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Updated: Jun 28, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
In French children, primary gastritis is more frequent than Helicobacter pylori gastritis
N Kalach1, S Papadopoulos, E Asmar
1Department of Pediatrics, Saint Antoine Paediatric Clinic, Saint Vincent de Paul Hospital, Catholic University of Lille, 59020 Lille Cedex, France. kalach.nicolas@ghicl.net
Insights
In symptomatic children, primary gastritis in the antrum and corpus is more common than Helicobacter pylori infection. Gastric atrophy and intestinal metaplasia are rare findings in pediatric endoscopy patients.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Infectious Diseases
Background:
- Symptomatic children undergoing upper gastrointestinal endoscopy require histological evaluation for upper gastrointestinal conditions.
- The updated Sydney classification provides a standardized framework for assessing gastric histology, including gastritis, activity, atrophy, intestinal metaplasia, and Helicobacter pylori (H. pylori).
Purpose of the Study:
- To analyze the histological characteristics of gastric biopsies in symptomatic children using the updated Sydney classification.
- To determine the prevalence of H. pylori infection and its association with histological findings in this pediatric population.
Main Methods:
- A 4-year retrospective descriptive study of 619 symptomatic children (median age 3.75 years) referred for upper gastrointestinal endoscopy.
- Six gastric biopsies were collected for histological analysis, direct examination, and H. pylori culture. H. pylori positivity was confirmed if at least two of three tests were positive.
Main Results:
- Only 10.66% of children tested positive for H. pylori.
- Histological gastritis was prevalent, detected in 53.95% (antrum) and 59.12% (corpus), predominantly mild (grade 1).
- H. pylori-positive children showed more significant gastritis and activity compared to H. pylori-negative children. Gastric atrophy and intestinal metaplasia were rare.
Conclusions:
- Primary antrum and corpus gastritis are significantly more frequent than H. pylori gastritis in French children presenting with symptoms.
- Histological gastritis and activity are typically mild in this pediatric cohort.
- Gastric atrophy and intestinal metaplasia are uncommon findings in symptomatic children undergoing endoscopy.
Abstract:
The aim of this study was to analyze the histological characteristics according to the updated Sydney classification (intensity of gastritis, degree of activity, gastric atrophy, intestinal metaplasia, and Helicobacter pylori) in symptomatic children referred for upper gastrointestinal endoscopy. A 4-year retrospective descriptive study was carried out in 619 children (282 females and 337 males), median age 3.75 years (15 days to 17.3 years) referred for endoscopy. Six gastric biopsies were done (three antrum and three corpus) for histological analysis (n = 4), direct examination and H. pylori culture (n = 2). H. pylori status was considered positive if at least two out of three tests were positive and negative if all three tests were negative. The results showed that only 66 children (10.66%) were H. pylori positive. Histological antral and corpus gastritis was detected in, respectively, 53.95% and 59.12% of all cases, most of them of mild grade 1. Antral and corpus activity was grade 1 in 18.57% and 20.03% of cases. H. pylori-positive versus H. pylori-negative children did differ in terms of moderate and marked histological gastritis and grade 2 or 3 activities. One girl had moderate gastric atrophy and another one moderate intestinal metaplasia, both being H. pylori negative. The findings indicate that primary antrum and corpus gastritis is 5.3 and 6.9 times, respectively, more frequent than H. pylori gastritis in French children, with usually mild histological gastritis and activity. Gastric atrophy and intestinal metaplasia are rare.
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