SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 2 | 39 SAGES CONGRESS 2022 ABSTRACTS Results A total of 88 patients were included in this study. There is a 81.8% male predominance with a mean age of 44.8 years. 39 cases (44.8%) were associated with substance abuse, the most common of which was methamphetamine (tik) use (25 cases). Use of non-steroidal anti- inflammatories was present in 27 cases (31%). 92% of the cases were performed by surgical trainees, 69.3% of which, without supervision. 14 cases (15.9%) were perforated duodenal ulcers the rest gastric ulcers. There were surgical complications noted in 25 cases (28.4%) with an overall an overall mortality at 30 days of 10.2%. Conclusion The mean age for perforated peptic ulcers is far lower in this cohort of patients when compared to middle to high economic standing countries and can be attributed to higher use of ‘tik’ and other substances. It is therefore important to have a low threshold for work up for a perforated peptic ulcer in the young ‘tik’ abusing patients who present with abdominal pain. THE BISAP SCORE ON ADMISSION IS USEFUL IN IDENTIFYING PATIENTS AT RISK FOR BOTH PROLONGED ORGAN FAILURE AND MORTALITY IN ACUTE PANCREATITIS. Author Dr Tende Makofane 1 1 Ukzn Introduction Identification of at risk patients with acute pancreatitis (AP) early on in the course of hospital admission remains a challenge. Early identification of these patients can facilitate early referral to tertiary hospitals with skilled multi-disciplinary teams and high dependency health care facilities. This study retrospectively reviewed the ability of the BISAP score and other biochemical markers to predict organ failure and mortality in acute pancreatitis. Methods All patients presenting to Grey’s hospital with AP between 2012 and 2020 were included in the study. The BISAP score and other biomarkers were evaluated at presentation in predicting organ failure ( ≥ 48 hours duration) and mortality. Results A total of 235 patients were included in the study. One hundred and forty four (61%) were male and 91 (39%) were female. Alcohol (81%) and gallstones (69%) were the commonest aetiological factor amongst males and females respectively. Forty two (29%) males and ten (11%) females developed organ failure during their hospital stay. The mortality rate was 11.8% for males, 6.59% for females. A BISAP score of 2 had a sensitivity of 87.98% and specificity of 59.62% at predicting organ failure (PPV= 88.46%, NPV= 58.49%, 95% CI, p-value= 0.001). A BISAP score of 3 and above had a sensitivity of 98.11% and specificity of 69.57% at predicting mortality (PPV= 96.74%, NPV= 80%, 95% CI, p-value= 0.001). A multivariate analysis of biomarkers bicarbonate, base excess, lactate, urea and creatinine showed them to be slightly superior to the BISAP score in predicting organ failure, but this did not reach statistical significance Conclusion BISAP score can be used to triage patients at district hospitals for transfer to centres with high dependency wards, intensive care & specialized multidisciplinary teams. AN EVALUATION OF BIOFILM PRODUCTION OF HELICOBACTER PYLORI STRAINS ISOLATED FROM GASTRIC BIOPSIES: AN IN VITRO STUDY IN CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL SOUTH AFRICA. Author Dr Ayodeji Idowa 1,2 , Hafeez Mohamed 2 , Priyamvada Pradeep 2 , Razinah Mamdoo 1 , Siyanda Mahlasela 1 , Nazeer Chopdat 1 , Hitendrakumar Bhaga 1 , Reidwaan Ally 1 1 African Institute of Digestive Diseases, Division of Gastroenterology, Chris Hani Baragwanath Academic Hospital (CHBAH), 2 Radogani Research Unit, Austell Laboratories Background Helicobacter pylori (Hp) strains from different parts of Africa differ in their expression of virulence factors and gastric pathologies. Hp biofilm formation, which has been shown to possibly be linked to Hp eradication failure, may also correlate with more severe gastric pathology. We aimed to determine qualitative and quantitative Hp biofilm formation, comparing different techniques, and relating it to gastric pathologies. Results Gastric specimens were subjected to microbiological, histopathological, and rapid diagnosis test analysis. Two phenotypic test methods, Congo red agar (CRA) and tissue culture plate (TCP) methods were compared with a polymerase chain reaction (PCR) molecular assay for the detection of Hp biofilm production and characterization. Eighty-one (40.5%) of the 200 recruited patients were positive for Hp by culture and confirmed by PCR analysis. Rapid Strong HelicotecUT®Plus yielded significant agreement of 97.5% (79/81) with the culture technique, while histopathological examination detected a low sensitivity of 39.5% (32/81) with culture gold standard. Of the total 81 Hp culture strains, PCR amplification of Hp hypothetical protein K747_10375 and outer membrane protein (homD) genes, identified 73 (90.1%) as biofilm formers uniformly. CRA and TCP methods detected 83% (67/81) and 86.4% (70/81) biofilm formation, respectively. A larger percentage were strong biofilm formers (39/70, 56%) and associated with severe gastric pathologies such as gastric cancer, peptic ulcers, and gastric erosion. Conclusions This study showed good performance and synergy between the three methods used in detecting Hp biofilm production. It also revealed that most Hp strains obtained in the study are strong biofilm formers and are associated with chronic gastric diseases. Keywords H. pylori (Hp), Congo red agar (CRA), tissue culture plate (TCP), Non-biofilm formers (NBF), Strong biofilm formers (SBF), Gastric biopsies, Disease pathologies.