Follow-up ofHelicobacter pyloriinfection in children over two decades (1988–2007): persistence, relapse and acquisition rates

Abstract

Helicobacter pylori culture on gastric biopsy was performed on 4964 subjects aged <18 years from 1988 to 2007 at a central laboratory in Brussels. The total number of biopsies increased markedly from 941 in 1988-1993 to 1608 in 2004-2007. Biopsies were repeated at least once for 922 subjects (603 initially negative and 319 initially positive for H. pylori). Persistence rate of H. pylori at 1 year after initial positive biopsy was greater in the 1998-2007 cohort than in the 1988-1997 cohort (72.7% vs. 45.8%, P = 0.002), suggesting a tailored selection of candidates for biopsy with non-invasive tests (13C urea breath test). Of 68 subjects initially positive and re-examined subsequently after a documented cure, re-infection/relapse rate was 48.6% within 5 years post-elimination of H. pylori. Acquisition rate over 10 years follow-up in the initially negative cohort (603 patients) was 38.7% (re-infection/relapse vs. acquisition: P < 0.001). Multivariate analysis showed a fourfold greater risk of H. pylori acquisition in children of non-European origin vs. European origin (P < 0.001). Clarithromycin and metronidazole susceptibility were determined in 226 and 223 paired positive cultures in cases of re-infection/relapse or persistence. An initial non-susceptibility profile was highly predictive of a subsequent non-susceptibility profile, and the non-susceptible proportion increased markedly from 13.3% to 21.2% for clarithromycin (P < 0.001) and from 27.3% to 35.0% for metronidazole (P = 0.014), with no difference regarding European or non-European origin.

Antibiotic resistance of Helicobacter pylori in Chinese children: A multicenter retrospective study over 7 years

“…[5][6][7][8][12][13][14] No significant change was seen in the metronidazole resistance rates in the consecutive years. The high rate of metronidazole resistance was detected in this region (75.20%), where resistance rate was higher than that in other regions of China and other countries (from 10.1% to 61.6%).…”

“…The rate of resistance to clarithromycin in children varies among different countries, such as 18.8% in South Korea, 15 11.9%-34.7% in Europe 5,7,12,13 , and 21.6% in Austria. The prescription of this drug in children during the last decade for respiratory tract infections might contribute to a high resistance rate of H. pylori to clarithromycin.…”

Risk of Gastric Cancer in Children with Helicobacter pylori Infection

“…Vanderpas et al (2014) found that the prevalence of H. pylori was 18.2% in children aged <6 years and 49.3% in adolescents aged 12-17 years. Ertem et al (2013) found …”

Clinical differences of Helicobacter pylori infection in children

“…29,30 Vanderpas et al reported that the reinfection after eradication for the period of 5 years amounted to 48.6%, and new infections that occurred in the period of 10 years in previously negative people amounted to 38.7%. 30 The risk of acquiring the infection was fourfold higher in non-European than in European children (p < 0.001). Other authors have also reported H. pylori seroconversion.…”