[Microflora of gastric juice in patients after eradication of Helicobacter pylori and treatment with a proton pump inhibitor].

UNLABELLED: Previous studies have suggested that decrease of acidity of gastric juice leads to microbial overgrowth in gastric juice.

AIM OF THE STUDY: Qualitative and quantitative evaluation of upper respiratory tract and gastric juice microflora depending on the change of gastric juice pH, which occurred during treatment with pantoprazole and eradication therapy.

MATERIAL AND

METHODS

40 patients suffering from duodenal ulcer or reflux esophagitis have been examined. Group 1, patients without infection of H. pylori have received pantoprazole 40 mg/d for 4 weeks. Group 2, patients with infection of H. pylori have received 7-day eradication therapy (pantoprazole, amoxicillin, clarithromycin) and then pantoprazole 40 mg/d for 3 weeks. The samples of gastric juice have been taken twice: before treatment and in the 4th week of treatment. The assessment of gastric juice included pH measurement and bacteriological analysis.

RESULTS

The mean values of gastric juice pH in the group 1 were as following--1.7 (SD +/- 0.53) before and 5.2 (SD +/- 2.26) during the treatment. Mean microbial counts were: 0.47 (SD +/- 1.01) logCFU/ml before, and 1.77 (SD +/- 1.48) logCFU/ml during the treatment. In group 2 the increase of approximate amount of gastric juice from 1.8 (SD +/- 0.77) before treatment to 3.8 (SD +/- 2.43) during the treatment was noticed. The average titer of gastric juice microflora increased from 0.5 logCFU/ml (SD +/- 0.83) to 1.39 logCFU/ml (SD +/- 1.52). Similarity between microflora isolated from gastric juice and tonsil swabs was noticed among most of the patients.

CONCLUSIONS

The increase of gastric juice pH during the treatment with pantoprazole can lead to microflora growth in gastric juice. Microorganisms isolated from gastric juice among patients treated with antisecretive drugs mainly derived from the upper respiratory tract. Mostly isolated strains were: S. aureus, E. coli, Candida albicans.