Increased Antibiotic Resistance in Children with Helicobacter pylori Infection: A Retrospective Study.

Luca Helmbold,Aliyah Bellm,Stefan Wirth,Marc A Hopkins,Beniam Ghebremedhin,Malik Aydin

doi:10.3390/pathogens11020178

Abstract

Children with recurrent abdominal pain may be suffering from a Helicobacter pylori (HP) infection. The gold standard for confirming HP gastritis is histological evaluation and microbiological tests performed on specimens collected by esophagogastroduodenoscopy (EGD). The aim of this study was to analyze HP positive cultures and antibiograms with regard to clinical and histopathological correlates. The data of 124 subjects with frequent gastrointestinal symptoms who underwent an EGD were retrospectively collected and analyzed. The mean age of the patients was 13 ± 3.6 years. The most frequent complaints were epigastric pain (84%; n = 100/119) and dyspepsia (79%; n = 94/119). HP gastritis was diagnosed in 54% (n = 67). Interestingly, 40% (n = 49) of the isolates were resistant to at least one antibiotic: amoxicillin (20%; n = 10/49), clarithromycin (45%; n = 22/49), or metronidazole (59%; n = 29/49). Isolates were resistant to two or more antibiotics in 16% (n = 20) of cases. In conclusion, we revealed remarkably high resistance rates to amoxicillin, metronidazole, and clarithromycin in our cohort. The presence of antibiotic resistance to more than one antibiotic was substantially increased in our HP-infected patients and this may negatively affect eradication treatment.

Highlights

IntroductionPediatric patients with recurrent or chronic abdominal pain (CAP)
Specific symptoms or prior drug therapies did not influence the rate of Helicobacter pylori (HP) infection or antibiotic resistance status
The histopathological findings in HP-infected children are generally important and are well-known diagnostic criteria in guidelines, and successful cultivation and antibiotic resistance testing of HP are crucial for the diagnostic pathway as well as for potential eradication treatment, as shown in the literature

Summary

Introduction

Pediatric patients with recurrent or chronic abdominal pain (CAP). Suspected Helicobacter pylori (HP) infection pose a well-known challenge for physicians [1]. In this context, recurrent abdominal pain (RAP) is defined as chronic intermittent pain episodes associated with functional impairments for more than three months in a course [2,3]. Most studies in children do not show any correlation between the described symptoms and HP infection [4]. HP infection with associated gastritis is occasionally linked to epigastric abdominal pain [4,5]. The prevalence of HP infections can be associated with socioeconomic status [6]. Immigrant children living in Germany were 21% (28%) [7,8] more likely to be diagnosed with

Objectives

Methods

Results

Discussion

Conclusion