Helicobacter Pylori In Children Research Articles

Association of Helicobacter pylori in Children With Self-Hand Hygiene, Maternal Hand Hygiene, Cooking, and Feeding Practices.

Background and objective Helicobacter pylori infection is widely prevalent, but its route of transmission is not clear. Person-to-person transmission seems plausible, with hand hygiene being one of the many factors that play a role. The objective of this study was to study the effect of the children's and their mother's hand hygiene and feeding practices on the prevalence of H. pylori in children. Methodology This cross-sectional study involved 475 children and their mothers. A questionnaire was administered to mothers to gather information about maternal hygiene practices, specifically handwashing before food handling and after using the toilet. Additionally, both mothers and children underwent assessments for nail length (whether cut or uncut) and the presence or absence of dirt under their nails, if nails were uncut. The association of these parameters with H. pylori seropositivity in children was comprehensively examined.Furthermore,children were divided into two distinct groups: a younger age group (one month to two years and 11 months) and an older age group (three years to 15 years). For one specific parameter- the presence of dirt under mothers' nails (i.e., if nails were uncut) - the association was further analyzed separately within these age groups. The chi-square test was applied to all variables. P< 0.05 was considered significant Results The association of all variables with H. pylori seropositivity in children was tested.Association with H. pylori seropositivity was not present in mothers with uncut nails (P = 0.050315), mothers with uncut nails harboring dirt under their nails within the entire sample of 475 mothers (P = 0.39476), and mothers with uncut nails harboring dirt under their nails in the older age group (three years to 15 years) of children (P = 0.760071). Association with H. pylori seropositivity was present in mothers with dirt under their uncut nails belonging to the younger age group of children (one month to two years and 11 months (P = 0.014127) and mothers who did not wash their hands before food handling (P= 0.003032) and after using the toilet (P = 0.003082). In all 475 children, association with H. pylori seropositivitywas significant with dirt under the uncut nails of children (P= 0.015194) and was not significant for children with merely grown nails but not harboring dirt under them (P= 0.355967). Conclusions Mother-to-child transmission is one of the likely routes of transmission of H. pylori, and poor hand hygiene seems to play a major role in this process.

Prevalence and Clinical Relevance of cagA and oipA Genotypes of Helicobacter pylori in Children and Adults with Gastrointestinal Diseases in Tehran, Iran.

Helicobacter pylori isa universal pathogen that causes gastric diseases and cancers in humans. In recent years, several virulence genes have been detected in this microorganism. Thus, we aimed to investigate the frequency of Helicobacterpylori strainswith cytotoxin-associated gene A(cagA) and outer membrane inflammatory protein A(oipA) genotypes among children and adult patients in Tehran, Iran, and evaluatetheir relation to themanifestations of different clinical symptoms. In this cross-sectional study, biopsy specimens were obtained from patients with gastrointestinal symptomsand evaluated for Helicobacter pylori infectionand its genotypes (cagA/oipA) througha polymerase chain reaction PCR assay. Clinical findings and demographic data of patients were documented and analyzed. A total of 80 patients with Helicobacter pylori infectionwere included in the study (34 children and 46 adults). The cagA and oipA genotypes of Helicobacter pylori wereidentified in 22 (64.7%) and 24 (70.5%) children and in 31 (67.3%) and 34 (73.9%) adults, respectively. These differences were not statistically significant between the 2 studied groups. In addition, the frequency of cagA-positive strains of Helicobacterpylori wasfound more among patients with gastric ulcers rather than other clinical outcomes. Our findings demonstrate a highfrequency of Helicobacter pylori strains with oipA and cagA genotypes among children and adults in this region. Although we could not find a significant relationship between virulence genes and clinical outcomes in the patients, further studies are suggested to evaluate these factors in patients and assess their potential roles in the presence of antibiotic-resistant strains.

Prevalence of Helicobacter Pylori in Children with Recurrent Abdominal Pain

Background: In children the recurrent abdominal pain is a commonest reason for seeking medical care. In various studies, H pylori and abdominal pain were shown to be significantly correlated in paediatric patients. Objective: To assess the prevalence of helicobacter pylori in children with recurrent abdominal pain Methodology: The current cross sectional study was carried out at the Pediatrics department Sandeman Provincial Hospital Quetta from March 2022 to August 2022. The research included all children with recurrent abdominal pain (according to Rome II criteria) who met the inclusion requirements. Under strict aseptic conditions, five milliliters of blood were taken and sent to the hospital laboratory for ELISA-based H pylori identification. All the information was entered into a predesigned proforma. For the analysis of data, IBM SPSS version 23 was used. Results: In our study, totally 150 children who met the inclusion criteria were enrolled. The male children in our study were 108 (72%) while female children were 32 (28%). The mean age (±SD) was 10 (±4.36) years. Based on ELISA, the helicobacter pylori prevalence was 39 (26%) in children with recurrent abdominal pain. Conclusion: Our study concludes that the in children with recurrent abdominal pain, the helicobacter Pylori prevalence is very high. All the children who visit the pediatrics clinics and having recurrent abdominal pain should be diagnosed for helicobacter pylori. Keywords: Prevalence; helicobacter pylori; children; recurrent abdominal pain

Consensus of Chinese experts on clinical application of lactoferrin

Lactoferrin is a natural protein with various physiological activities, which has the function of regulating immunity, anti-microbial, regulating iron absorption, promoting the proliferation of intestinal cells, and multiple pathophysiological processes. In recent years, lactoferrin has been widely used in infants, pregnant women, and the elderly. In order to more comprehensively understand the clinical application of lactoferrin and establish the method and index system of lactoferrin application in different populations, clinical nutritionists, together with experts from multiple disciplines, used the evidence grading method of GRADE Collaboration Network Ⅱ under the principle of evidence-based medicine to search for clinical evidence and repeatedly discuss. The experts group reached a consensus on the effect of lactoferrin reducing the risk of infection in premature infants, the incidence of respiratory and gastrointestinal diseases in infants, improving the anemia status of infants and pregnant women, improving the eradication rate of Helicobacter pylori in children and adults, and improving the immune function of the elderly, which could be used as a reference for medical professionals in clinical work.

Effect of Helicobacter Pylori in Children with Nephrotic Syndrome to the Dysfunction of Stomach and Duodenum

Effect of Helicobacter Pylori in Children with Nephrotic Syndrome to the Dysfunction of Stomach and Duodenum

Are pro- and/or synbiotics beneficial in Helicobacter pylori eradication therapy in children? A narrative review.

To assess the effect of pro- and synbiotics in the eradication therapy of Helicobacter pylori (Hp), as well as their effect on adverse effects and therapy compliance in children, a review was performed. We searched for relevant studies published in the English language in PubMed in the last 5years. Articles were extracted using subject heading and keywords of interest to the topic. There is low-quality evidence that Lactobacillus casei, Bifidobacterium infantis, and Clostridium butyricum (only one RCT for all three) and Saccharomyces boulardii (more than 1 RCT) increase the eradication rate and decrease the adverse effects. Data with synbiotics report only a trend towards a better eradication. Heterogeneity in study designs and outcomes is a major limitation to propose evidence-based recommendations. A reduced incidence of antibiotic-associated diarrhoea is reported. Therapy compliance has been poorly studied. Conclusion: Due to study heterogeneity, there is very low evidence that some specific probiotics strains increase the eradication rate of Hp when added to standard eradication therapy in children. Whether this is related to immunological effects of the strain or a decrease of adverse effects is not known. More studies, especially comparative trials, are needed before the addition of pro- or synbiotics to Hp eradication treatment can be recommended in daily routine. What is Known: • Eradication treatment of Helicobacter pylori in children has a low success rate and induces frequently adverse effects. • The addition of probiotics might improve eradication and decrease adverse effects, but no paediatric guideline does recommend probiotics as part of the eradication treatment. What is New: • There is low-quality evidence that Lactobacillus casei, Bifidobacteria infantis, and Clostridium butyricum (only one randomized controlled trial (RCT) for all three) and Saccharomyces boulardii (more than 1 RCT) increase the eradication rate and decrease the adverse effects. • Data with synbiotics report only a trend towards a better eradication.

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.

Сучасний стан антибіотикорезистентності Helicobacter pylori та його клінічне значення

У статті наведений аналіз літературних даних останніх років із питання формування та поширеності резистентності Helicobacter pylori до різних антибактеріальних препаратів, що використовуються для ерадикації цього мікроорганізму. Обговорені особливості терапевтичних підходів, шляхи подолання стійкості даної інфекції, вибір схем ерадикаційної терапії залежно від рівня резистентності Helicobacter pylori до антибактеріальних препаратів. Особливу увагу приділено питанню про поширеність антибіотикорезистентності Helicobacter pylori в дитячому віці.

Comparison of Drug Resistance of Helicobacter pylori Between Children and Adults in Jilin, China.

The drug resistance of Helicobacter pylori in children is gaining more and more attention. Polymerase chain reaction-reverse dot blot was used to analyze main virulence genes and drug resistance of H. pylori. (1) The main H. pylori vacA virulence genotypes were s1/m1 and s1/m2 in Jilin, China. There was no significant difference in H. pylori virulence genotypes between children and adults. (2) The resistance rates of H. pylori to clarithromycin, metronidazole, and levofloxacin were high, the resistance rate to tetracycline and amoxicillin were relatively low. The drug-resistance rate of clarithromycin in children was significantly higher than that in adults. The single drug-resistance rate of metronidazole in adults was significantly higher than that in children. (3) The mutation sites of clarithromycin resistance in H. pylori were mainly A2143G of 23S rRNA gene, G616A of rdxA gene in metronidazole, N81K and D91G/N/Y of gyrA gene in levofloxacin, T556S and N562D/Y of PBP1 gene in amoxicillin, AGA926-928TTC and AG926-927GT of 16S rRNA gene in tetracycline. There was significant difference in D91Y of gyrA gene in levofloxacin between children and adults. (4) In different groups, the drug-resistance rate of clarithromycin in male children was higher than that in male adults. The drug-resistance rate of clarithromycin in children with peptic ulcers was higher than that in adults. There are some differences in drug resistance of H. pylori between children and adults, which indicated us to pay attention to the infection of H. pylori in children.

INVESTIGATION ON CLINICAL, SUBCLINICAL CHARACTERISTICS, AND RESULTS OF PEPTIC ULCER TREATMENT IN CHILDREN&amp;NBSP;

Background: Helicobacter pylori is considered the main cause of peptic ulcer in children. Studies show that the current treatment regimens for stomach ulcers caused by HP face many difficulties: partly due to poor adherence to treatment in children and partly due to increasing antibiotic resistance of HP bacteria today. 50% of children and young adults with peptic ulcer disease have multiple recurrences per year and 70% relapse the following year. Understanding the clinical and subclinical characteristics as well as the treatment results for children with peptic ulcer disease caused by HP based on the current treatment regimen will provide doctors with a basis to propose more effective treatment measures for patients. Objectives: To describe the clinical and subclinical characteristics and to investigate factors related to the treatment outcome of peptic ulcer disease caused by Helicobacter pylori in children. Subjects and methods: The study subjects included 61 patients with peptic ulcer disease caused by Helicobacter pylori. Longitudinal follow-up descriptive research method was used. Diagnosis of peptic ulcer disease caused by Helicobacter was performed via gastroduodenal endoscopy and Clotest (+). The patients were treated according to the protocol of the Ministry of Health and were evaluated for improvement in clinical symptoms after 4 weeksBackground: Helicobacter pylori is considered the main cause of peptic ulcer in children. Studies show that the current treatment regimens for stomach ulcers caused by HP face many difficulties: partly due to poor adherence to treatment in children and partly due to increasing antibiotic resistance of HP bacteria today. 50% of children and young adults with peptic ulcer disease have multiple recurrences per year and 70% relapse the following year. Understanding the clinical and subclinical characteristics as well as the treatment results for children with peptic ulcer disease caused by HP based on the current treatment regimen will provide doctors with a basis to propose more effective treatment measures for patients. Objectives: To describe the clinical and subclinical characteristics and to investigate factors related to the treatment outcome of peptic ulcer disease caused by Helicobacter pylori in children. Subjects and methods: The study subjects included 61 patients with peptic ulcer disease caused by Helicobacter pylori. Longitudinal follow-up descriptive research method was used. Diagnosis of peptic ulcer disease caused by Helicobacter was performed via gastroduodenal endoscopy and Clotest (+). The patients were treated according to the protocol of the Ministry of Health and were evaluated for improvement in clinical symptoms after 4 weeks Key words: Peptic ulcer, children, Helicobacter pylori.

Impact of eradication therapy of Helicobacter pylori in children with chronic immune thrombocytopenic purpura

BackgroundAlthough some investigators have confirmed the association between H. pylori and chronic ITP in adults, studies in pediatric patients are still few and have produced conflicting results. The study was carried out to detect the prevalence of H. pylori among chronic ITP children and to investigate the impact of treatment of H. pylori infection on platelet count response.ResultsThe prevalence of H. pylori in chronic ITP children was 63%. The platelet count was statistically significantly higher among H. pylori stool antigen (HpSA)-negative children. A significant difference was reported in which platelet count increased from 70.55 ± 4.788 million/μL before H. pylori eradication therapy to 110.78 ± 15.128 million/μL after therapy.ConclusionWe concluded that H. pylori eradication therapy was effective in increasing platelet count in H. pylori-positive chronic ITP patients.

Assessment of Community Pediatric Providers’ Approach to Children With Helicobacter pylori

In 2016, the European and North American Societies for Pediatric Gastroenterology, Hepatology, and Nutrition updated guidelines for management of Helicobacter pylori in children, adjusting the previous diagnostic and therapeutic approaches in response to changing epidemiology and antibiotic resistance patterns. In this study, we assessed knowledge, practice habits of H. pylori management, and adherence to new guideline recommendations among one state’s community pediatric providers. The majority of the surveyed community pediatric providers are not following the new pediatric guidelines for H. pylori management. An evidence-practice gap for diagnosis and treatment of H. pylori disease can lead to poor resource utilization, inadequate antibiotic usage, increased antibiotic resistance, and prolonged symptoms in patients. By understanding pediatric provider practices, pediatric gastroenterologists can assist in addressing the gap through development of educational interventions for community pediatric providers.

Применение омепразола в отечественной педиатрической практике

Objective of the Review: To analyse clinical and pharmacological characteristics and normative documents in the use of modern proton pump inhibitors (PPI) in paediatric patients in the Russian Federation. Key Points. PPIs remain a widely used and efficient therapy of acid-related disorders in children; however, prescription should be based not only on clinical characteristics of a patient, but also on normative documents, e.g., instructions for the use of PPIs in paediatric population for certain indications approved by the Ministry of Health of Russia, since healthcare providers are responsible for off-label prescriptions. Conclusion. Omeprazole is one of the most well-studied PPIs; it has good evidence base for the use in children; however, in Russia, most omeprazoles have contraindications in paediatric population. Omez is indicated for the management of gastroesophageal reflux and duodenal ulcer caused by Helicobacter pylori in children. Keywords: acid-related disorders, children, paediatrics, proton pump inhibitors, Omeprazole.

Frequency of H. Pylori infection in children with recurrent abdominal pain at a Tertiary Care Hospital.

Objectives: Recurrent abdominal pain (RAP) impacts quality of life of the children. RAP also hampers education and physical activity of the children. Current study was aimed to find out the frequency of Helicobacter pylori in children with RAP in our tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: From 27-12-2017 to 26-06-2018. Material &amp; Methods: A total of 185 patients suffering from RAP, aged 2-12 years, with a disease duration &gt; 3 months, were enrolled. Age of the children, gender, duration of illness, number of episodes of pain, maternal literacy, family income, residential status, source of drinking water and h.pylori infection were calculated in these children. Post stratification chi-square test was applied to see its effect on H. Pylori infection. Results: Of these 185 study cases, 101 (54.6 %) were male patients while 84 (45.4%) were female. Mean age of our study cases was 7.57 ± 1.93 years. Of A total of 95 (51.4%) children belonged to rural areas and 90 (48.6 %) to urban areas. Helicobacter pylori infection was noted in 103 (55.7%) of our study cases. When helicobacter pylori was stratified with regards to study variables, male gender, age &lt; 8 years, monthly family income &lt;Rs. 35000, source of drinking water as Hand Pump and disease duration &lt; 6 months turned out to be statistically significant (P value &lt; 0.05). Conclusion: Frequency of H.pylori was high in children with RAP. Helicobacter pylori was significantly associated with male gender, younger age, poor socioeconomic status, source of drinking water and disease duration.

Frequency of H. Pylori infection in children with recurrent abdominal pain at a Tertiary Care Hospital.

Objectives: Recurrent abdominal pain (RAP) impacts quality of life of the children. RAP also hampers education and physical activity of the children. Current study was aimed to find out the frequency of Helicobacter pylori in children with RAP in our tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: From 27-12-2017 to 26-06-2018. Material &amp; Methods: A total of 185 patients suffering from RAP, aged 2-12 years, with a disease duration &gt; 3 months, were enrolled. Age of the children, gender, duration of illness, number of episodes of pain, maternal literacy, family income, residential status, source of drinking water and h.pylori infection were calculated in these children. Post stratification chi-square test was applied to see its effect on H. Pylori infection. Results: Of these 185 study cases, 101 (54.6 %) were male patients while 84 (45.4%) were female. Mean age of our study cases was 7.57 ± 1.93 years. Of A total of 95 (51.4%) children belonged to rural areas and 90 (48.6 %) to urban areas. Helicobacter pylori infection was noted in 103 (55.7%) of our study cases. When helicobacter pylori was stratified with regards to study variables, male gender, age &lt; 8 years, monthly family income &lt;Rs. 35000, source of drinking water as Hand Pump and disease duration &lt; 6 months turned out to be statistically significant (P value &lt; 0.05). Conclusion: Frequency of H.pylori was high in children with RAP. Helicobacter pylori was significantly associated with male gender, younger age, poor socioeconomic status, source of drinking water and disease duration.

Dental Caries-A Hiding Niche for Helicobacter Pylori in Children.

Background: Helicobacter pylori (H. pylori) is one of the human pathogens proven to be present in the oral cavity due to microaerophilic nature of the dental biofilm. The present study aimed to investigate the presence of H. pylori in cavitated carious lesions of children by polymerase chain reaction (PCR). Study design: Forty-eight children aged between 4 to 7-years attending outpatient Pediatric clinic were enrolled in the study. Caries status and caries severity were assessed using the dmft and ICDAS caries index. Dentine samples were collected for DNA isolation for the detection of H. pylori by PCR. Results: H. pylori was detected among 30% of children with severe caries lesions detected by PCR. Overall, the mean ± SD of the dmft score for H. pylori positive children was higher compared to the negative control. Amongst the H. pylori-positive group, the decayed (mean-dt) number of teeth were significantly higher (p<0.05) than the other group. Moreover, association between severity of caries lesions (codes 5 and codes 6) and presence of H. pylori were significant (p<0.05) when compared negative group. Conclusion: The results demonstrate presence of H. pylori in the cavitated, non-gastric niche of children with severe caries, which possibly could serve as a reservoir for microbial dissemination to other sites of the body.

Efficacy analysis of probiotics combined with standard therapy for eradication of Helicobacter pylori in children

Objective To evaluate the efficacy and safety of compound Lactobacillus acidophilus tablets or Saccharomyces boulardii Sachets combined with standard protocols for eradication of Helicobacter pylori(Hp) in children. Methods From March 2017 to March 2018, 120 children aged 3-10 years with Hp infection were admitted into the Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, including 67 male and 53 female childen.They were divided into 3 groups (control group, compound Lactobacillus acidophilus group, Saccharomyces boulardii Sachets group) by the method of random number table.Control group was given Clarithromycin+ Amoxicillin+ Omeprazole, for 14 days orally; compound Lactobacillus acidophilus group and Saccharomyces boulardii Sachets group were given drugs respectively on the first day, 500 mg of compound Lactobacillus acidophilus was added, twice a day or 250 mg of Saccharomyces boulardii Sachets group, twice a day orally, for 14 days, respectively.The adverse reactions in children were observed during the treatment, andurea 13C breath test or the stool Hp antigen test was performed at least 4 weeks by the end of the treatment, and the children with negative results were judged to be eradicated successfully.The ulcer healing, Hp eradication rate and incidence of adverse reactions(nausesa, vomiting, loss of appetite, constipation, diarrhea) among the 3 groups were observed and the Hp eradication rate and the incidence of adverse reactions (nausea, vomiting, loss of appetite, constipation, diarrhea) were compared. Results The eradication rates in the control group, the compound Lactobacillus group, and Saccharomyces boulardii Sachets group were 80.0% (32/40 cases), 85.0% (34/40 cases), and 87.5% (35/40 cases), respectively, and the difference was not statistically significant (P=0.646); the ulcer healing rate was 100.0% of 101 Hp eradicators in 3 groups, and the ulcer healing rate of 19 cases without Hp eradicated was 48.15%, and there was a significant difference between them (χ2=51.30, P 0.05). The overall incidence of adverse reactions in Saccharomyces boulardii Sachets group (P=0.021) and the incidence of diarrhea (P=0.002) and loss of appetite (P=0.021) was lower than that in the control group, and the differences were statistically significant.There was no significant difference in the incidence of adverse reactions between the two probiotic groups (P>0.05). Conclusions Both compound Lactobacillus acidophilus tablets and Saccharomyces boulardii Sachets group can reduce the overall incidence of adverse reactions and the incidence of diarrhea and appetite declines in children′s standard Hp eradication regimen without affecting Hp eradication rate. Key words: Helicobacter pylori; Eradication therapy; Probiotics; Child

Analysis of antibiotic resistance and influencing factors for Helicobacter pylori in children

Objective To investigate the antibiotic resistance of Helicobacter pylori(Hp) isolates cultured from endoscopic gastric mucosal samples and influencing factors for antibiotic resistance in children. Methods From April 2013 to February 2016, Hp cultured from mucosa samples of the gastric antrum and the body of stomach was investigated in 246 patients with 13C breath test positive examined by gastroscopy.Resistance to Amoxicillin, Clarithromycin, Metronidazole, Tetracycline was tested for Hp by using E-test.The clinical data were collected from the patients, and the relationship among age, gender, endoscopic diagnosis, histological performance, eradication number factors and antibiotic resistance rate were analyzed. Results Of 246 specimens, 174 cases (70.7%) were positive.The overall antibiotic resistance rates of isolates obtained were 96.55% (168/174 cases), 57.47% (100/174 cases), 4.02% (7/174 cases), 1.15%(2/174 cases) with respect to Clarithromycin, Metronidazole, Tetracycline and Amoxicillin.An antibiotic resistance rate was 43.10% (75/174 strains), among which the Clarithromycin resistance rate was 93.33% (70/75 strains), and the Metronidazole resistance rate was 6.67% (5/75 strains). Double resistance rate was of 54.02%(94/174 strains), among which the resistances rate of Clarithromycin+ Metronidazole was 52.30%(91/94 strains), and the resistances rate of Clarithromycin+ Tetracycline was 1.72%(3/94 strains). Triple resistance rate of Clarithromycin+ Metronidazole+ Tetracycline was 1.15%(2/174 strains). Quadruple resistance rate of Clarithromycin+ Metronidazole+ Amoxicillin+ Tetracycline was 1.15%(2/174 strains). Factor analysis showed that the resistance rate of Clarithromycin in children who had failed in eradication therapy [98.7%(148/150 cases)] was higher than that in children who had not undergone eradication therapy [83.3%(20/24 cases)], and the difference was statistically significant(χ2=14.610, P 0.05). Conclusions Hp resistance rate to Clarithromycin, Metronidazole is very high in children, but it is relatively low to Amoxicillin and Tetracycline, and multiple antibiotic resistance is at high prevalence. Key words: Helicobacter pylori; Antibiotic resistance; Child

Eradication of Helicobacter pylori in Children Restores the Structure of the Gastric Bacterial Community to That of Noninfected Children

Eradication of Helicobacter pylori in Children Restores the Structure of the Gastric Bacterial Community to That of Noninfected Children

Prevalence of clarithromycin-resistant Helicobacter pylori in children living in South of Sweden: a 12-year follow-up

Objective: The occurrence of Helicobacter pylori (HP) and clarithromycin resistant HP (crHP) have not been investigated longitudinally in the Swedish childhood population. The aims were to study the prevalence of gastric HP-DNA and crHP strains in a cohort of children living in the southernmost parts of Sweden who were investigated with upper endoscopy between 2005 and 2016.Methods: HP colonisation and crHP in 1768 children who underwent 1887 endoscopic procedures with gastric biopsies, of whom 393 were referred for abdominal pain, gastritis, ulcer or gastrointestinal bleeding (Group I) and 1494 were referred for other reasons (Group II). The occurrence of HP-DNA from gastric biopsies was given as a global prevalence as information on previous eradication were missing.Results: The global prevalence of HP-DNA was 222/1887 (11.8%; 95% CI 10.4%–13.3%) of which 46/222 (20.7%; 95% CI 15.9%–26.5%) were crHP. The prevalence of HP-DNA in Group I was 141/393 (35.9%; 95% CI 31.3%–40.7%), which was higher compared with that of 81/1494 (5.4%; 95% CI 4.4%–6.7%) in Group II (p < .0001). crHP strains occurred equally frequent in the biopsies in both groups and found in 29/141 (20.6%; 95% CI 14.7%–28.0%) in Group I and 17/81 (21.0%; 95% CI 13.5%–31.1%) in Group II, respectively (p > .9999).Conclusions: More than one in every ten (12%) children investigated with upper endoscopy in the southernmost parts of Sweden were gastric HP-DNA positive of which 21% were crHP regardless of indication for investigation. Clarithromycin is therefore not recommended as first line empirical treatment for eradicating an HP infection in children.