Helicobacter pylori. Al_Baldawi Al_Baldawi 9. Helicobacter pylori. ( Normal flora ) Staphylococcus aureus. Microaerophilic 2 H.pylori. 3 H.

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1 8 Amphotericin (Biopsies) (AL-Baldawi) Skirrow Vancomycin Polymyxin B Trimethoprim B 86 Ciprofloxacin Amoxicillin Metronidazol Cephotaxime Doxycyclin Tetracycline Clarithromycin ( Normal flora ) Staphylococcus aureus Yeast 6 ( Skirrow ) ( Albaldawi ) Marshall (Warren) 8 Microaerophilic H.pylori

2 DBL. SQUIBB (Endoscopic forceps ) Culturing (biopsies). (homogenizer) ( Albaldawi ) oxoid Skirrow's medium 8 º DBL (S). (AL-Baldawi) (Nalidixic acid) Cephalothin) 8 Oxoid

3 8 E. coli HB Amoxicillin AML Oxoid Metronidazol Mt Clarithromycin Crr Tetracyclin TE Oxoid Doxycyclin Do Oxoid 6 Cephotaxime CTX Oxoid Ciprofloxacin Cip Helicobacter pylori (S) Nalidixic acid Cephalothin 8

4 8 8 H.pylori (X)

5 8 86 (Albaldawi) (Albaldawi) ( Albaldawi )

6 H.pylori Staphylococcus aureus Yeast Pseudomonas aeruginosa 6 Vancomycin B Polymyxin Trimethoprim Vancomycin Trimethoprim Amphotericin B Cefosoldin Vancomycin Trimethoprim Nalidixic acid Amphotericin Vancomycin Trimethoprim Polymyxin B P. aeruginosa Amphotericin B Amoxicillin Metronidazol Ciprofloxacin Clarithromycin Tetracyclin Doxycyclin Cefotaxime

7 8 H 8 H8

8 References : - Warren, J. R. ; Marshall, B. J. (8). Unidentified curved bacilli on gastric epithelium in active chronic gastritis, Lancet, I :. - Labigne, A. & de Reuse, H. (6). Review determinants of Helicobacter pylori pathogen city, Infect. Agen. And disea., () :. - Itoh, T.; Yanagawa, Y.; Sningaki, M. ; Takahashi, M. ; Kai, A. ; Ohashi,M. & Hamana, G. (8). Isolation of Campylobacter pyloridis from human gastric mucosa and characterization of the isolation, Microbiol. Immunol., : 6 6. Abstract. - Hachem, C. Y. ; Clarridge, J. E. ; Evans, D. G. & Graham, D. Y. (). Comparison of agar based media for primary isolation of, J. Clin. Pathol., 8 : 6. - Krajden, S. ; Bohnen, J.; Anderson, J. ; Kempston, J. ; Fuksa, M. ; Matlow, A. ; Marcon, N. ; Haber, G. ; Kortan, P. ; Karmali,M. ; Corey, P. ; Petrea, C. ; Babida, C. & Hayman, S. (8). Comparison of selective and nonselective media for recovery Campylobacter pylori from Antral biopsies, J. Clin Microbiol., : Glupczynski,Y. (8). Microbiological and serological diagnostic test for : an overview, Brit. Med. Bull., () : Parsonnat, J. ; Welch, K. ; Compton, C. ; Strauss, R. ; Timothy, W. ; Kelsey, P. & Ferraro, M. J. ( 88 ). Simple microbiological detection of Campylobacter pylori, J. Clin. Microbiol., 6 () : Holt, J. G. ; Krieg, N. R. ; Staley, J. T. &Williams, S. T. () Group aerobic / microaerophilic, motile, Helical / viberoid gram negative bacteria. In: Bergey's manual of determination bacteriology, pp. 8. th edition, Williams & Wilkins, USA. - Hindler, J. (8). Antimicrobial susceptibility testing. In : Essential procedures for Clinical microbiology, by: Isenberg, H. D., ASM press, Washington D.C. Amoxicillin B-lactamase H. Amoxicillin pylori Amoxicillin Amoxicillin 6 Metronidazol Amoebiasis Ciprofloxacin H.pylori H.pylori 8 8 Tetracyclin Doxycyclin Cefotaxime Clarithromycin

9 8 isolates from patients with peptic ulcer diseases., Indian J. Med. Res., : Abstract. - Marshall, B. J. ; Mcgechie, D. B. ; Rogers, P. A. & Glancy, R. J. (8). Pyloric Campylobacter infection and gastroduodenal disease, M. J. A, :. - Daw, A. M. ; Seifenaser, N. E. & Hasan, M. H. (). Pattern of Helicobacter pylori resistance to antimicrobials in Libya, SMJ, 8 () : 6. - Flores, B. M. ; Fennell, C. L. ; Holmes K. K. & Stamm, W.E. (8). In vitro susceptibility of Campylobacter Like organisms to twenty Antimicrobial Agents, Antimicrob. Age. Chemother. 8 () : Lambert, T. H. ; Megraud, F. ; Gerband, G. & courvalin, P. (86). Susceptibility of Campylobacter pylori to antimicrobial agents, Antimicrob. Age. Chemother., () :. - Al-Jalili, F. Y. A. (6). Helicobacter pylori and peptic ulceration in Iraqi patients. Pathological and serological study. M. Sc. Thesis. College of Science, AL-Mustansyria University Abstract Biopsies from Iraqi patients with gastric and duodenal ulcers were cultured by using two selective media for primary isolation of, the first medium was Skirrow selective medium, the second was modified Skirrow selective medium (Al_baldawi) containing brain heart infusion agar supplemented with % lysed horse blood&antibiotics: Vancomycin (µg/ml), Trimethoprim µg/ml, polymyxin- B (.) IU/ml and Amphotericin-B µg /ml. Isolation percentage were 86.% and % by using modified Skirrow selective medium (Al_baldawi) and Skirrow medium respectively. Results showed that number of colonies were greater in modified medium than that in Skirrow selective medium, also the results shows less contamination percentage by using modified Skirrow selective medium (Al_baldawi) than Skirrow - Marshall, B. J. ; Royce, H. & Annear, D. L. ( 8 ). Original isolation of Campylobacter pyloridis from human gastric mucosa, Microbiol. Lett., : Cited by : Buckley, M.J.M. & O'Morain, C.A. (8). Helicobacter biology-discovery, Brit. Med. Bull., () :. - Taylor, D.E. ; Hargreares, J. A. ; Laiking, N. G. ; Sherbauink, R.W. & Jewell, L. D. ( 8 ). Isolation and characterization of Campylobacter pyloridis from gastric biopsies, J. Clin. Pathol., 8 :. - Skirrow, W. B. ( ). Campylobacter enteritis :a " new " disease, BMJ, :. - Dent, J. C. & McNulty, C.A.M. (88). Evaluation of new selective media for Campylobacter pylori, Eur. J. Clin. Microbiol. Infect. Dis., : Megraud, F. (8). Microbiological characteristics of Campylobacter pylori, Eur. J. Gastroenterol. & Hepatol., ():. - Borysiewicz, J. ; Bolek, A. ; Prazmowska, B. ; Komorowski, J. ; & Mikolajska, M. (). Drug resistance of strains isolated from patients with inflammation of stomach mucous membrane and peptic ulcer of stomach and duodenum, Med. Dosw. Microbiol., () :. Abstract. 6- Dor, M. P. ; Sepulred, A. R. ; Mura, I. ; Realdi, G. ; Osato,M. S. & Graham, D. Y. (). Explanation for variability of Omeprazole Amoxicillin therapy? Tolerance of to Amoxicillin, Gastroenterol., () : A. - Reddy, R. M.; Osato, M. ; Gutierrez, O. ;Kim, J. G. &Graham, D.Y. (6). Metronidazole resistance is high in Koria and Columbia and appears to be rapidly increasing in the U.S., Gastroentrol., : A6. 8- Sharma, S. ; Parsad, K. N. ; Chamoli, D. & Ayyagari, A. (). Antimicrobial susceptibility pattern & biotyping of

10 medium. These results indicated superiority of modified medium for primary isolation. Antibiotic sensitivity test for () isolates indicates that isolates were resistant () % to amoxicillin, metronidazol and ciprofloxacin while these isolates were sensitive () % to clarithromycin, tetracycline, doxycyclin and cephotaxime. These results clarify the importance of using specific regime therapy which is not absolutely involved a Amoxicillin and metronidazol, the two antibiotic that are used allover the world in gastroduodenal ulcers therapy.

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