Finding a treatment for common infections

Dr Shiraaz Gabriel
Senior Registrar in Gastroenterology, Groote Schuur Hospital
MMed: Helicobacter Pylori resistance patterns and standard drug efficiency at Groote Schuur Hospital

Under the microscope

Dr Shiraaz Gabriel graduated from the University of Cape Town and did his internship and community service in KwaZulu-Natal. He has been at Groote Schuur since 2007. A committed family man, Dr Gabriel attributes his decision to become a doctor to his parents, and to his love of helping people. “My parents believed medicine was a good field to get into, and they didn’t have the opportunity in their lives to study further so that inspired me,” he says. He also loves the process of seeing someone who is ill made well again, and smiling. When he isn’t chasing tummy bugs he likes to relax with his family and go to the movies.

Local knowledge is key to understanding and treating common infections like Helicobacter Pylori (HP), says Dr Shiraaz Gabriel.

At Groote Schuur Hospital’s gastroenterology unit a significant part of a doctor’s day is treating patients for dyspepsia, or more specifically HP-related disease. Helicobacter Pylori infects more than half the world’s population. Though it shows up more commonly as heartburn, it can have deadly consequences. HP was classified in 1994 as a group 1 carcinogen by the International Agency for Research on Cancer. In the 1990s treatment showed remarkable success rates but in recent years those successes have plunged from 90% to around 60%. At Groote Schuur

Hospital that figure has been cited as low as 36%. Eradication rates are falling worldwide and there is the presumption that drug resistance plays a role though there is no local data to back this up. And that’s where Dr Shiraaz Gabriel comes in. His research is focusing on establishing local resistance patterns for HP in previously untreated patients and those who have received standard first line therapy and to use this information to optimise eradication rates with first line microbials. “We know from a study in PE that antibiotic resistance in HP treatment was about

95% but it is essential to gather local knowledge in order to understand our own patterns of eradication” says Dr Gabriel. He hopes that his research could lead to an informed change in the treatment policy of HP. This will, of course, improve patient care at Groote Schuur and in surrounding hospitals and clinics. Dr Gabriel’s Discovery Foundation Academic Fellowship Award will finance HP culture and drug susceptibility testing and the data will facilitate completion of his MMed. “Dr Gabriel is passionate about research and imparting the clinical and research skills he will learn at Groote Schuur to other doctors. As a relatively senior doctor he will assist in the training of junior doctors, medical students and nurses,” says Dr Sabelo Hlatshwayo of the hospital’s gastrointestinal clinic.

“Dr Gabriel is keen to increase the research output of the division of gastroenterology at Groote Schuur and this is a highly worthwhile project which will provide solid rationale for local management of this common infection in our local population. “It should also contribute much needed further information to base national recommendation,” says Professor Sandie Thomson, head of the gastrointestinal clinic.