Pylori-positive Children Research Articles

Characterization of the unique oral microbiome of children harboring Helicobacter pylori in the oral cavity

ABSTRACT Objective Helicobacter pylori infection is acquired in childhood via the oral cavity, although its relationship with the characteristics of the oral microbiome has not been elucidated. In this study, we performed comprehensive analysis of the oral microbiome in children and adults with or without H. pylori in the oral cavity. Methods Bacterial DNA was extracted from 41 adult and 21 child saliva specimens, and H. pylori was detected using PCR. 16S rRNA gene amplification was performed for next-generation sequencing. Bioinformatic analyses were conducted using Quantitative Insights into Microbial Ecology 2 (QIIME 2). Results Faith’s phylogenetic diversity analysis showed a significant difference between H. pylori-negative adult and child specimens in terms of α-diversity (p < 0.05), while no significant difference was observed between H. pylori-positive adult and child specimens. There was also a significant difference in β-diversity between H. pylori-positive and negative child specimens (p < 0.05). Taxonomic analysis at the genus level revealed that Porphyromonas was the only bacterium that was significantly more abundant in both H. pylori-positive adults and children than in corresponding negative specimens (p < 0.01 and p < 0.05, respectively). Conclusion These results suggest unique oral microbiome characteristics in children with H. pylori infection in the oral cavity.

Important Recommendations Regarding the Test-and-Treat Strategy for Helicobacter pylori Infection in Children.

Helicobacter pylori is a commonly encountered pathogen in medical practice. It causes chronic gastritis in patients of different ages. Many published papers have provided different opinions on whether the test-and-treat strategy for H. pylori infection should be implemented in children. It is critical that the opinion in favor of this strategy was published in Europe, where ESPGHAN/NASPGHAN guidelines have not recommended the use of test-and-treat strategy for H. pylori in children. Herein, I propose my opinion regarding this debate using 4 main points. First, this strategy should be implemented in areas where its benefits outweigh the associated risks. Thus, if it is not tailored to the locality, the results of the test-and-treat strategy for H. pylori in children may be erroneous. Second, the association between H. pylori infection and other diseases such as asthma and other allergic diseases should not be factored in when considering the test-and-treat strategy. This is because these diseases are associated with H. pylori noninfection and not with its posteradication status. Third, there is evidence that H. pylori infection can significantly alter children's intestinal microbiota. Finally, gastroscopy should not be performed in all H. pylori-positive children, particularly if the drug susceptibility test is not available. In the near future, it will be possible to easily conduct drug susceptibility tests for H. pylori using fecal samples. I believe that this report may expand the test-and-treat strategy for children infected with asymptomatic H. pylori outside of Japan and prevent not only gastric cancer but also minor diseases such as iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, and failure to thrive. Pediatricians are responsible for keeping children healthy not only during childhood but also in adulthood. Thus, even if there are only a few H. pylori-related diseases and no severe cases in children, it is necessary to take early measures to prevent problems (eg, incidence of gastric cancer) in adulthood.

Mucosal distribution of somatostatin-secreting gastric Delta cells in children with gastrointestinal reflux diseases

IntroductionGastric delta cells (D-cells) secrete somatostatin, which is the primary paracrine suppressor of acid secretion. The number and distribution of D-cells were investigated in children exhibiting endoscopic findings of duodenogastric and gastroesophageal reflux. This study aimed to determine whether the number of D-cells in the gastric body differs from that in the gastric antrum in children using endoscopic findings.MethodsWe retrospectively used immunohistochemical assessments to determine the number of D-cells in the gastric body and antrum in 102 children who presented with abdominal symptoms. The number and distribution of D-cells were investigated according to symptoms, endoscopic findings of gastroesophageal reflux and duodenogastric reflux, and Helicobacter pylori infection status.ResultsThe average age of the patients was 13.3 ± 3.3 years, and the male-to-female ratio was 1:1.68. The mean number of D-cells per high-power field in the antrum and body did not significantly differ by symptoms. However, these values were significantly lower in the gastric body than in the antrum for all symptoms (p &amp;lt; 0.05). Children with reflux had a higher mean number of D-cells (9.6 ± 8.8) in the gastric body than did those without reflux (4.3 ± 3.4) (p = 0.007). Furthermore, the number of D-cells in the gastric body was marginally significantly lower in Helicobacter pylori-positive children (4.9 ± 6.5) than in Helicobacter pylori-negative children (8.5 ± 8.2) (p = 0.053).ConclusionThe number of D-cells in the gastric body decreased in Helicobacter pylori-positive children but significantly increased in children with duodenogastric reflux. Therefore, somatostatin peptide secretion by D-cells may be a major pathophysiological pathway in gastrointestinal reflux disease.

&lt;i&gt;Helicobacter pylori&lt;/i&gt; infection in children with immune thrombocytopenia

To detect the association between Helicobacter pylori (H. pylori) infection and immune thrombocytopenia in children and adolescents. Immune thrombocytopenia (ITP) is a common bleeding disorder in childhood. H. pylori is a widespread organism that is present in about 50% of the global population. There is an obvious relation between helicobacter pylori infection and chronic idiopathic thrombocytopenic purpura. A cross-sectional study was conducted in 95 patients with ITP who were recruited from the Hematology Unit, Department of Pediatrics, Menoufia University Hospital in the period from June 2021 to June 2022. The age of the patients ranged between 3.5 and 7.5 years. Fifty-five of them were males and 40 were females. The study was approved by the Ethical Committee of the Faculty of Medicine, Menoufia University. Out of the studied ITP children, 62 (65.3%) were positive for H. pylori antigen in stool, and 33 (34.7%) were negative. There was a significant difference between H. pylori-positive and H. pylori-negative patients regarding the grade of bleeding at presentation; 51 (82.3%) H. pylori-positive patients presented with grade 3 bleeding, 35 (56.5%) of them presented with skin and gum bleeding, 16 (25.8%) presented with skin bleeding and epistaxis. There was a statistically significant difference in the rate of recovery between H. pylorinegative patients (78.8%) and H. pylori-positive patients (22.6%). There was a significant rise in the platelet count in H. pylori-positive patients after the treatment of H. pylori. The prevalence of H. pylori infection in ITP pediatric patients was 65.3%. There was a significant rise in the platelet count in H. pylori-positive ITP children after the treatment of H. pylori.

Selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract

Despite the success of the treatment of infected individuals, Helicobacter pylori infection remains the most common human bacterial pathogen, infecting half of the world’s population. In a large part of people, H. pylori causes gastroduodenal diseases, in particular, chronic antral gastritis and ulcer disease. The possible role of selenium in the course of chronic inflammatory H. pylori-associated pathology of the upper gastrointestinal tract in children has not yet been fully investigated and understood. The aim is to determine selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract. Materials and methods. The study included 135 school-age children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract, who made up the main study group (55 children with chronic gastritis (CG), 57 children with chronic gastroduodenitis (CGD), 23 children with duodenal ulcer (DU), and 20 practically healthy age-matched children were the comparison group. Quantitative measurements of plasma selenium were performed using inductively coupled plasma mass spectrometry (MS-ICP) on an Optima 2000 DV spectrometer (Perkin Elmer, USA). Results. The lowest level of plasma selenium was registered in children with H. pylori-negative DU (67.81 ± 2.67 μg/l), while in children with H. pylori-associated DU, its level was higher – 73.56 ± 2.34 μg/l (p &lt; 0.05), however, it did not reach the level in children of the comparison group. A similar direction of changes in the selenium plasma concentration was observed in children with CGD: higher levels of selenium were detected in children with H. pylori-positive CGD compared to H. pylori-negative CGD (75.61 ± 2.48 μg/l and 70.99 ± 2.31 μg/l, respectively, p &lt; 0.05). Conclusions. Significantly lower levels of plasma selenium in children with chronic destructive-inflammatory diseases of the upper gastrointestinal tract were found, which could be explained by the acute phase of inflammation in the mucous membrane of the stomach and duodenum resulting in a decrease in selenium absorption. In H. pylori-positive children, the level of selenium was significantly higher compared to H. pylori-negative children indicating a possible role of selenium in the pathogenesis and further progression of H. pylori-associated diseases.

Helicobacter pylori Infection in a Pediatric Population from Romania: Risk Factors, Clinical and Endoscopic Features and Treatment Compliance.

Background and Objectives: The aim of this study was to investigate the association between H. pylori positivity with specific symptoms, risk factors and endoscopic patterns among the pediatric population in northeastern Romania. Materials and Methods: A prospective study was performed in 18 months on 185 children aged 6–18 years with an indication for upper digestive endoscopy. Demographic, anamnestic, symptomatic, endoscopic and histologic data were recorded. Results: Of 116 H. pylori-positive children, the most affected group was 15–17 years. Most (65.5%) of them were girls, with a significant association (p < 0.001). The majority (66.4%) lived in a rural area and 47.4% of children had an unsafe source of water and lived in overcrowded houses with no basic sanitary comfort. The most frequent symptom was epigastric pain (56.9%), and the main endoscopic appearance was nodularity and hyperemia. Patients diagnosed with H. pylori started triple-therapy treatment for 14 days. Only 13.8% stopped the treatment, mainly because of a misunderstanding of the treatment protocol (9.5%). Conclusions: Romanian teen girls living in rural areas are at high risk for H. pylori infection. Epigastric pain and endoscopic nodularity of the gastric mucosa were associated with the infection. As the resistance of the bacteria is unknown in our country, future research is needed in order to improve the eradication rate.

Interleukin-1β and Interleukin-1 receptor antagonist gene polymorphism in pediatric patients with Helicobacter pylori-associated chronic gastritis.

The severity of Helicobacter pylori infection is determined by the interplay between bacterial virulence, host genetic and environmental factors. This study aimed to identify interleukin-1 beta (IL-1β) and interleukin receptor antagonist (IL-1RN) gene polymorphisms and their associations with H. pylori infection, and severity of chronic gastritis in Egyptian children. A case control study was conducted on 100 children (50 H. pylori positive and 50 controls). Genotyping of IL-1β-31 gene was done by PCR-CTPP (confronting two-pair primers), of IL-1β-511 was performed using allele specific PCR, and investigation of the variable number tandem repeat polymorphism of the IL-1RN gene was done by PCR. The genotype C/T of IL1β-511 was the predominant genotype (36/50; 72%) among H. pylori positive cases (p ≤ 0.001). The presence of C/T genotype at position 511 of IL1β was associated with increased risk of infection with H. pylori (p ≤ 0.001, odds ratio = 6.612) and with more severe disease (p = 0.004, odds ratio = 8.333). No association of IL-1β-31 or IL-1RN gene polymorphisms with H. pylori infection or with risk of severe gastric diseases was found. Children who carry two polymorphisms are almost four times at risk for development of H. pylori infection (p = 0.026, odds ratio = 3.937). Polymorphism at position -511 of IL1β gene is associated with increased risk of H. pylori infection as well as of severe corpus gastric disease in Egyptian children. This population should be considered a high-risk group, which needs regular gastric endoscopic surveillance, and should be target for H. pylori eradication. Lay summaryThe genotype C/T of IL1β-511 gene was the predominant genotype (36/50; 72%) among H. pylori positive children. Polymorphism at position -511 of IL1β gene is associated with increased risk of Helicobacter pylori infection as well as of severe corpus gastric disease in Egyptian children. No association of IL-1β-31 or IL-1RN gene polymorphisms with H. pylori infection or with risk of severe gastric diseases in Egyptian children.

Eradication therapy for Helicobacter pylori infection based on the antimicrobial susceptibility test in children: A single-center study over 12 years.

Helicobacter pylori (H. pylori) infection causes chronic gastritis, duodenal and to a lesser extent, gastric ulcers, and gastric cancer. Most H. pylori infections are acquired in childhood, and effective treatment of childhood infection is very important. Esophagogastroduodenoscopy (EGD) is useful for endoscopic diagnosis, mucosal tissue biopsy, and culture examination for H. pylori in children and adults. In this paper, we report results of susceptibility tests and eradication rates in H. pylori-positive children who underwent EGD over a 12-year period. The subjects were H. pylori-positive pediatric patients who had gastrointestinal symptoms and underwent EGD in the Department of Pediatrics, Juntendo University Hospital (January 2007-December 2018). Patients underwent serum IgG antibody tests, fecal antigen tests, or urea breath tests, and subsequently, culture tests by gastric mucosal biopsy during EGD. H. pylori positivity was defined as a positive result on both tests. Patients received triple therapy for 14days using our regimen, and eradication was assessed at 2, 6, and 12months after therapy. Forty-five patients were H. pylori-positive, and the overall clarithromycin (CAM) resistance rate was 71.1 % (32/45). The CAM resistance rate for the 2013-2018 period was significantly higher than the 2007-2012 period (52.6% vs. 84.6%, P<0.05). According to the results of the antimicrobial susceptibility test, we prescribed effective antibiotics, and this resulted in a primary eradication rate of 97.7%. We suggest that antimicrobial susceptibility testing can significantly improve rates of primary eradication of H. pylori infection.

Correlation Analysis of Helicobacter pylori Infection and Digestive Tract Symptoms in Children and Related Factors of Infection.

Background:To analyze the correlation between Helicobacter pylori infection and digestive tract symptoms in children and other related factors, and to explore the risk factors of H. pylori infection in children and the expression of inflammatory factors in H. pylori-positive and H. pylori-negative children.Methods:Overall, 234 children with H. pylori test in Xuzhou Children’s Hospital, Xuzhou Medical University (Xuzhou, China) were enrolled. Among them, 73 children were H. pylori-positive and 161 were H. pylori-negative. The expression levels of cytokines interleukin-8 (IL-8), interleukin-18 (IL-18) and interferon-γ (IFN-γ) in H. pylori-positive and H. pylori-negative children were determined by ELISA. The correlation between H. pylori-positive and general data, digestive tract symptoms, other clinical symptoms, living habits, eating habits, family history and other related factors was statistically analyzed. Multivariate Logistic regression analysis was used to analyze the independent risk factors of H. pylori infection in children.Results:Family monthly income, inattentive eating, sharing toothbrushes and cups, gnawing fingers, eating fried food, drinking raw water, eating smoked and pickled food, father suffering from gastropathy and mother suffering from gastropathy were independent risk factors for H. pylori infection in children. The most common digestive tract symptoms of children with H. pylori infection were abdominal pain, accompanied by one or more clinical symptoms. The expression levels of IL-8, IL-18 and IFN-γ in H. pylori-positive children were significantly higher than those in H. pylori-negative children.Conclusion:Prevention of H. pylori infection in children is helpful for healthy growth of children, and cytokines IL-8, IL-18, IFN-γ have the potential to be used as biomarkers for diagnosis of H. pylori-positive children.

Serum Levels of Vitamin B12 in Helicobacter pylori positive Children on Chronic Hemodialysis

Serum Levels of Vitamin B12 in Helicobacter pylori positive Children on Chronic Hemodialysis

Lack of association between Helicobacter pylori infection and childhood overweight/obesity.

The reduction in the prevalence of Helicobacter pylori (H. pylori) infection in developed countries coincides with the increasing incidence of obesity and might be a contributing factor to the obesity epidemic. We aimed to evaluate the association between H. pylori infection and childhood overweight/ obesity in Israeli children. Patients diagnosed with H. pylori infection by endoscopy, histology, and a positive culture, between January 2013 and August 2018, were identified and compared with H. pylori-negative children, of the same age and gender, undergoing endoscopy for the same indications during the same time period. Data collected included the following: age, gender, height, weight, BMI, BMI percentile, and the indication for endoscopy. Patients with missing anthropometric data or having a disease affecting growth were excluded. We included 146 H. pylori-positive children and 146 age- and gender-matched H. pylori-negative patients. 63.7% (186/292) were female, mean age 13.1±3.7. Overweight (BMI between the 85th-95th percentile) and obesity (BMI>95th percentile) were present in 56/292 (19.2%). Among the H. pylori-positive children, 11.6% were overweight, 7.5% obese, among the H. pylori-negative children, 10.3% were overweight, 8.9% obese, demonstrating no differences between the groups. The main indication for endoscopy was abdominal/ epigastric pain in 79.8% (233/292). The percent of children with a BMI≥85% did not differ by gender age or the indication for endoscopy. No association between H. pylori infection and childhood overweight/ obesity was demonstrated. This is in contrasts with previous pediatric studies demonstrating an inverse correlation.

Association between Helicobacter pylori infection and delayed growth in children: A meta-analysis.

Helicobacter pylori (H. pylori) infection is associated with extra-gastrointestinal diseases in children. The present study aimed to investigate the potential association between H. pylori infection and growth in children. The PubMed, Exerpta Medica dataBASE, Cochrane Library and Chinese Biomedical Literature Database databases were comprehensively searched for relevant publications dated between January 1st 1994 and January 1st 2019. Delayed childhood growth was defined according to the age-appropriate criteria in the World Health Organization Child Growth Charts (2006 edition). The odds ratios (ORs) and 95% CIs were pooled using the fixed-effects model and subgroup and sensitivity analyses were performed using Review Manager (version 5.3; Cochrane) and STATA (version 12.0; StataCorp LP) software. A total of 15 observational studies comprising 4,199 subjects were included in the present study. A higher frequency of delayed growth was observed in H. pylori-positive children compared with that in H. pylori-negative children (OR, 1.51; 95% CI, 1.28-1.78), particularly for linear growth (OR, 1.63; 95% CI, 1.32-2.00). The aforementioned association was only observed when H. pylori infection was detected using 13C-urea breath tests (OR, 1.72; 95% CI, 1.22-2.40) or serum IgG antibodies targeted against H. pylori (OR, 1.81; 95% CI, 1.35-2.44). H. pylori infection was also associated with delayed childhood growth in studies with a H. pylori prevalence of ≤30% (OR, 1.71; 95% CI, 1.31-2.23) or >30% but not >50% (OR, 1.43; 95% CI, 1.10-1.86). The association between infection and growth was only statistically significant in the cross-sectional (OR, 1.43; 95% CI, 1.18-1.73) and case-control (OR, 1.81; 95% CI, 1.23-2.67) studies. No significant heterogeneity among studies was identified in the present analysis. According to Begg's and Egger's linear regression methods for funnel plots and quantification assessments, no publication bias was identified. The trim and fill method further suggested that H. pylori-positive children were prone to delayed linear growth. Therefore, the present study suggested that preventing and detecting H. pylori infection in children may be critical to ensure normal growth and development during childhood.

Does H. pylori therapy augments the effect of iron therapy among children with iron deficiency anemia?

Background: To assess beneficial effects of H. pylori therapy on children with pre-existing Iron Deficiency Anemia (IDA).Methods: A total of 218 consecutive patients with iron deficiency anemia (Hb 6-11 gm/dl) were invited to participate in the study. Patients underwent endoscopic biopsy and rapid urease test for H. pylori detection. A total of three groups were formed- Group I (n=13) - positive for H. pylori, underwent treatment for H. pylori therapy and IDA, Group II (n=16) - positive for H. pylori, underwent treatment for IDA only, Group III (n=101) - negative for H. pylori, underwent treatment for IDA only. All the patients were followed up after every 4 weeks till week 12. Change in haematological parameters and anaemic and iron status was assessed. Chi-square paired ‘t’-test and ANOVA were used using SPSS 21.0.Results: All the 3 groups showed a significant increase in S. Hb, Ferritin and iron levels and a decrease in S. TIBC levels. At 12 weeks, mean S. ferritin and S. iron levels were significantly higher in Groups I and III as compared to Group II while Mean S. TIBC levels were significantly higher in Group II as compared to that in Groups I and II. A total of 73.3% of Group III, 53.8% of Group I and 56.3% of Group II patients had hemoglobin levels &gt;11 g/dl, but difference was not significant (p=0.175).Conclusions: The findings of study showed that H. pylori therapy augments the effect of iron therapy among H. pylori positive children with iron deficiency anemia.

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.

CD103 &lt;sup&gt;+&lt;/sup&gt;CD4 &lt;sup&gt;+&lt;/sup&gt; T Cell with Pro-Inflammatory Role Predominates in &lt;i&gt;Helicobacter pylori&lt;/i&gt;- Positive Children Gastritis

Background: The mucosal resident T cells have been characterized in gastric tissue, but their role in Helicobacter pylori (H. pylori) infection children remains unclear. Methods: Biopsy specimens were obtained from the gastric mucosa of H. pylori-positive children. Surface receptors, intracellular cytokines and transcription factors were determined by flow cytometry and western blot. Immunofluorescence was used to analyze CD4 / CD103 co-localization and TUNEL positive cells in stomach section. Findings: Integrin receptor CD103 is highly expressed in CD4+ T cells of gastric mucosa from H. pylori-positive children. Mucosal resident CD103+CD4+ T cells exhibited a memory phenotype and high expression of chemokines compared with CD103— CD4+ T cells. In vitro co-culture study demonstrated that H.pylori specific antigen CagA/ VacA-primed DC induced proliferation of CD103+CD4+ T cells, as well as IFN-γ, TNF and IL-17 production. Increased T-bet and Blimp1 levels were also observed in CD103+CD4+ T cells in H.pylori-positive children. CD103+CD4+ T cells were positively correlated with numbers of dead gastric cells. Interpretation: Our results explored the function of CD103+ T cells in H.pylori-positive children, which may provide therapeutic target for treatment of gastritis. Funding Statement: This work was supported by grants from National Natural Science Foundation of China (81770552, 81801571). Declaration of Interests: The authors state they have no financial conflicts of interest. Ethics Approval Statement: The study was approved by the Ethics Committee of Guangzhou Women and Children's Medical Center, Jinan University. Biopsy specimens from the H. pylori-positive children were collected from Guangzhou Women and Children's Medical Center (Guangzhou, China), and an informed written consent was obtained from participants and their parents prior to commencement of the study.

Prevalence of Helicobacter pylori vacA Genotypes and cagA Gene in Dental Plaque of Asymptomatic Mexican Children.

The variability in Helicobacter pylori vacA and cagA genes has been related to the progression of the gastrointestinal disease; also the presence of H. pylori in the oral cavity has been associated with periodontal disease in adults, but, in children without dyspeptic symptoms, little is known about this. We evaluated the prevalence of H. pylori and the presence of vacA/cagA genotypes in the oral cavity of Mexican children without dyspeptic symptoms. The gingival status was measured, and dental plaque samples (n = 100) were taken. 38% of children were positive for H. pylori 16S rRNA gene by qPCR. A significant association between H. pylori oral infection and gingival status was observed (P < 0.001). In 34.6% (9/26) of mild gingivitis cases, s1m2 genotype was found, while s1m1 was typed in 50% (3/6) of moderate gingivitis. The cagA prevalence among H. pylori-positive children was 80.8% (21/26), 83.3% (5/6), and 16.7% (1/6) of cases of mild gingivitis, moderate gingivitis, and nongingivitis, respectively (P < 0.001). The s1m1/cagA+ combinational genotype was the most detected in children with gingivitis. Our results suggest that the prevalence of H. pylori and detection of vacA/cagA genotypes-associated gastrointestinal disease in the oral cavity could be related to the progression of gingivitis in asymptomatic children.

The prevalence and sociodemographic determinants of uninvestigated dyspepsia in the Czech Republic: a multicentre prospective study accomplished 10 years after the first study from the same geographical areas.

The epidemiology of uninvestigated dyspepsia was studied in the Czech Republic for the first time in 2001. The aim of the current multicenter prospective study was to evaluate dyspepsia using the same methods in a representative sample of general unselected population from the same geographical areas 10 years later. A total of 38 147 individuals comprised the general population for a random two-step selection process. A total of 1836 participants (863 males and 973 females; aged 5-98 years) took part in the questionnaire-based study. Helicobacter pylori status was investigated in all participants by means of C-urea breath test. The overall prevalence of dyspepsia was 2.6% among children and adolescents aged 5-17 years and 16.0% among adults aged 18-98 years. We did not detect any statistically significant sex differences in the prevalence of total dyspepsia or its subtypes. Overall, 2.4% of H. pylori-negative children and adolescents aged less than 18 years reported dyspepsia, and 16.8% of H. pylori-negative adults reported it. Among H. pylori-positive children and adolescents and adults, dyspepsia was present in 8.3 and 15.8%, respectively. Type A dyspepsia (as the only long-lasting symptom) was statistically significantly associated with H. pylori status among children and adolescents. Among adults aged 18 years or older, we noted a lower prevalence of dyspepsia in adults with elementary education compared with university education. Current use of antibiotics was associated with an increased prevalence of dyspepsia in adults. Despite the substantial decrease of H. pylori infection in the Czech Republic over the past 10 years, the prevalence and sociodemographic determinants of uninvestigated dyspepsia did not change significantly.

Prevalence of Helicobacter Pylori Infection in Anemic and Non-Anemic Children in Helwan, Egypt : Impact on Blood Cell Parameters

Background: Helicobacter (H.) pylori is the most common chronic bacterial infection of humans; affecting ~50% of the world’s population. It is the cause of disease states of varying degrees of severity. Anemia is a widespread public health problem; ~50% of cases are diagnosed as iron deficiency anemia (IDA). Recent studies have suggested an association between H. pylori infection and IDA in children. Aims of the work: this study was conducted to evaluate the prevalence of H. pylori infection in children with and without IDA diagnosis and also to determine effects of the bacterium on complete blood count parameters of those children. Subjects and Methods: a case-control (retrospective) study design was chosen to conduct this research. The prevalence of H. pylori antibody (Ab) seropositivity was compared between 50 children diagnosed with IDA vs. 50 non-anemic control children matching in age and sex. Results: a total of 18 (36%) anemic and 10 (20%) non-anemic children were found positive to H. pylori Ab (P=0.0013). Also, comparison of the anemic to the control group revealed statistically significant lowering of ferritin, and red blood cell (RBC) parameters (i.e., hemoglobin, packed cell volume, mean corpuscular volume, and mean corpuscular hemoglobin), and also platelet count in the anemic group. Moreover, comparison of H. pylori positive and negative anemic children revealed statistically significant lowering of RBC parameters in the H. pylori positive anemic children. Also, comparison of H. pylori positive and negative children revealed statistically significant lowering of RBC parameters in H. pylori positive children. In addition, correlation of H. pylori with all other parameters revealed negative significant correlation between H. pylori and RBC parameters. Conclusions: H. pylori infection had a higher prevalence among preschool children with IDA and the hematological impact was more on H. pylori positive anemic children. Recommendations: both IDA and H. pylori are treatable diseases, so children having IDA must be investigated for H. pylori infection for early treatment to avoid serious complications of both diseases.

Helicobacter pylori in children with asthmatic conditions at school age, and their mothers.

Helicobacter pylori prevalence in Western countries has been declining simultaneously with increases in childhood asthma and allergic diseases; prior studies have linked these phenomena. To examine the association between H. pylori colonisation in children and risk of asthma and related conditions at school age. We secondly examined additional effects of maternal H. pylori status by pairing with children's status. This study was embedded in a multi-ethnic population-based cohort in Rotterdam, The Netherlands. We measured anti-H. pylori and anti-CagA antibodies in serum of children obtained at age 6 years, and of their mothers obtained during midpregnancy. Asthma or related conditions were reported for children at age 6 years. We used multivariate logistic regression analyses among 3797 subjects. In children, the H. pylori positivity rate was 8.7%, and 29.2% of these were CagA-positive. A child's colonisation with a CagA-negative-H. pylori strain was associated with an increased risk of asthma (Odds ratio 2.11; 95% CI 1.23-3.60), but this differed for European (3.64; 1.97-6.73) and non-European (0.52; 0.14-1.89) children. When taking into account maternal H. pylori status, only H. pylori-positive children with an H. pylori-negative mother had increased risk of asthma (2.42; 1.11-5.27), accounting for 3.4% of the asthma risk. Colonisation of a European child with a CagA-negative-H. pylori strain at age 6 was associated with an increased prevalence of asthma, but there was no association for non-European children. The underlying mechanisms for the observed risk differences require further research.

Serum Zinc, Copper, Magnesium and Selenium Levels in Children with Helicobacter Pylori Infection.

Helicobacter pylori infection can cause disease from mild to severe that may be accompanied by micronutrient deficiencies. We aimed to investigate serum zinc, copper, magnesium and selenium levels in Helicobacter pylori positive children. Thirty-four children, with chronic abdominal pain and diag-nosed to be Helicobacter pylori-positive and 20 healthy children with the same demo-graphic characteristics were included in the study. Serum zinc, copper and magnesium levels were measured in the flame unit of atomic absorption spectrophotometer, selenium levels were measured in the graphite unit of the same atomic absorption spectrophotometer. Serum zinc levels were significantly higher and serum magnesium levels were significantly lower (p<0.05) in Helicobacter pylori positive children than those of the control group. Although copper levels were lower in patient group than in control group, this difference was not statistically significant (p>0.05). There was no significant difference between serum selenium levels of two groups. We concluded that in Helicobacter pylori-positive children, many trace elements and mineral metabolism may change.