Genotypic, clinical, and demographic characteristics of children infected with Helicobacter pylori
Related Experiment Video
Updated: Jul 25, 2026
Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
B D Gold1, L J van Doorn, J Guarner
1Department of Pediatrics, Division of Pediatric Gastroenterology, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston, USA. ben_gold@oz.ped.emory.edu
Insights
This study analyzed Helicobacter pylori strains in North American children, finding no direct link between specific genotypes and disease severity. It establishes a baseline for future research on H. pylori evolution and transmission.
Area of Science:
- Microbiology
- Pediatric Gastroenterology
- Epidemiology
Background:
- Helicobacter pylori (H. pylori) infection is a global health concern with varying disease outcomes.
- H. pylori virulence factors, such as CagA and VacA genotypes, are implicated in disease pathogenesis.
- Geographic variations in H. pylori strains suggest distinct evolutionary pathways and potential associations with host factors.
Purpose of the Study:
- To investigate the association between H. pylori virulence genotypes and endoscopic/histologic disease severity in children.
- To analyze the distribution of H. pylori strains, including CagA and VacA genotypes, in a pediatric cohort.
- To establish a baseline understanding of H. pylori epidemiology in North American children.
Main Methods:
- Retrospective analysis of 38 children undergoing upper endoscopy.
- H. pylori virulence genotyping using reverse hybridization line probe assay and type-specific PCR.
- Correlation analysis between H. pylori genotypes, endoscopic findings, histologic parameters, and host demographics.
Main Results:
- All children had histological gastritis; 45% presented with endoscopic ulcers or erosions.
- The majority of isolates were cagA-positive (74%), frequently associated with vacA s1b or s1a genotypes.
- Distinct H. pylori strain patterns were observed in Hispanic (vacA s1b,m1) and Asian-Canadian (vacA s1c) children.
- No significant correlation was found between H. pylori strain type and endoscopic or histopathologic disease severity.
Conclusions:
- This study provides a foundational profile of H. pylori strains in North American children.
- While specific genotypes showed ethnic associations, no direct link to disease severity was identified in this cohort.
- The findings serve as an epidemiological resource for future studies on H. pylori transmission and disease development.
Abstract:
Helicobacter pylori isolates vary between geographic regions. Certain H. pylori genotypes may be associated with disease outcome. Thirty-eight children underwent diagnostic upper endoscopy at four medical centers and were retrospectively analyzed to determine if H. pylori virulence genes were associated with endoscopic disease severity, histologic parameters, and host demographics. The H. pylori virulence genotype was analyzed by a reverse hybridization line probe assay and type-specific PCR. Endoscopic ulcers or erosions were found in 17 (45%) patients, with 13 (34%) of these patients having antral nodularity. Histological gastritis, of varying severity, was present in all children. Four patients harbored more than one H. pylori strain: one subject had both cagA(+) and cagA-negative strains, while three patients harbored either two different cagA-negative strains (two children) or two cagA(+) strains (one child). There were 28 (74%) cagA(+) isolates; 19 were associated with the vacA s1b genotype, 7 were associated with the vacA s1a genotype, 1 was associated with the vacA s1c genotype, and 1 was associated with the s2 genotype. Of 14 cagA-negative isolates, 6 were vacA s2 genotype, 4 were vacA s1b, 3 were vacA s1a, and 1 was vacA s1c. Nine of ten (90%) Hispanics had similar H. pylori strains (vacA s1b,m1), and all Asian-Canadian children were infected by strains with vacA s1c genotype. No correlation between H. pylori strain and endoscopic or histopathologic abnormalities was found. This study provides a baseline framework of North American children and their H. pylori strains, serving as a powerful epidemiological tool for prospective investigations to better understand the transmission and evolution of diverse disease outcomes.
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