Factors associated with Helicobacter pylori infection by a cagA-positive strain in children

D M Queiroz1, E N Mendes, A S Carvalho

  • 1Laboratory of Research in Bacteriology, Faculdade de Medicina/UFMG, 30130-100, Belo Horizonte, MG, Brazil. dqueiroz@medicina.ufmg.br

Insights

Helicobacter pylori cagA-positive strains are linked to duodenal ulcers in children. This cagA status also correlates with more severe gastritis and older age in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Microbiology
  • Molecular Diagnostics

Background:

  • Helicobacter pylori infection is a known risk factor for duodenal peptic ulcers in adults.
  • The association between cagA-positive H. pylori strains and duodenal ulcers in children remains under-investigated.

Purpose of the Study:

  • To investigate the association between cagA-positive H. pylori strains and duodenal ulcer disease in a pediatric cohort.
  • To evaluate the relationship between cagA status and the severity of gastritis in children.

Main Methods:

  • Polymerase chain reaction (PCR) was used to detect the cagA gene in H. pylori strains.
  • H. pylori strains were isolated from children with and without duodenal ulcers.
  • Gastric mucosal biopsies were analyzed for gastritis severity and inflammatory cell infiltration.

Main Results:

  • A significantly higher prevalence of cagA-positive H. pylori was observed in children with duodenal ulcers (100%) compared to those without (62.3%) (P=.00007).
  • cagA-positive status was associated with more severe macroscopic gastritis, increased inflammatory infiltrate, and mucosal degenerative/regenerative changes.
  • Increased cagA positivity correlated with older age in the pediatric study group.

Conclusions:

  • The cagA-positive status of H. pylori is strongly associated with duodenal ulcer disease in children.
  • cagA-positive H. pylori infection contributes to more severe gastric inflammation and mucosal damage in pediatric patients.
  • Age is a factor associated with cagA positivity in children with H. pylori infection.

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