Antibiotic Resistance of Helicobacter pylori in Children with Gastritis and Peptic Ulcers in Mekong Delta, Vietnam.

BACKGROUND: Helicobacter pylori (H. pylori) infection causes gastritis, duodenal and gastric ulcers, and gastric cancer. H. pylori eradication efficacy is low worldwide, and antibiotic resistance is the leading cause of therapy failure; therefore, this study was performed to determine the characteristics of antibiotic resistance of H. pylori in children with gastritis, duodenal and gastric ulcer. METHODS: A cross-sectional study was conducted on 237 pediatric patients diagnosed with gastroduodenal inflammation and ulcer at two hospitals in Vietnam from March 2019 to April 2022. Pediatric patients with positive H. pylori tests continued to do E-tests to measure the minimum inhibitory concentration of the antibiotic so that we could prescribe effective antibiotics based on the sensitivity. RESULTS: In 237 pediatric patients (51.1% males) with a median age of 10.3 years (range 5-16 years), endoscopic images showed that inflammatory lesions and peptic ulcers accounted for 69.2% and 30.8%, respectively. Resistance rates of H. pylori were 80.6% to clarithromycin (CLR), 71.7% to amoxicillin (AMX), 49.4% to metronidazole (MTZ), 45.1% to levofloxacin (LEV), and 11.4% to tetracycline (TET); dual resistance to AMX + CLR was 64.2%, AMX + LEV 35%, AMX + MTZ 33.3%, CLR + MTZ 32.5%, and TET + MTZ 7.2%. The frequency of clarithromycin resistance was significantly increased, particularly in pediatric patients who had received prior H. pylori treatment. The percentage of amoxicillin resistance increased with age; amoxicillin resistance of H. pylori was more prevalent among pediatric patients with peptic ulcers than those with gastroduodenal inflammation and higher in males than females. CONCLUSIONS: The proportions of resistance to CLR, AMX, MTZ, and LEV were extremely high, in contrast to TET, which was lower in pediatric patients. Our study suggests that the standard triple therapy with CLR should be limited as the empiric therapy for pediatric patients, and we should consider using eradication regimens with TET for children over 8 years of age if the medical facility is not qualified to perform antibiotic susceptibility tests of H. pylori in the Mekong Delta.

Characterization of gluten-free rice bread prepared using a combination of potato tuber and ramie leaf enzymes.

A combination of freeze-dried powder of disproportionating enzyme (D-enzyme)-containing potato tuber and ß-amylase-containing ramie leaf was used to improve the gluten-free (GF) bread, and its physicochemical properties were characterized. The presence of D-enzyme and ß amylase in the potato tuber and ramie leaf was confirmed. Sixty five percent of partially gelatinized rice flour and 20% corn starch was combined with 10% freeze-dried potato tuber and 1% ramie leaf powder, and baked. The specific volume increased by 23% compared to the control with improved internal characteristics. Texture profile analysis revealed that retrogradation of the bread was retarded when stored for 90 h at 4 °C. The bread crumb amylose content was reduced from 14 to 9% and amylopectin branch chain-length distribution was rearranged, whereby the proportions of the branch chains with Degree of polymerization (DP) < 9 and DP > 19 decreased. The results suggest that D-enzyme and ß-amylase cooperatively altered amylose/amylopectin ratio and amylopectin structure.

Characterization of a panel of Vietnamese rice varieties using DArT and SNP markers for association mapping purposes.

BACKGROUND: The development of genome-wide association studies (GWAS) in crops has made it possible to mine interesting alleles hidden in gene bank resources. However, only a small fraction of the rice genetic diversity of any given country has been exploited in the studies with worldwide sampling conducted to date. This study presents the development of a panel of rice varieties from Vietnam for GWAS purposes. RESULTS: The panel, initially composed of 270 accessions, was characterized for simple agronomic traits (maturity class, grain shape and endosperm type) commonly used to classify rice varieties. We first genotyped the panel using Diversity Array Technology (DArT) markers. We analyzed the panel structure, identified two subpanels corresponding to the indica and japonica sub-species and selected 182 non-redundant accessions. However, the number of usable DArT markers (241 for an initial library of 6444 clones) was too small for GWAS purposes. Therefore, we characterized the panel of 182 accessions with 25,971 markers using genotyping by sequencing. The same indica and japonica subpanels were identified. The indica subpanel was further divided into six populations (I1 to I6) using a model-based approach. The japonica subpanel, which was more highly differentiated, was divided into 4 populations (J1 to J4), including a temperate type (J2). Passport data and phenotypic traits were used to characterize these populations. Some populations were exclusively composed of glutinous types (I3 and J2). Some of the upland rice varieties appeared to belong to indica populations, which is uncommon in this region of the world. Linkage disequilibrium decayed faster in the indica subpanel (r2 below 0.2 at 101 kb) than in the japonica subpanel (r2 below 0.2 at 425 kb), likely because of the strongest differentiation of the japonica subpanel. A matrix adapted for GWAS was built by eliminating the markers with a minor allele frequency below 5% and imputing the missing data. This matrix contained 21,814 markers. A GWAS was conducted on time to flowering to prove the utility of this panel. CONCLUSIONS: This publicly available panel constitutes an important resource giving access to original allelic diversity. It will be used for GWAS on root and panicle traits.

Applying standard epidemiological methods for investigating foodborne disease outbreak in resource-poor settings: lessons from Vietnam.

An outbreak of gastroenteritis occurred among workers of company X after eating lunch prepared by a catering service. Of 430 workers attending the meal, 56 were hospitalized with abdominal pain, diarrhea, vomiting, and nausea, according to the initial report. We conducted an investigation to identify the extent, vehicle, and source of the outbreak. In our case-control study, a case was a worker who attended the meal and who was hospitalized with acute gastroenteritis; controls were randomly selected from non-ill workers. Cases and controls were interviewed using a standard questionnaire. We used logistic regression to calculate adjusted odds ratios for the consumption of food items. Catering service facilities and food handlers working for the service were inspected. Food samples from the catering service were tested at reference laboratories. Of hospitalized cases, 54 fulfilled the case definition, but no stool specimens were collected for laboratory testing. Of four food items served during lunch, only "squash and pork soup" was significantly associated with gastroenteritis, with an adjusted odds ratio of 9.5 (95 % CI 3.2, 27.7). The caterer did not separate cooked from raw foods but used the same counter for both. Cooked foods were kept at room temperature for about 4 h before serving. Four of 14 food handlers were not trained on basic food safety principles and did not have health certificates. Although no microbiological confirmation was obtained, our epidemiological investigation suggested that squash and pork soup caused the outbreak. Hospitals should be instructed to obtain stool specimens from patients with gastroenteritis. Food catering services should be educated in basic food safety measures.