{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T01:53:26Z","timestamp":1724550806481},"reference-count":47,"publisher":"Akademiai Kiado Zrt.","issue":"49","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,12,1]]},"abstract":"<jats:p>A 27 \u00e9ve felfedezett<jats:italic>Helicobacter pylori<\/jats:italic>az eltelt \u00e9vtizedekben a f\u00f6ldkereks\u00e9g leggyakoribb fert\u0151z\u00e9se maradt. A szerz\u0151 felt\u00e9telezi, hogy a peptikus fek\u00e9ly gyakoris\u00e1g\u00e1nak XIX\u2013XX. sz\u00e1zadi emelked\u00e9s\u00e9t a gyomorszond\u00e1z\u00e1s sz\u00e9les k\u00f6r\u0171 elterjed\u00e9se seg\u00edthette el\u0151, amelynek sor\u00e1n a bakt\u00e9rium iatrog\u00e9n \u00e1tvitel\u00e9vel a patog\u00e9n t\u00f6rzsek terjedhettek el. \u00daj virulenciat\u00e9nyez\u0151ket mutattak ki: a<jats:italic>Helicobacter pylori<\/jats:italic>t\u00f6rzsek membr\u00e1nfeh\u00e9rj\u00e9ket (outer membrane protein, OMP), valamint dupA (duodenal ulcer promoting) feh\u00e9rj\u00e9t k\u00f3dol\u00f3 g\u00e9neket tartalmaznak, amelyek egyr\u00e9szt proinflammatorikus citokinek termel\u00e9s\u00e9hez vezetnek, m\u00e1sr\u00e9szt a j\u00f6v\u0151ben ter\u00e1pi\u00e1s c\u00e9lpontok lehetnek. A fert\u0151z\u00e9s els\u0151 vonalbeli kezel\u00e9s\u00e9ben ide\u00e1lis m\u00f3dszer nincs, szak\u00e9rt\u0151k szerint ezek hat\u00e9konys\u00e1ga az ut\u00f3bbi \u00e9vekben elfogadhatatlan szintre cs\u00f6kkent, b\u00e1r ez a jelens\u00e9g a szerz\u0151 adatai szerint multifaktori\u00e1lis \u00e9s nem \u00e1ltal\u00e1nos\u00edthat\u00f3. Alternat\u00edv kezel\u00e9sk\u00e9nt a levofloxacin, furazolidon \u00e9s rifabutin hat\u00e9konys\u00e1g\u00e1t metaanal\u00edzisek igazolt\u00e1k. A szekvenci\u00e1lis \u00e9s a bizmutmentes n\u00e9gyes kezel\u00e9s nemzetk\u00f6zileg m\u00e9g nem terjedt el. A fert\u0151z\u00e9s rekurrenci\u00e1j\u00e1nak ar\u00e1nya 2,67%\/\u00e9v a fejlett \u00e9s 13,0%\/\u00e9v a fejl\u0151d\u0151 orsz\u00e1gokban. Gyermekekben 8\u201320%-ban, feln\u0151ttekben 5\u201311%-ban spont\u00e1n eradik\u00e1ci\u00f3 l\u00e9p fel. A clarithromycinrezisztencia gyakoris\u00e1ga vil\u00e1gszerte n\u00f6veked\u0151ben van, hazai adatok szerint orsz\u00e1gosan vid\u00e9ki nagyv\u00e1rosokban 10,9%, Budapest IX. ker\u00fclet\u00e9ben 2005\u20132009 k\u00f6z\u00f6tt 16\u201322% k\u00f6z\u00f6tt volt, n\u00f6veked\u00e9si tendencia n\u00e9lk\u00fcl. \u00daj ter\u00e1pi\u00e1s c\u00e9lpontk\u00e9nt a rezisztenci\u00e1t nem okoz\u00f3 enzimg\u00e1tl\u00f3k (ure\u00e1z, karboanhidr\u00e1z \u00e9s gamma-glutamil-transzpeptid\u00e1z), m\u00f3dos\u00edtott antibiotikum \u00e9s effluxpumpag\u00e1tl\u00f3k kifejleszt\u00e9se van folyamatban: emberi alkalmaz\u00e1sra m\u00e9g egyik sem ker\u00fclt. Orv. 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