I Ketut Mariadi*, I Dewa Nyoman Wibawa*, Ida Bagus Nyoman Putra Dwija**

*Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, University of Udayana, Bali

**Department of Clinical Microbiology, Faculty of Medicine, University of Udayana, Bali

Corresponding author: I Dewa Nyoman Wibawa. Division of Gastroentero-hepatology, Department of Internal Medicine, Sanglah General Hospital. Jl. Diponegoro Denpasar Indonesia. Phone/facsimile: +62-361-244177. E-mail: dnwib@ dps.centrin.net.id

ABSTRACT

Background: Helicobacter pylori (H. pylori) infection causes various abnormalities in the stomach. Only particular strain can cause severe problems in the stomach. CagA is a microbial virulent factor which is associated with more severe stomach problems, such as: peptic ulcer and stomach cancer. We would like to know the prevalence of CagA in Balinese population, and the association of H. pylori CagA status with the severity of endoscopic appearance in dyspepsia patients.

Method: Study design being used was analytic cross sectional study, involving 71 dyspepsia patients who underwent upper gastrointestinal endoscopic examination in Surya Husada Hospital and Balimed Hospital in June-December 2013. Sample was chosen in consecutive manner. Later, polymerase chain reaction (PCR) examinations of the stomach mucous biopsy tissue to determine H. pylori infection status and CagA status were performed. Further, Chi-square test was used to identify the difference in proportion of H. pylori and CagA between mild and severe endoscopic appearance.

Results: In this study, we found that the prevalence of H. pylori infection was 22.5% using PCR examination. Prevalence of CagA positive in H. pylori positive was 62.5%. There was significant association between status of H. Pylori infection and severity of endoscopic appearance (p = 0.038; OR= 2.67; 95% CI = 1.18-6.05). Status of CagA in H. pylori infected patients was not associated with the severity of endoscopic appearance. Additionally, there was significant association between patients’ age and severity of endoscopic appearance.

Conclusion: The prevalence of CagA in H. pylori positive was 62.5%. H. pylori infection was associated with severity of endoscopic appearance and CagA status in H. pylori infected patients was not associated with severity of endoscopic appearance.

Keywords: Helicobacter pylori, CagA, endoscopic appearance

Indones J Gastroenterol Hepatol Dig Endosc Vol.17, No.2, August 2016 (FULL TEXT)