Helicobacter pylori Infection in Pediatrics

Abstract

This review includes the main pediatric studies published from April 2014 to March 2015. The host response of Treg cells with increases in FOXP3 and TGF‐β1 combined with a reduction in IFN‐γ by Teff cells may contribute to Helicobacter pylori susceptibility in children. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. Helicobacter pylori infection is associated with variables indicative of a crowded environment and poor living conditions, while breast‐feeding has a protective effect. Intrafamilial infection, especially from mother to children and from sibling to sibling, is the dominant transmission route. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura in H. pylori‐infected children and adolescents. The prevalence of H. pylori was higher in chronic urticaria patients than in controls and, following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. Antibiotic resistance and insufficient compliance to treatment limit the efficacy of eradication therapy. Sequential therapy had no advantage over standard triple therapy. In countries where H. pylori infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality.

The All‐Age Prevalence of Helicobacter pylori Infection and Potential Transmission Routes. A Population‐Based Study

“…In addition, questions regarding potential transmission routes were included. Based on the previous literature, five variables representing possible transmission routes of H. pylori infection prior to the age of 18 years were addressed: the type of toilet available , the source of drinking water , breast‐feeding or not during infancy , contact with pets , and contact with farm animals . The simplified questionnaire for adolescents contained questions from the adult questionnaire regarding gastrointestinal complaints, lifestyle factors, and biometric data.…”

Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after Helicobacter pylori eradication

“…HP infection is thought to occur in early childhood when gastric acid is weak and HP can survive (20) (21). After infection, gastric inflammation and mucosal atrophy gradually expand to the gastric body.…”

Antibacterial photodynamic therapy: overview of a promising approach to fight antibiotic-resistant bacterial infections

“…Conventional treatment of H. pylori infections includes the administration of antibiotics together with proton pump inhibitors [177], which often causes undesired side effects such as epigastric pain, nausea, and diarrhea [177]. Resistance of H. pylori to different antibiotic regimens including amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin has been reported in regional studies from different countries [178][179][180][181] and is particularly causing chronic health problems in children [182]. Consequently, APDT has been employed as a possible, more patient-friendly alternative to conventional therapy [183][184][185].…”