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Management of Helicobacter pylori infection is an important aspect of many upper gastrointestinal tract diseases, such as chronic gastritis, peptic ulcer disease, gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. The Thailand Consensus on H. pylori treatment 2015 consisted of 22 national experts who took active roles, discussed all important clinical information and investigated clinical aspects in four workshops, focuising on: (1) Diagnosis (2) Treatment (3) Follow-up after eradication and (4) H. pylori infection and special conditions. Experts were invited to participate on the basis of their expertise and contribution to H. pylori works and/or consensus methodology. The results of each workshop were taken to a final consensus vote by all experts. Recommendations were developed from the best evidence and availability to guide clinicians in management of this specific infection associated with variety of clinical outcomes.

Polymerase chain reaction (PCR) for detection of single nucleotide mutations in 23S rRNA gene of clarithromycin resistance Helicobacter pylori were investigated worldwide. In Thailand, the prevalence of these mutations had not been extensively investigated. The authors conducted a 32-months prospective study to estimate the prevalence of clarithromycin resistant Helicobacter pylori and to compare the sensitivity and specificity of hybridization real time PCR for 23S rRNA gene of Helicobacter pylori detection with the combination of rapid urease test, immunohistochemistry straining and Helicobacter pylori culture. A total of 200 patients with endoscopic examination with gastric biopsy were enrolled from January 2006 to September 2008. Eight gastric specimens were biopsied and performed rapid urease test, immunohistochemistry straining for Helicobacter pylori, Helicobacter pylori culture and hybridization real time PCR for 23S rRNA dectection, as well as single nucleotide mutation detection, such as G2111A, A2115G A2142G, A2143G andA2144G. The clarithromycin susceptibility of Helicobacter pylori isolated was determined by E-test. The prevalences of clarithromycin, amoxicillin, metronidazole and tetracycline resistance were 13.8%, 21.3%, 55.0% and 8.8%, respectively. Most of clarithromycin resistant Helicobacter pylori (81.80%) had very high minimal inhibition concentration (MIC) more than 256 microg/ml. The resistance to mutation gene at A2142G was found in 4 patients (36.40%). Two patients were found to have multiple mutations at G2111A, A2115G and A2144G (18.20%). The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio to test positive and likelihood ratio to test negative of hybridization RT-PCR in detecting 23S rRNA gene of Helicobacter pylori was 95.6%, 94.4%, 93.2%, 96.7%, 17.2 and 4.6, respectively. In conclusion A2142G mutation was most common and associated with high MIC. Hybridization RT-PCR had good sensitivity and specificity to detect 23S rRNA gene, as well as clarithromycin resistance gene mutation of Helicobacter pylori.

Background: Helicobacter pylori is one of the most common human infections worldwide. It has been established as etiology of chronic gastritis and peptic ulcer disease, gastric adenocarcinoma and mucosal associated lymphoid tissue lymphoma (MALT). During this decade, there have been some reports showing a decline in global prevalence of H. pylori infection and peptic diseases including in many Asian countries., Objective: To study the H. pylori infection in patients with peptic diseases, association with other factors and comparison to previous data., Material and Method: Retrospective observational study of endoscopic reports for upper gastrointestinal tract diseases in patients with peptic diseases from October 2009 to September 2010 at the Endoscopic Unit, Department of Medicine, Rajavithi Hospital. Patients were examined for the presence of H. pylori infection by rapid urease test (RUT) or histology staining., Results: Five hundred and seventy patients with a mean age of 55.0 +/- 16.02 years with peptic diseases were studies. Endoscopic findings showed 106 GU patients (18.6%), 29 DU patients (5.1%), 3 combined GU and DU patients (0.5%) and 432 NUD patients (75.8%). The prevalence of H. pylori infection were 64% (365 of 570 patients). Prevalence of H. pylori infection were 61.3% of NUD cases, 68.9% of GU cases, 82.8% in DU cases and 100% in combined GU and DU cases. Comparison with previous data (Anantapunpong S. Rajavithi Med J 1999; 10: 17-26), the prevalence of H. pylori infection overall and in DU are not changed but in NUD and GU are increased., Conclusion: The prevalence of H. pylori infection is still high in peptic diseases. The patients with age more than 50 years have more GU, less NUD than the younger groups. In comparison with a previous study, the prevalence of H. pylori infection in overall and in DU are not changed but in NUD and GU are increased.