الفهرس 
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Abstract
Helicobacter pylori infection has a very high prevalence. It is influenced by socio-economic status as well as levels of hygiene.
Helicobacter pylori has been traditionally considered a non-invasive pathogen. It is a facultative intracellular bacterium of innate immune cells. To avoid the acidic environment of the stomach lumen, H. pylori uses its flagella to reach the epithelial cells underneath, where it is less acidic. It also neutralizes the acid in its environment by producing large amounts of urease.
Helicobacter pylori infections typically do not have symptoms, they can lead to peptic ulcers, gastritis, and a known risk factors for gastric carcinoma.
Extra gastric diseases of H.pylori include, haematological manifestations, It has been associated with the development of neurologic diseases, type 2 DM, cardiovascular disease and autoimmune conditions.
Diagnostic tests to detect H.pylori infection are usually divided into invasive and noninvasive methods. Invasive methods include endoscopy, molecular techniques, rapid urease, test, and culture. Among the noninvasive methods, the urea breath test, antibody detection and stool antigen test are used.
First-line treatment is Clarithromycin Triple Therapy, or Bismuth quadruple therapy (BQT), or Non-bismuth quadruple therapies. Second-line treatment is PPI+levofloxacin+ amoxacillin or a Bismuth quadruple therapy. Third-line treatment should be based on culture with susceptibility testing or molecular determination of Genotype resistance.
This study included ninety patients with symptoms consistent with Helicobacter pylori infection who attended the endoscopy unit of the Hepatology, Gastroenterology, and Infectious Disease Department, Ain Sham UniversityHospitals.
Rapid immunoassay for the detection of H.pylori antigens RAPID STRIP HpSA (Meridian, Italy) was done on stool samples of patients confirmed by histopathological examination.Real-time PCRs to detect H. pylori mutations associated with clarithromycin resistance was done on stool samples with positive H.pylori stool antigen test.
The results revealed that H.pylori was diagnosed in 66 out of 90 (73%) patients by histopathological examination.
50 out of 66 (76%) stool specimens of patients confirmed by histopthalogical examination had positive H.pylori stool antigen by rapid strip test (27 male, 23 female).
The results revealed that clarithromycin resistant rate was high (46%), of which A2143G (28%) and A2142G was (18%). There was no significant difference between clarithromycin resistance detection among males and females. There was no statistically significant correlation between Clarithromycin resistance and age.