title: Helicobacter pylori: prevalence and antibiotic susceptibility among Kenyans.
abstract: BACKGROUND
  Helicobacter pylori infection in Kenya is staggeringly high. Evidence links infection of the gastric mucosa by H. pylori with subsequent development of gastric pathologies.
  
  
  OBJECTIVE
  We investigated the prevalence of H. pylori in dyspeptic patients, its relationship with gastric pathologies, and associated antibiotic susceptibility profiles, and compared two media to find the appropriate medium that enhances growth and expedites culture and isolation.
  
  
  METHODS
  Rapid urease and histological tests were used to screen for H. pylori. Culture was performed to test sensitivity and evaluate media. Selective and nutritional supplements were added to culture media (Colombia blood agar and brain-heart infusion agar) for growth enhancement. E-test strips for metronidazole, amoxicillin and clarithromycin were used for susceptibility testing.
  
  
  RESULTS
  The prevalence of H. pylori infection in children was 73.3%, and 54.8% in adults. All the H. pylori investigated in this study were largely sensitive to clarithromycin (100%, minimum inhibiting concentration (MIC) <2 microg/ml), amoxicillin (100%, MIC <2 microg/ml) and metronidazole (95.4%, MIC <8 microg/ml). There was, however, occasional resistance to metronidazole (4.6%, MIC >8 microg/ml). Both Colombia blood and brain-heart infusion agar, with the supplements, effectively supported H. pylori growth. Growth was achieved in an average of 36 hours for primary isolations and 24 hours for subcultures.
  
  
  CONCLUSIONS
  The media described here reduce the time required to culture and isolate bacteria and perform susceptibility testing. Despite the high prevalence of H. pylori infection, the associated pathology is low and does not parallel H. pylori prevalence in the population.
authors.affiliation: Medical Microbiology Subdepartment, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya. kinyerere@yahoo.com
authors.forename: Andrew Nyerere
authors.initials: AN
authors.lastname: Kimang'a
authors.forename: Gunturu
authors.initials: G
authors.lastname: Revathi
authors.forename: Samuel
authors.initials: S
authors.lastname: Kariuki
authors.forename: Shahin
authors.initials: S
authors.lastname: Sayed
authors.forename: Smita
authors.initials: S
authors.lastname: Devani
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D044383:Black People / Q000706:statistics & numerical data*; D002648:Child; D017291:Clarithromycin / Q000627:therapeutic use; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D004415:Dyspepsia / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D016480:Helicobacter pylori; D006801:Humans; D007630:Kenya; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin