الفهرس 
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Abstract
The aim of this work was to detect the prevalence and genotypes of H. pylori in one hundred Egyptian patients attending for Upper Gastrointestinal Endoscope at Suez Canal University.
Age in more than half of patients (58%) was equal or above 40 years with mean age was 40.8±11.3 years and a range 18-67 years. Fifty two of patients were male and 53% of the patients lived in rural area.
The majority of the patients were married (87%). Regarding educational level, 45% of the patients had middle education and 38% of them can read and write. More than quarter of the patients was smokers (26%) and 35 % of patients were dyspeptic according to short-form Leeds dyspepsia questionnaire (SF-LDQ). The commonest identifiable endoscopic finding was normal mucosa/gastritis (49%), followed by GERD (24%), then erosive gastro-duodenitis (12%) and peptic ulcer disease (9%). Six percent of the patients had upper GI swellings.
Overall, H. pylori was detected in 47% and 88% of the subjects by PCR and histology, respectively in our 100 studied patients and the maximum percent of H. pylori colonization was 95.5% in age group ≥50 years. Nearly all (98.8%) of H. pylori positive patients had either acute or chronic gastritis, whereas intestinal metaplasia, glandular atrophy were seen in 38.6%, 39.8% of H. pylori positive patients respectively.
Neutrophilic activity was present in 92.0% of H. pylori-infected patients, which was significantly higher than that of those H. pylori-negative (58.3%). Also MNC infiltration was present in 98.9% of H. pylori infected patients compared to 66.7% in H. pylori negative and this was statistically significant. Intestinal metaplasia was slightly low frequency among H. pylori-positive compared to H. pylori-negative patients (38.6% compared to 41.7%, p=0.8). But the glandular atrophy was high frequency among H. pylori-positive compared to H. pylori-negative patients (39.8% compared to 25.0%, p=0.5)
Twenty five 16S rRNA fragments from the total 47 positive PCR samples were aligned with known bacterial sequences at Genebank with following results; 13 of sequenced PCR fragments were identical to Helicobacter species, 5 identical to non-Helicobacter species and 7 undefined DNA sequences. The five non-H. Pylori species were; Gemella (2 strains), one Neisseria, one Streptococcus and one Hydrogenobaculum. Most of non-Helicobacter species were seen in GERD and UGI swelling (4/5) patients.
High grade neutrophilic activity was seen in H. pylori mono-infection, H. pylori co-infection and undefined sequences, 46.2%, 40%, and 0% respectively. The degree of chronic inflammation in the gastric mucosa were significantly more severe in patients who have mixed infection (80%) compared to patients with H. pylori mono-infection and undefined sequences 69.3% and 14.3% respectively.
By sequence comparison, between thirteen 16S rRNA sequences and partial bacterial genome at gene bank, each sequence showed a variable homology with genome of known Helicobacter species as following; Four H. pylori SouthAfrica20; one H. pylori SouthAfrica7; two H. pylori Gambia94/24(Gambia); two H. pylori oki828 (Japan); one H. pylori oki898 (Japan); one H. pylori NY40 DNA (Japan); one H. pylori BM012B (USA); one H. pylori J166 (USA).