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Homan M, Jones NL, Bontems P, Carroll MW, Czinn SJ, Gold BD, Goodman K, Harris PR, Jerris R, Kalach N, Kori M, Megraud F, Rowland M, Tavares M. Updated joint ESPGHAN/NASPGHAN guidelines for management of Helicobacter pylori infection in children and adolescents (2023). J Pediatr Gastroenterol Nutr 2024; 79:758-785. [PMID: 39148213 DOI: 10.1002/jpn3.12314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 04/25/2024] [Accepted: 05/10/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Evolving epidemiological data and increasing antibiotic resistance mandate an update of the European and North American Societies of Pediatric Gastroenterology, Hepatology and Nutrition guidelines. METHODS Certainty of evidence and strength of recommendations were rated by experts according to the Grading of Recommendation Assessment, Development, and Evaluation approach. PICO (patient population, intervention, comparator, and outcome) questions were developed and voted on by the group. Recommendations were formulated using the Evidence to Decision framework. RESULTS The current literature supports many of the previous recommendations and several new recommendations. Invasive testing with strain antimicrobial susceptibility analysis is recommended for the diagnosis and selection of eradication therapy for H. pylori infection. Molecular methods are acceptable for detection of infection and of antibiotic resistance in gastric biopsy specimens. Reliable, noninvasive tests can be used as a screening method for children with history of gastric cancer in a first-degree relative. When investigating causes of chronic immune thrombocytopenic purpura, testing for H. pylori is no longer recommended. When investigating other diseases such as inflammatory bowel disease, celiac disease, or eosinophilic esophagitis, specific diagnostic biopsies for H. pylori infection are not indicated. However, if H. pylori is an incidental finding, treatment may be considered after discussing the risks and benefits. Treatment should be based on antibiotic antimicrobial susceptibility testing and, if unavailable, regimens containing clarithromycin should be avoided. CONCLUSIONS Due to decreasing prevalence of infection, increasing challenges with antibiotic resistance, and emerging evidence regarding complications of infection, clinicians must be aware of these recommended changes to appropriately manage H. pylori infection and its clinical sequelae in children.
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Affiliation(s)
- Matjaž Homan
- Faculty of Medicine, Children's Hospital in Ljubljana, University of Ljubljana, Ljubljana, Slovenia
| | - Nicola L Jones
- Division of Gastroenterology Hepatology and Nutrition, SickKids, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Bontems
- Université Libre de Bruxelles, Hôpital Unversitaire des Enfants Reine Fabiola, Hôpitaux Universitaires de Bruxelles, Brussels, Belgium
| | - Matthew W Carroll
- Division of Gastroenterology and Nutrition, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Steven J Czinn
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Benjamin D Gold
- GI Care for Kids, LLC, Children's Center for Digestive Healthcare LLC, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Karen Goodman
- Faculty of Medicine and Dentistry, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | - Paul R Harris
- Department of Pediatric Gastroenterology and Nutrition, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Robert Jerris
- Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nicolas Kalach
- Department of Pediatrics, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University of Lille, Lille, France
| | - Michal Kori
- Pediatric Gastroenterology, Kaplan Medical Center, Rehovot, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Marion Rowland
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Marta Tavares
- Unidade de Gastroenterologia, Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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Chen CB, Chugh S, Rao D. Iron Pill-Induced Gastritis in a Pediatric Patient Taking Ferrous Sulfate Tablets. J Pediatr Pharmacol Ther 2024; 29:425-428. [PMID: 39144394 PMCID: PMC11321807 DOI: 10.5863/1551-6776-29.4.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/23/2024] [Indexed: 08/16/2024]
Abstract
Iron supplementation is frequently used in the treatment of iron deficiency anemia in the pediatric population. We describe a case of an 11-year old male who developed adverse side effects following treatment with oral ferrous sulfate tablets for 2 months. The diagnosis was made following findings of iron deposition on histology obtained during endoscopy. The iron supplementation was changed from tablet to liquid form, and repeat endoscopy 4 months following initial diagnosis showed resolution of the histologic findings of iron pill-induced gastritis.
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Affiliation(s)
- Charles B. Chen
- Division of Gastroenterology (CBC), Department of Pediatrics, University of Missouri School of Medicine, Columbia, MO
| | - Shreeya Chugh
- Division of Gastroenterology, Hepatology & Nutrition (SC), Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
| | - Deepthi Rao
- Department of Pathology and Anatomical Sciences (DR), University of Missouri, Columbia, MO
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Elmas A, Akçam M. Trend of Helicobacter pylori Infection in Childhood: A Single-Center Experience. Turk Arch Pediatr 2024; 59:264-269. [PMID: 39140851 PMCID: PMC11181283 DOI: 10.5152/turkarchpediatr.2024.23312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/27/2024] [Indexed: 08/15/2024]
Abstract
Helicobacter pylori (HP) is the most common bacterial infection in humans. Helicobacter pylori infection, which frequently increases with age, is seen in 30%-56.6% of children in Turkey, although it varies by region. In this study, we aimed to determine the frequency of HP in children and adolescents who underwent upper gastrointestinal endoscopy and gastric biopsy in our region and to compare the changes over the years. Cases who underwent upper gastrointestinal endoscopy for various indications between 2007 and 2022 in our pediatric gastroenterology unit were included in the study. The clinical and endoscopic characteristics of 1737 cases whose histopathologic specimens were obtained, have been retrospectively analyzed from their records. The diagnosis of HP infection was based on the presence of HP on histopathologic examination of gastric biopsy specimens. Of 1737 cases, 504 (29%) were HP positive. The HP positive case rates were 14.5%, 26.9%, and 33.6% in the 0-6, 7-12, and 13-18 age groups, respectively. H. pylori positivity was detected in 65.7% of patients with duodenal ulcers, and the relationship between duodenal ulcers and HP positivity was significant (P < .001). The average HP positivity rates were 44%, 28.6%, and 24.2% in 2007-2012 (group 1), 2013-2017 (group 2), and 2018-2022 (group 3). H. pylori positivity rates significantly decreased in years (P = .001/P = .056/P < .001). We found that the frequency of HP infection in children decreased in our region over the years. Helicobacter pylori positivity was higher in older than younger children. A decrease in HP frequency prevalence may be possible in parallel with awareness and socioeconomic development.
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Affiliation(s)
- Abdulkerim Elmas
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Süleyman Demirel University School of Medicine, Isparta, Türkiye
| | - Mustafa Akçam
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Süleyman Demirel University School of Medicine, Isparta, Türkiye
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Altamimi E, Salameh L, AlNsour H, Rawabdeh N. Helicobacter pylori gastritis in Jordanian children: persistence versus resolution. PRZEGLAD GASTROENTEROLOGICZNY 2023; 19:311-320. [PMID: 39802966 PMCID: PMC11718494 DOI: 10.5114/pg.2023.132461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/11/2023] [Indexed: 01/04/2025]
Abstract
Introduction Helicobacter pylori (H. pylori) is the most common cause of infectious gastritis. Helicobacter pylori is an infection that is typically acquired during childhood. Aim This study aims to describe children with H. pylori infection and compare the clinicopathological features of children with resolved and persistent infection. Material and methods This is a retrospective review of all children with biopsy-proven H. pylori infection over a 6-year period. Hospital electronic files, endoscopic database, and histopathology database were reviewed. Patients who underwent follow-up endoscopy were identified, and their data was compared. Results A total of 176 patients were identified, of whom 100 (56.2%) were females. The average age at presentation was 10.2 years (range: 2.5-17 years). Children older than 10 years were the most affected age group. The most commonly presenting symptom was recurrent abdominal pain (92 (51.69%)), followed by epigastric pain/dyspepsia and vomiting (44 (24.72%) and 18 (10.11%), respectively). The most common macroscopic feature was antral nodularity (76 (42.70%)). The most prevalent microscopic findings were moderate inflammation of moderate chronicity. None of the patients developed gastric atrophy. Forty-four (23.5%) patients had comorbid diseases. On follow-up, upper endoscopy was available for 42 (23.59%) patients. The resolution of H. pylori based on histological examination was observed in only 10 (23.81%) patients. Children whose infections resolved were older. Conclusions A significant number of children with biopsy-proven H. pylori infection presented with abdominal pain. Female gender, older age, and less severe macroscopic and microscopic findings may be associated with a higher chance of infection resolution.
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Affiliation(s)
- Eyad Altamimi
- Paediatric Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Lma Salameh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanin AlNsour
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Naif Rawabdeh
- Pediatric Department, King Abdullah University Hospital, Irbid, Jordan
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Rosu OM, Gimiga N, Popescu R, Ioniuc I, Rusu CD, Clipa T, Florea DM, Pleșca DA, Nemtoi A, Tataranu E, Stefanescu G, Diaconescu S. Pattern of Primary Resistance of Helicobacter pylori to Clarithromycin among Pediatric Patients from North-Eastern Romania. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1752. [PMID: 38002843 PMCID: PMC10670121 DOI: 10.3390/children10111752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Helicobacter pylori antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with Helicobacter pylori by gastric biopsy. METHODS We studied 84 positive gastric samples for Helicobacter pylori. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. RESULTS Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6-17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. CONCLUSIONS One in 2.4 children infected with Helicobacter pylori had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.
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Affiliation(s)
- Oana-Maria Rosu
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Str., 540139 Targu Mures, Romania
| | - Nicoleta Gimiga
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Roxana Popescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Ileana Ioniuc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Carmen Daniela Rusu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Tatiana Clipa
- Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
| | - Diana-Maria Florea
- Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
| | - Doina-Anca Pleșca
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 21 Dionisie Lupu Str., 020021 Bucharest, Romania
| | - Alexandru Nemtoi
- Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
| | - Elena Tataranu
- Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
| | - Gabriela Stefanescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Smaranda Diaconescu
- Faculty of Medicine, “Titu Maiorescu” University of Medicine, 67A Gheorghe Petrascu Str., 031592 Bucharest, Romania
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Galoș F, Boboc C, Ieșanu MI, Anghel M, Ioan A, Iana E, Coșoreanu MT, Boboc AA. Antibiotic Resistance and Therapeutic Efficacy of Helicobacter pylori Infection in Pediatric Patients-A Tertiary Center Experience. Antibiotics (Basel) 2023; 12:antibiotics12010146. [PMID: 36671347 PMCID: PMC9854557 DOI: 10.3390/antibiotics12010146] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
One of the most widespread bacterial infections worldwide, Helicobacter pylori is thought to affect almost half of the world's population. Due to rising antibiotic resistance, treatment should be tailored according to antibiotic susceptibility testing (AST). This study aims to evaluate Helicobacter pylori antibiotic resistance and its therapeutic efficacy in children. We conducted a prospective, single-center study, that evaluated 68 children referred for upper gastrointestinal endoscopy (UGE) following chronic dyspeptic syndrome. Each patient underwent multiple biopsies to perform bacterial cultures with AST and histopathological examinations for the diagnosis. Patients without antibiotic resistance or negative cultures received a 10-day sequential therapy, while the others had the antibiotic regimen tailored based on AST. Fifty-nine patients with a positive biopsy-based diagnosis (24 males) were finally included. Bacterial cultures with AST were positive for 13 patients (22.03%) and the antibiotic resistance for clarithromycin was 15.38%. Fifty-seven patients were administered sequential therapy with an eradication rate of 94.73%. Clarithromycin-resistant patients were successfully treated with 10-day triple therapy of esomeprazole, amoxicillin, and metronidazole. Although bacterial cultures had a low positivity rate, sequential therapy had a successful eradication rate. Further studies are necessary to better assess Helicobacter pylori antibiotic resistance to provide tailored treatment and identify children that need closer monitoring.
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Affiliation(s)
- Felicia Galoș
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Cătălin Boboc
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Mara-Ioana Ieșanu
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence:
| | - Mălina Anghel
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Andreea Ioan
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Elena Iana
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Maria Teodora Coșoreanu
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
| | - Anca Andreea Boboc
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania
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Dănilă C, Cardos IA, Pop-Crisan A, Marc F, Hoza A, Chirla R, Pascalău A, Magheru C, Cavalu S. Correlations between Endoscopic and Histopathological Assessment of Helicobacter pylori-Induced Gastric Pathology-A Cross-Sectional Retrospective Study. Life (Basel) 2022; 12:life12122096. [PMID: 36556461 PMCID: PMC9783750 DOI: 10.3390/life12122096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Helicobacter pylori (H. pylori) infects about half of the world’s population and can lead to premalignant lesions and gastric cancer. Updated data about the correlation of histopathological diagnostics with endoscopic diagnostics are scarce. The objective of this study was to identify the concordance between endoscopic and histopathologic findings, with a focus on premalignant lesions. We performed a cross sectional, retrospective study over a 4-year period (2017−2021) on adult patients with dyspeptic symptoms and positive RUT (rapid urease test) in a single hospital centre, with a total of 133 patients infected with H. pylori being included in the study. Statistical associations between endoscopic appearance and histopathological results were found for atrophic antral gastritis (p = 0.001), intestinal metaplasia of the antrum (p = 0.018), gastric polyps (p < 0.001) and gastric corpus cancer (p = 0.012). Females were more likely to be diagnosed through endoscopy with gastric atrophy or intestinal metaplasia (p = 0.031), while chronic atrophic gastritis in corpus was more prevalent in patients older than 65 (p = 0.024). Overall, our study reveals only 21% concordance between Giemsa stain and RUT, highlighting the importance of combining rapid testing with endoscopic and histopathological diagnostic methods for a more accurate early diagnosis and prevention of gastric cancer.
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Yu M, Ma J, Song XX, Shao QQ, Yu XC, Khan MN, Qi YB, Hu RB, Wei PR, Xiao W, Jia BL, Cheng YB, Kong LF, Chen CL, Ding SZ. Gastric mucosal precancerous lesions in Helicobacter pylori-infected pediatric patients in central China: A single-center, retrospective investigation. World J Gastroenterol 2022; 28:3682-3694. [PMID: 36161049 PMCID: PMC9372804 DOI: 10.3748/wjg.v28.i28.3682] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/02/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infects about 50% of the world population and is the major cause of chronic gastritis, peptic ulcers, and gastric cancer. Chronic H. pylori infection induces gastric mucosal precancerous lesions mostly in adulthood, and it is debatable whether these pathological conditions can occur in childhood and adolescents as well. Since this is a critical issue to determine if intervention should be offered for this population group, we investigated the gastric mucosal precancerous lesions in pediatric patients in an area in central China with a high prevalence of H. pylori and gastric cancer.
AIM To investigate the relationship of H. pylori infection and gastric mucosal precancerous lesions in children and adolescents in central China.
METHODS We screened 4258 ward-admitted children and adolescent patients with upper gastrointestinal symptoms, and finally enrolled 1015 pediatric patients with H. pylori infection and endoscopic and histological data. H. pylori infection status was determined by rapid urease test and histopathological examination. Both clinical and pathological data were collected and analyzed retrospectively. Occurrence of gastric mucosal precancerous lesions, inflammatory activity and degree of inflammatory cell infiltration between H. pylori-positive and -negative groups were compared.
RESULTS Among the 1015 eligible children and adolescents, the overall H. pylori infection rate was 84.14% (854/1015). The infection rate increased with age. The incidence of gastric mucosal precancerous lesions in H. pylori-infected children was 4.33% (37/854), which included atrophic gastritis (17 cases), intestinal metaplasia (11 cases) and dysplasia (9 cases). In H. pylori-negative patients, only 1 atrophic gastritis case [0.62%, (1/161)] was found (P < 0.05). Active inflammation in H. pylori-infected patients was significantly higher than that in non-infected patients, and the H. pylori-infected group showed more severe lymphocyte and neutrophil granulocyte infiltration (P < 0.001). In addition, endoscopy revealed that the most common findings in H. pylori-positive patients were antral nodularity, but in H. pylori-negative patients only superficial gastritis was observed.
CONCLUSION In children and adolescents, gastric mucosal precancerous lesions occurred in 4.33% of H. pylori-infected patients in central China. These cases included atrophic gastritis, intestinal metaplasia, and dysplasia. The data revealed an obvious critical issue requiring future investigation and intervention for this population group.
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Affiliation(s)
- Miao Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Jing Ma
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xiao-Xia Song
- Department of Pathology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Qiao-Qiao Shao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Xue-Chun Yu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Muhammad Noman Khan
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ya-Bin Qi
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ruo-Bing Hu
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Pei-Ru Wei
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Wei Xiao
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Bai-Ling Jia
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Yan-Bo Cheng
- Department of Pediatrics, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Ling-Fei Kong
- Department of Pathology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Chuan-Liang Chen
- Department of Medical Imaging, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
| | - Song-Ze Ding
- Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
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Helicobacter pylori Infection in a Pediatric Population from Romania: Risk Factors, Clinical and Endoscopic Features and Treatment Compliance. J Clin Med 2022; 11:jcm11092432. [PMID: 35566557 PMCID: PMC9099726 DOI: 10.3390/jcm11092432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/17/2022] [Accepted: 04/22/2022] [Indexed: 12/18/2022] Open
Abstract
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.
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14/w mit anhaltenden Oberbauchschmerzen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01448-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Krzyżek P, Paluch E, Gościniak G. Synergistic Therapies as a Promising Option for the Treatment of Antibiotic-Resistant Helicobacter pylori. Antibiotics (Basel) 2020; 9:antibiotics9100658. [PMID: 33007899 PMCID: PMC7599531 DOI: 10.3390/antibiotics9100658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 12/17/2022] Open
Abstract
Helicobacter pylori is a Gram-negative bacterium responsible for the development of gastric diseases. The issue of spreading antibiotic resistance of H. pylori and its limited therapeutic options is an important topic in modern gastroenterology. This phenomenon is greatly associated with a very narrow range of antibiotics used in standard therapies and, as a consequence, an alarmingly high detection of multidrug-resistant H. pylori strains. For this reason, scientists are increasingly focused on the search for new substances that will not only exhibit antibacterial effect against H. pylori, but also potentiate the activity of antibiotics. The aim of the current review is to present scientific reports showing newly discovered or repurposed compounds with an ability to enhance the antimicrobial activity of classically used antibiotics against H. pylori. To gain a broader context in their future application in therapies of H. pylori infections, their antimicrobial properties, such as minimal inhibitory concentrations and minimal bactericidal concentrations, dose- and time-dependent mode of action, and, if characterized, anti-biofilm and/or in vivo activity are further described. The authors of this review hope that this article will encourage the scientific community to expand research on the important issue of synergistic therapies in the context of combating H. pylori infections.
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Mahmood T, Owais M, Noh KJ, Yoon HS, Haider A, Sultan H, Park KR. Artificial Intelligence-based Segmentation of Nuclei in Multi-organ Histopathology Images: Model Development and Validation (Preprint). JMIR Med Inform 2020. [DOI: 10.2196/24394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Helicobacter pylori infection in children and adolescents differs in comparison to adults with respect to epidemiology, host responses, and disease manifestations. Furthermore, treatment options are limited in this population and antibiotic resistance rates continue to increase. Therefore, ongoing research is vital to understand disease pathogenesis and provide optimal management of children with infection. This review summarizes relevant publications from April 2019 to March 2020. Similar to adults, recent studies show a decreasing prevalence of infection in the pediatric population. Studies of pathogenesis investigated serum immune responses and the potential inverse association of infection and allergy. Several studies investigated the effect of H pylori and related inflammation on the gut microbiome. The recommendation of endoscopy-based testing to identify the cause of symptoms and not just H pylori, reserving noninvasive UBT or stool antigen tests for post-eradication follow-up, was supported by the current literature.
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Affiliation(s)
- Ji-Hyun Seo
- Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Kristen Bortolin
- Department of Paediatrics, Division of Gastroenterology Hepatology and Nutrition, University of Toronto, SickKids, Toronto, Canada
| | - Nicola L Jones
- Departments of Paediatrics and Physiology, Division of Gastroenterology Hepatology and Nutrition, Cell Biology Program, SickKids Research Institute, University of Toronto, SickKids, Toronto, Canada
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Osmančević L, Osmančević E. The association of recurrent abdominal pain and Helicobacter pylori infection in correlation with esophagogastroduodenoscopy findings. SANAMED 2020. [DOI: 10.24125/sanamed.v15i2.443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract: Aim: The aim of this research was to determine the association of recurrent abdominal pain and Helicobacter pylori (H. pylori) infection in childhood, in correlation with the finding of an upper endoscopy. Introduction: Recurrent abdominal pain (RAP) was defined according to Apley and Naish's criteria from the year 1959 as at least three or more episodes of abdominal pain lasting longer than three months in children older than 3 years, and severe enough to prevent normal activities in child. The association of RAP and H. pylori has been analyzed in several different researches, and there are conflicting results about their interconnection. However, the etiological association of the presence of H. pylori with the onset and development of acute and chronic active gastritis and duodenal ulcer is known. Material and method: The research protocol included a total of 77/183 (42.07%) children divided by age into three subgroups: preschool age (3 to 6.9 years), school-age (7 to 10.9 years) and adolescent age (11 to 15 years) in whom the diagnosis of RAB was determined by meeting the criteria according to Apley and Naish (1959), and the American Academy of Pediatrics (2005). H. pylori infection was confirmed by enzyme-linked immunosorbent assay (ELISA), while esophagogastroduodenoscopy was performed by the device for upper endoscopy type Olimpus GIF Type Q156, in the endoscopic cabinet of the Clinic for Internal Medicine, University Clinical Center Tuzla. Results: Of the total number of examined children (77), the analyse of Helicobacter pylori infection presence showed the biggest number of positive findings in school age 91.3%, in adolescent age 78.0%, while the smallest number was in preschool age (25.0%). The most common findings of upper endoscopy and microscopic findings were described as: antritis acuta in 16%, gastritis chronica activa et erosiva in 32%, and duodenitis acuta (12%). Conclusion: A significant association of H. pylori infection and RAP are confirmed by positive finding of esophagogastroduodenoscopy, leading to conclusion that immunological testing for the presence of this bacteria is justified. After obtaining a positive finding with confirmed infecion, it is necessary to start with the treatment.
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