Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infection in symptomatic children and adolescents

Ogata, Silvio Kazuo; Kawakami, Elisabete; Patrı́cio, Francy Reis da Silva; Pedroso, Margareth Zabeu; Santos, António Mário

doi:10.1590/s1516-31802001000200006

Cited by 53 publications

(56 citation statements)

References 42 publications

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“…Therefore, we recommend evaluating two gastric biopsy specimens per child, in order to optimize the diagnosis of H. pylori infection. According to Ogata et al (2001), 5-10 % of H. pylori-infected children and adolescents have been misdiagnosed with a single antral-biopsy-based test.…”

Section: Resultsmentioning

confidence: 99%

Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children over a period of 10 years

Boyanova

Lazarova²,

Jelev³

et al. 2007

Journal of Medical Microbiology

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The aims of the study were to evaluate the incidence of Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children from 1996 to 2006, to analyse the performance of diagnostic tests, and to look at H. pylori density in specimens by culture. Antral specimens from children with chronic gastritis (n5513), peptic ulcers (n554) and other diseases (n591) were evaluated by direct Gram staining (DGS), in-house rapid urease test (RUT) and culture. The living environment and semi-quantitative H. pylori density were assessed in 188 and 328 children, respectively. H. pylori infection was found in children with ulcers (77.8 %), chronic gastritis (64.5 %) and other diseases (36.3 %). Half (51.4 %) of patients aged 1-5 years and 77.4 % of those aged 16-17 years were H. pylori-positive. Of all children, 328 (49.8 %) showed positive DGS, 184 (28 %) had a positive RUT, and 386 (58.7 %) were culture-positive. Unlike gastric mucus specimens, frozen biopsy specimens provided reliable diagnosis. H. heilmannii was observed in two (0.3 %) children. High H. pylori density (growth into all quadrants of plates) was found in 18 % of 328 children evaluated, involving 31 % of ulcer and 16.7 % of non-ulcer patients. H. pylori infection was more common in rural children with chronic gastritis (91.3 %) than in the remainder (66.7 %). In conclusion, H. pylori infection was common in symptomatic Bulgarian children. The infection prevalence was .77 % in patients aged 16-17 years, in children with a duodenal ulcer, and in rural patients. H. heilmannii infection was uncommon. The performance of the bacterial culture was good. The impact of H. pylori density on the clinical expression and eradication of the infection requires further evaluation. The results highlight the need for routine H. pylori diagnosis in rural children with chronic gastritis. INTRODUCTIONHelicobacter pylori infection is associated with gastroduodenal diseases in humans (Matysiak-Budnik et al., 2006). The incidence of the infection in children ranges from 10 to 80 %, and is high in developing and some other countries (Torres, 2000; Janulaityte-Gunther et al., 2005;Kato et al., 2004). H. pylori infection is most often intrafamilial and spreads by oral-oral or faecal-oral transmission (Megraud, 2003;Mladenova et al., 2006). Helicobacter heilmannii can also infect the human stomach. The incidence (usually ,1 %) of this zoonotic infection in dyspeptic patients is much lower than that caused by H. pylori (Ierardi et al., 2001;Okiyama et al., 2005). There are, however, only a few reports concerning H. heilmannii incidence in children (Coman et al., 1996;Mention et al., 1999; Sykora et al., 2004).The aims of the present study were to assess the incidence and characteristics of H. pylori and H. heilmannii infections in untreated Bulgarian children over a period of 10 years, according to age, sex, disease and living environment; to analyse the performance of diagnostic tests according to the type of antral specimen; and to evaluate H. pylori density in the biopsy spec...

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Section: Resultsmentioning

confidence: 99%

Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children over a period of 10 years

Boyanova

Lazarova²,

Jelev³

et al. 2007

Journal of Medical Microbiology

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“…This solution contains 100 mg urea in 1 mL distilled water, with a drop of phenol red. RUT is evaluated within 1 hour after immersion of two gastric antrum fragments, and was previously validated in our service, with 100% sensitivity and 84.2% specificity (12) .…”

Section: Rapid Urease Test (Rut)mentioning

confidence: 99%

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Kawakami

Machado

Ogata

et al. 2008

Arq. Gastroenterol.

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-Background -Decreasing prevalence of H pylori infection has been reported in some countries. Aim -To evaluate the prevalence of Helicobacter pylori infection in a 10-year period in children submitted to upper digestive endoscopy. Methods -It was a retrospective observational study. The records of 1,165 endoscopies performed during a 10-year period in a public hospital of the City of São Paulo, SP, Brazil, in patients up to 18-year-old. Only the first endoscopy was considered. Helicobacter pylori infection was defined by the rapid urease test, performed with one fragment of antral mucosa. Chi-square for trend has been estimated to compare Helicobacter pylori prevalence across the period. Results -The main indication for endoscopy was epigastric pain (47.4%). There were 392 patients with H pylori infection (33.6%), 12.8% being infants, 19.4% toddlers, 28.8% schoolchildren and 46.3% adolescents. Prevalence was 60.47% in the first year of the study and 30.43% in the last. Among the less than 6-year-old patients there was a decrease in infection prevalence from 25% for the 1993-6 period to 14.3% in the 2000-02 period, while among the over 12-year-old patients the decrease was from 55.5% in the first period to 39.6% in the latter. The decrease in H pylori infection prevalence was more intense within patients with epigastric pain, in which prevalence has decreased from 48.2% (92/191) in 1993-6, to 41.9% (65/155) in 1997-9 and 27.7% (57/206) in 2000-02. Conclusion -The study suggests a significant decrease in the prevalence of H pylori infection regarding the studied patients. The trend was mainly observed in the younger age group and in patients with epigastric pain.

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“…Esta diferença talvez possa ser atribuída à distribuição focal da bactéria e ao menor número de fragmentos de biópsia coletados. A histologia e o teste rápido da urease são métodos diagnósticos que apresentam boa acurácia, como observado em nosso serviço, com sensibilidade e especificidade, respectivamente, de 92 e 100%, e de 100 e 84,2% (teste não comercializado) 8 . O paciente que apresentou apenas o teste rápido da urease positivo tinha resultado anterior de histologia positivo e apresentava biópsia com infiltrado neutrofílico, achado com alta especificidade para infecção por H. pylori, uma vez que a distribuição da bactéria pode ser focal 24 .…”

Section: Discussionunclassified

“…O teste rápido da urease foi realizado com solução aquosa com uréia a 10%, não comercializada, preparada no dia do exame e mantida em temperatura ambiente 8 . Para análise histológica, os fragmentos foram colocados em papel de filtro, orientados e fixados em solução de formaldeído a 10%.…”

Section: Detecção Do Helicobacter Pyloriunclassified

Clinical and histological features of duodenal ulcer in children and adolescents

Kawakami¹,

Machado²,

Fonseca³

et al. 2004

J Pediatr (Rio J)

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Objective: To evaluate clinical and histological features of duodenal ulcer in children and adolescents.Methods: Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6 year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection.Results: Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74 ResumoObjetivo: Avaliar as características clínicas e histológicas de crianças e adolescentes com úlcera duodenal.Métodos: Foram avaliadas prospectiva e consecutivamente 43 pacientes com úlcera duodenal ao longo de 6 anos (7,2 pacientes por ano). A avaliação consistiu de questionário clínico de sintomas dispép-ticos, exame físico e endoscopia digestiva com biópsias gástricas para exame histológico e detecção do Helicobacter pylori.Resultados: A idade no diagnóstico variou de 4 anos e 8 meses a 17 anos e 4 meses (mediana = 12 anos e 4 meses ARTIGO ORIGINALGastrite crônica associada à infecção por Helicobacter pylori está presente na grande maioria das crianças com úlcera duodenal primária, havendo consenso para o tratamento de erradicação da bactéria, pela diminuição acentuada do índice de recidivas ulcerosas 1 . A colonização da mucosa gástrica por H. pylori, bacilo gram-negativo, microaerofílico, espiralado, atualmente ocorre em uma minoria das crianças de países desenvolvidos, ao contrário das crianças de países em desenvolvimento, sendo a prevalên-cia até 10 anos de idade de 5-10% e até 80%, respectivamente 2 . Os principais fatores de risco para contrair a infecção são: viver em país em desenvolvimento e ser criança com pais infectados e de baixo poder aquisitivo 3 . A maioria dos pacientes é assintomática, estimando-se que cerca de 15% evoluem para úlcera péptica e 1% para câncer gástrico 4 . Após a instalação da gastrite, a bactéria geralmente persiste por toda a vida, sendo rara a erradicação espontânea. Não há conclusão definitiva a respeito da influência dos fatores de virulência da bactéria, assim como da resposta do hospedeiro ou das condições ambientais que poderiam interferir no curso evolutivo desta afecção.

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Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infection in symptomatic children and adolescents

Cited by 53 publications

References 42 publications

Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children over a period of 10 years

Helicobacter pylori and Helicobacter heilmannii in untreated Bulgarian children over a period of 10 years

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Clinical and histological features of duodenal ulcer in children and adolescents

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