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Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Total family unit Helicobacter pylori eradication and pediatric re-infection rates
Stephen Farrell1, Irene Milliken, Gary M Doherty
1Department of Child Health, Institute of Clinical Science, Queen's University Belfast, UK. s.farrell@qub.ac.uk
Insights
Eradicating Helicobacter pylori from an entire family did not significantly reduce childhood re-infection rates. Treating only the infected child is as effective as treating the whole family for preventing H. pylori re-infection.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Family Medicine
Background:
- Helicobacter pylori re-infection is more common in children than adults.
- The family unit is implicated in primary childhood H. pylori infection.
- The role of family in pediatric H. pylori re-infection is unclear.
Purpose of the Study:
- To investigate if the family unit influences pediatric H. pylori re-infection.
- To determine if eradicating H. pylori from the entire family reduces childhood re-infection risk.
Main Methods:
- Fifty families with an H. pylori-infected child were recruited.
- All family members underwent 13C-urea breath tests.
- Families were randomized to either treat the entire family or only the index child.
Main Results:
- Long-term follow-up (mean 62.2 months) showed low re-infection rates in both groups.
- Re-infection occurred in three children in the 'index case treatment' group versus one in the 'family unit treatment' group.
- Re-infection rates were 2.4% per patient per year (index case treatment) and 0.7% per patient per year (family unit treatment), p = .31.
Conclusions:
- This is the first study to assess H. pylori eradication in the entire family unit for pediatric re-infection.
- The study reports the longest follow-up period for pediatric H. pylori re-infection.
- Family unit H. pylori eradication does not significantly reduce re-infection rates in children.
Background:
Re-infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re-infection and if eradication of H. pylori from the entire family reduces the risk of childhood re-infection.
Methods:
Fifty families, each with an H. pylori-infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a 'family unit treatment' group (all infected family members treated) or an 'index case treatment' group (index case only treated).
Results:
At long-term follow-up (mean 62.2 months), there were three re-infected children in the 'index case treatment' group compared with one in the 'family unit treatment' group. The re-infection rate was 2.4% per patient per year in the 'index case treatment' group and 0.7% per patient per year in the 'family unit treatment' group (p = .31).
Conclusions:
This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re-infection rates and reports the longest period of re-infection follow-up in children. In childhood, re-infection with H. pylori is not significantly reduced by family unit H. pylori eradication.
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