,09 ile en yüksek orana sahipken, Etimesgut %8,79 ile en düşük oranı göstermiştir.
Sonuç: Son yıllarda H. pylori prevalansında düşüş gözlenmiştir, ancak özellikle düşük sosyoekonomik bölgelerde enfeksiyon oranları yüksek seyretmektedir. Çalışma, altyapı, hijyen ve yaşam standartlarındaki iyileştirmelerin enfeksiyon oranlarını azaltmada önemli bir rol oynadığını göstermektedir. Ayrıca, kadınlarda ve yaş ilerledikçe pozitiflik oranlarının arttığı tespit edilmiştir. H. pylori'nin yaygınlığının azaltılması için yeni tanı ve tedavi stratejilerinin geliştirilmesine ihtiyaç duyulmaktadır.

References

  • Hooi JKY, Lai WY, Ng WK, Michael M. Y. Suen, F.E. Underwood, D Tanyingoh, et al. Global prevalence of Helicobacter pylori infection: Systematic review and meta-analysis. Gastroenterology 2017; 153(2): 420-9. https://doi.org/10.1053/j.gastro.2017.04.022
  • Bor S, Kitapcioglu G, Kasap E. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori. World J Gastroenterol 2017; 23(3): 525-32. https://doi.org/10.3748/wjg.v23.i3.525
  • Kaplan M, Tanoglu A, Duzenli T, A.N. Tozun. Helicobacter pylori treatment in Türkiye: Current status and rational treatment options. Nor th Clin Istanb 2020; 7(1): 87-94. https://doi.org/ 10.14744/nci.2019.62558
  • Elmer W. Koneman Çeviri A. Başustaoğlu, A.D. Helicobacter cinsi. Us Color Atlas and Textbook of Diagnostic Microbiology. Türkçe 7. Baskı 2017: 442-3
  • Bofinger J.J, Fekete T, Samuel R. Bacterial peritonitis caused by Kingella kingea.J. Clin Microbiol 2007; (9): 3118-20. https://doi.org/10.1128/JCM.00878-07
  • Christensen H, Bisgaard M, Angen O, J.E. Olsen. Final classification of Biagaard taxon 9 Actinobacillus arthritidis sp, nov and recognition of a novel genomospecies for eguine strains of Actinobacillus lignicressi. Int J SystEvol Microbiol 2002; 52(Pt 4): 1239-46. https://doi.org/10.1099/00207713-52-4-1239
  • Elliot SP. Rat bite fever and Streptobacillus moniloformis. Clin Microbiol Rev 2007; 20(1): 13-22. https://doi.org/10.1128/cmr.00016-06
  • IARC Helicobacter pylori Working Group. Helicobacter Pylori Eradication as a Strategy for Preventing Gasric Cancer. Lyon, France: International Agency for Research on Cancer (IARC Working Group reports, no.8); 2014.)
  • Malfertheiner P, Selgrad M, Bornschein J. Helicobacter pylori: clinical management. Curr Opin Gastroenterol 2012; 28(6):608-14. https://doi.org/10.1097/MOG.0b013e32835918a7
  • Georgopoulos SD, Papastergiou V, Karatapanis S. Current options for the treatment of Helicobacter pylori. Expert Opin Pharmacother 2013; (2): 211-23. https://doi.org/10.1517/14656566.2013.763926
  • Lawson AJ. Helicobacter. In: Jorgensen JH, Landry ML, Warnock DW (Eds.) Manual of Clinical Microbiology. Washington DC: ASM Press, 2011: 900-15. https://doi.org/10.1128/9781555816728.ch54
  • Lehours P, Yilmaz O. Epidemiology of Helicobacter pylori infection. Helicobacter. 2007; 12(1): 1-3 https://doi.org/10.1111/j.1523-5378.2007.00541.x
  • Kayali S, Manfredi M, Gaiani F, Bianchi L, Bizzarri B, Leandro G, et al. Helicobacter pylori, transmission routes and recurrence of infection: state of the art. Acta Biomed. 2018; 89(8): 72-6. https://doi.org/10.23750/abm.v89i8-S.7947
  • Megraud F, Lehours P. Helicobacter pylori detection and antibiotic susceptibility testing. Clin Microbiol Rev. 2007; 20(2): 280-322. https://doi.org/10.1128/cmr.00033-06
  • Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World J Gastroenterol. 2013; 19(45): 8188-91. https://doi.org/10.3748/wjg.v19.i45.8188
  • Malfertheiner P, Megraud F, O’Morain CA, J P Gisbert, E J Kuipers, A T Axon, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017(1): 6-30. https://doi.org/10.1136/gutjnl-2016-312288
  • McColl K. Sould Non-invasive Helicobacter pylori testing replase endoscopy in investigation of dyspepsia: Helicobacter. 2000; 5(1): 11-5. https://doi.org/10.1046/j.1523-5378.2000.0050S1011.x
  • M.A. Al-Moagel, D.G. Evans, M.E. Abdulghani, E. Adam, D.J. Evans Jr., H.M. Malaty, et al. Prevalence of Helicobacter Pylori (formerly Campylobacter) infection in Saudi Arabia, and comparison of those with and without upper gastrointestinal symptoms, Am. J. Gastroenterol. 1990; 85(8): 944-8.
  • Tünger Ö. Helicobacter pylori infeksiyonları. Infeks Derg. 2008; 22(2): 107-15.
  • Özdemir M, Baykan M. Dispeptik hastalarda H. pylori infeksiyonu tanısında H. pylori gaita antijeninin tanı değerlerinin incelenmesi. Genel Tıp Derg. 2005; 15(2): 65-70.
  • Zamani M, Ebrahimtabar F, Zamani V, W. H. Miller, R. Alizadeh-Navaei, J. Shokri-Shirvani, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018; 47(7): 868-76. https://doi.org/10.1111/apt.14561
  • Venneman K, Huybrechts I, Gunter MJ, Vandendaele L, Herrero R, Van Herck K. The epidemiology of Helicobacter pylori infection in Europe and the impact of lifestyle on its natural evolution toward stomach cancer after infection: a systematic review. Helicobacter. 2018; 23(3): e12483. https://doi.org/10.1111/hel.12483
  • Tkachenko MA, Zhannat NZ, Erman LV, Elena L Blashenkova, Sergey V Isachenko, Olga B Isachenko, et al. Dramatic changes in the prevalence of Helicobacter pylori infection during childhood: a 10-year follow-up study in Russia. J Pediatr Gastroenterol Nutr. 2007; 45(4): 428- 32. https://doi.org/10.1097/MPG.0b013e318064589f
  • Bahçeci İ, Yıldız İE. İlimizde Helicobacter pylori sıklığının değerlendirmesi: yedi yıllık çalışma. Turk J Clin Lab. 2021; 12(3): 260-4. https://doi.org/10.18663/tjcl.954009
  • Sakman A, Bayram Y, Parlak M, Güdücüoğlu H. Aile sağlığı merkezine başvuran hastalarda Helicobacter pylori sıklığı. TJFMPC. 2021; 15(3): 418-23. https://doi.org/10.21763/tjfmpc.813379
  • Ozaydın N, Turkyılmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Türkiye: a nationallyrepresentative, cross-sectional, screening with the 13C-urea breath test. BMC Public Health. 2013; 13: 1215. https://doi.org/10.1186/1471-2458-13-1215
  • Türkölmez S, Cayir D, Aydoğan F, Korkmaz M. The relationship of the Helicobacter pylori positively with age, sex, and ABO/rhesus blood groups in patients with gastrointestinal complaints in Türkiye. Helicobacter. 2007; 12(3): 244-50. https://doi.org/10.1111/j.1523-5378.2007.00500.x
  • Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Türkiye. Turk J Med Sci. 2020; 50(9): 489-94. https://doi.org/10.3906/sag-2004-187
  • Ibrahim A, Morais S, Ferro A, Lunet N, Peleteiro B. Sex-differences in the prevalence of Helicobacter pylori infection in pediatric and adult populations: systematic review and meta-analysis of 244 studies. Dig Liver Dis. 2017; 49(7): 742-9. https://doi.org/10.1016/j.dld.2017.03.019
  • Nagy P, Johansson S, Molloy-Bland M. Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA. Gut Pathog. 2016; 8: 8. https://doi.org/10.1186/s13099-016-0091-7

Prevalence and Sociodemographic Distribution of Helicobacter pylori Positivity in Türkiye: A Retrospective Analysis between 2018-2023 and Impact of COVID-19 Measures

Year 2025, Volume: 15 Issue: 2, 288 - 293, 22.05.2025
https://doi.org/10.33631/sabd.1558324

Abstract

Aim: Helicobacter pylori is a gram-negative, multi-flagellated bacterium that resides in the gastric mucosa and is a significant cause of chronic antral gastritis, peptic ulcers, gastric lymphoma, and adenocarcinoma. Its prevalence is inversely related to socioeconomic development, with higher rates in developing countries. The bacterium is believed to spread primarily through fecal-oral and oral-oral routes, with an estimated global infection rate of around 50%.
Material and Methods: This study retrospectively examined the presence of H. pylori antigen in stool samples from 40784 patients admitted to our hospital between 2018 and 2023. The tests were performed using MICROCULT (Biotech, China) kits and the results were analysed according to age, sex and geographical regions.
Results: The overall positivity rate was found to be 14.47%. Female had a higher positivity rate (16.73%) compared to male (11.64%). The positivity rate was 6.46% in children and 16.77% in adults. The highest regional positivity was observed in the Southeastern Anatolia region (25.71%), while the lowest was in the Black Sea region (11.95%). In Ankara, Altındağ district had the highest positivity rate (17.09%), while Etimesgut had the lowest (8.79%).
Conclusion: The study highlights a decline in H. pylori prevalence in recent years, though higher rates persist in less developed regions, underscoring the need for improved infrastructure, hygiene, and targeted screening and treatment strategies.

References

  • Hooi JKY, Lai WY, Ng WK, Michael M. Y. Suen, F.E. Underwood, D Tanyingoh, et al. Global prevalence of Helicobacter pylori infection: Systematic review and meta-analysis. Gastroenterology 2017; 153(2): 420-9. https://doi.org/10.1053/j.gastro.2017.04.022
  • Bor S, Kitapcioglu G, Kasap E. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori. World J Gastroenterol 2017; 23(3): 525-32. https://doi.org/10.3748/wjg.v23.i3.525
  • Kaplan M, Tanoglu A, Duzenli T, A.N. Tozun. Helicobacter pylori treatment in Türkiye: Current status and rational treatment options. Nor th Clin Istanb 2020; 7(1): 87-94. https://doi.org/ 10.14744/nci.2019.62558
  • Elmer W. Koneman Çeviri A. Başustaoğlu, A.D. Helicobacter cinsi. Us Color Atlas and Textbook of Diagnostic Microbiology. Türkçe 7. Baskı 2017: 442-3
  • Bofinger J.J, Fekete T, Samuel R. Bacterial peritonitis caused by Kingella kingea.J. Clin Microbiol 2007; (9): 3118-20. https://doi.org/10.1128/JCM.00878-07
  • Christensen H, Bisgaard M, Angen O, J.E. Olsen. Final classification of Biagaard taxon 9 Actinobacillus arthritidis sp, nov and recognition of a novel genomospecies for eguine strains of Actinobacillus lignicressi. Int J SystEvol Microbiol 2002; 52(Pt 4): 1239-46. https://doi.org/10.1099/00207713-52-4-1239
  • Elliot SP. Rat bite fever and Streptobacillus moniloformis. Clin Microbiol Rev 2007; 20(1): 13-22. https://doi.org/10.1128/cmr.00016-06
  • IARC Helicobacter pylori Working Group. Helicobacter Pylori Eradication as a Strategy for Preventing Gasric Cancer. Lyon, France: International Agency for Research on Cancer (IARC Working Group reports, no.8); 2014.)
  • Malfertheiner P, Selgrad M, Bornschein J. Helicobacter pylori: clinical management. Curr Opin Gastroenterol 2012; 28(6):608-14. https://doi.org/10.1097/MOG.0b013e32835918a7
  • Georgopoulos SD, Papastergiou V, Karatapanis S. Current options for the treatment of Helicobacter pylori. Expert Opin Pharmacother 2013; (2): 211-23. https://doi.org/10.1517/14656566.2013.763926
  • Lawson AJ. Helicobacter. In: Jorgensen JH, Landry ML, Warnock DW (Eds.) Manual of Clinical Microbiology. Washington DC: ASM Press, 2011: 900-15. https://doi.org/10.1128/9781555816728.ch54
  • Lehours P, Yilmaz O. Epidemiology of Helicobacter pylori infection. Helicobacter. 2007; 12(1): 1-3 https://doi.org/10.1111/j.1523-5378.2007.00541.x
  • Kayali S, Manfredi M, Gaiani F, Bianchi L, Bizzarri B, Leandro G, et al. Helicobacter pylori, transmission routes and recurrence of infection: state of the art. Acta Biomed. 2018; 89(8): 72-6. https://doi.org/10.23750/abm.v89i8-S.7947
  • Megraud F, Lehours P. Helicobacter pylori detection and antibiotic susceptibility testing. Clin Microbiol Rev. 2007; 20(2): 280-322. https://doi.org/10.1128/cmr.00033-06
  • Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World J Gastroenterol. 2013; 19(45): 8188-91. https://doi.org/10.3748/wjg.v19.i45.8188
  • Malfertheiner P, Megraud F, O’Morain CA, J P Gisbert, E J Kuipers, A T Axon, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017(1): 6-30. https://doi.org/10.1136/gutjnl-2016-312288
  • McColl K. Sould Non-invasive Helicobacter pylori testing replase endoscopy in investigation of dyspepsia: Helicobacter. 2000; 5(1): 11-5. https://doi.org/10.1046/j.1523-5378.2000.0050S1011.x
  • M.A. Al-Moagel, D.G. Evans, M.E. Abdulghani, E. Adam, D.J. Evans Jr., H.M. Malaty, et al. Prevalence of Helicobacter Pylori (formerly Campylobacter) infection in Saudi Arabia, and comparison of those with and without upper gastrointestinal symptoms, Am. J. Gastroenterol. 1990; 85(8): 944-8.
  • Tünger Ö. Helicobacter pylori infeksiyonları. Infeks Derg. 2008; 22(2): 107-15.
  • Özdemir M, Baykan M. Dispeptik hastalarda H. pylori infeksiyonu tanısında H. pylori gaita antijeninin tanı değerlerinin incelenmesi. Genel Tıp Derg. 2005; 15(2): 65-70.
  • Zamani M, Ebrahimtabar F, Zamani V, W. H. Miller, R. Alizadeh-Navaei, J. Shokri-Shirvani, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018; 47(7): 868-76. https://doi.org/10.1111/apt.14561
  • Venneman K, Huybrechts I, Gunter MJ, Vandendaele L, Herrero R, Van Herck K. The epidemiology of Helicobacter pylori infection in Europe and the impact of lifestyle on its natural evolution toward stomach cancer after infection: a systematic review. Helicobacter. 2018; 23(3): e12483. https://doi.org/10.1111/hel.12483
  • Tkachenko MA, Zhannat NZ, Erman LV, Elena L Blashenkova, Sergey V Isachenko, Olga B Isachenko, et al. Dramatic changes in the prevalence of Helicobacter pylori infection during childhood: a 10-year follow-up study in Russia. J Pediatr Gastroenterol Nutr. 2007; 45(4): 428- 32. https://doi.org/10.1097/MPG.0b013e318064589f
  • Bahçeci İ, Yıldız İE. İlimizde Helicobacter pylori sıklığının değerlendirmesi: yedi yıllık çalışma. Turk J Clin Lab. 2021; 12(3): 260-4. https://doi.org/10.18663/tjcl.954009
  • Sakman A, Bayram Y, Parlak M, Güdücüoğlu H. Aile sağlığı merkezine başvuran hastalarda Helicobacter pylori sıklığı. TJFMPC. 2021; 15(3): 418-23. https://doi.org/10.21763/tjfmpc.813379
  • Ozaydın N, Turkyılmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Türkiye: a nationallyrepresentative, cross-sectional, screening with the 13C-urea breath test. BMC Public Health. 2013; 13: 1215. https://doi.org/10.1186/1471-2458-13-1215
  • Türkölmez S, Cayir D, Aydoğan F, Korkmaz M. The relationship of the Helicobacter pylori positively with age, sex, and ABO/rhesus blood groups in patients with gastrointestinal complaints in Türkiye. Helicobacter. 2007; 12(3): 244-50. https://doi.org/10.1111/j.1523-5378.2007.00500.x
  • Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, Alp Meşe E. COVID-19 outbreak control, example of ministry of health of Türkiye. Turk J Med Sci. 2020; 50(9): 489-94. https://doi.org/10.3906/sag-2004-187
  • Ibrahim A, Morais S, Ferro A, Lunet N, Peleteiro B. Sex-differences in the prevalence of Helicobacter pylori infection in pediatric and adult populations: systematic review and meta-analysis of 244 studies. Dig Liver Dis. 2017; 49(7): 742-9. https://doi.org/10.1016/j.dld.2017.03.019
  • Nagy P, Johansson S, Molloy-Bland M. Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA. Gut Pathog. 2016; 8: 8. https://doi.org/10.1186/s13099-016-0091-7
There are 30 citations in total.

Details

Primary Language English
Subjects Medical Microbiology (Other)
Journal Section Research Articles
Authors

İsmail Selçuk Aygar 0000-0002-3344-3508

Sevinç Karabulut 0009-0004-4708-3381

Kemal Tekin 0000-0002-6610-6540

Publication Date May 22, 2025
Submission Date October 1, 2024
Acceptance Date April 17, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

Vancouver Aygar İS, Karabulut S, Tekin K. Prevalence and Sociodemographic Distribution of Helicobacter pylori Positivity in Türkiye: A Retrospective Analysis between 2018-2023 and Impact of COVID-19 Measures. VHS. 2025;15(2):288-93.