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Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance
Published on: July 28, 2023
[Epidemiologic and clinical aspects of Helicobacter pylori infection in children]
1Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. jtorresl@axtel.net
Insights
Helicobacter pylori (H. pylori) infection prevalence varies globally in children, with risk factors like socioeconomic status and household crowding. Further pediatric research is crucial for understanding its long-term effects and developing effective diagnostics and treatments.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori (H. pylori) prevalence in children shows significant global disparity, being lower in developed nations and higher in developing countries.
- Key risk factors for H. pylori infection in children include socioeconomic status, household crowding, ethnicity, and family member infection status.
- While H. pylori is linked to antral gastritis in children, its clinical significance and association with duodenal ulcers or recurrent abdominal pain remain unclear.
Purpose of the Study:
- To review the current understanding of Helicobacter pylori infection in children.
- To highlight knowledge gaps concerning risk factors, clinical manifestations, host response, and diagnostic methods in pediatric populations.
- To emphasize the need for further multicenter pediatric studies to elucidate the natural history and management of H. pylori infection in children.
Main Methods:
- Review of existing literature on H. pylori prevalence, risk factors, and clinical associations in children.
- Analysis of the host immune response to H. pylori infection in pediatric cases compared to adults.
- Discussion of the limitations of current diagnostic methods and the need for improved, non-invasive techniques for pediatric use.
Main Results:
- H. pylori infection in children is associated with chronic inflammatory changes in the gastric antrum but lacks specific symptoms.
- Pediatric H. pylori infections show a distinct inflammatory profile compared to adults, with fewer neutrophils.
- The role of virulence factors like cagA and vacA and the effectiveness of eradication treatments in children require further investigation.
Conclusions:
- Significant gaps exist in understanding H. pylori infection in children, necessitating further research.
- Development of sensitive, specific, and non-invasive diagnostic tools for pediatric H. pylori detection is essential.
- Consensus on eradication treatment criteria and the long-term impact of pediatric H. pylori infection requires robust multicenter studies.
Abstract:
Worldwide, H. pylori prevalence in children ranges from under 10% to almost 80%. Prevalence is low in developed countries; whereas high prevalence is observed in most developing countries. Documented risk factors for infection include socioeconomic status, household crowding, ethnicity, migration from high prevalence regions, and infection status of family members. H. pylori infection is not associated with specific symptoms in children; although it is consistently associated with antral gastritis, which clinical significance is unclear. H. pylori associated duodenal ulcers are seldom seen in children under 10 years of age. The role of the infection in recurrent abdominal pain is highly controversial. H. pylori-infected children demonstrate a chronic inflammatory cell infiltrate, with a lack neutrophils, as compared with the response observed in adults. The importance of virulence determinants such as cagA and vacA, described as relevant for disease during H. pylori infection, has not been extensively studied in children. Sensitive and specific methods for the detection of H. pylori in children are needed, especially in infant populations where the colonization is in its early phases. Non-invasive, cheap, and simple methods are needed for epidemiologic studies. There is no consensus about criteria for the use of eradication treatment in H. pylori-infected children. Multicenter pediatric studies are needed to solve the many unanswered question on the natural history of H. pylori infection in children, including identification of risk factors for infection, identification of prognostic indicators for the development of gastroduodenal disease later in life, and the host response to infection.
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