The normal gastric microflora and Helicobacter pylori; before, during and after treatment with omeprazole and amoxycillin

Abstract

Objective: To study the microflora in patients with Helicobacter pylori infection during treatment with omeprazole alone and in combination with amoxycillin, to study transmission of relapsing H. pylori strains by fingerprinting and to investigate if H. pylori is detectable in saliva and dental plaque by polymerase chain reaction (PCR). Methods: Twenty-eight dyspeptic patients with H. pylori infection were divided into two treatment groups: omeprazole 20 mg plus amoxycillin 1000 mg, or omeprazole 20 mg plus placebo twice a day for 14 days. Biopsies were taken before, during and after treatment. The biopsies were cultivated in order to study the commensal microflora and H. pylori PCR was used to detect H. pylori in the biopsies, saliva and dental plaque. The H. pylori strains were fingerprinted with arbitrary primed PCR. Results: Twenty-five patients harbored H. pylori, of whom 22 also harbored a normal mucosal microflora. H. pylori was present in all patients in the omeprazole-placebo group and in 39% of the patients in the omeprazole-amoxycillin group 4 weeks after treatment. There were no significant differences in the number of bacteria in antrum and corpus. Conclusions: There was an inverse relationship between the growth of commensal microflora and H. pylori during treatment in both groups. H. pylori was detectable in saliva and dental plaque by PCR. The original H. pylori strain was present in all but one relapsing patient.