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Review: Helicobacter pylori infection in children
Ji-Hyun Seo1, Kristen Bortolin2, Nicola L Jones3
1Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea.
Insights
Helicobacter pylori infection in children presents unique challenges, with decreasing prevalence but rising antibiotic resistance. Research is crucial for effective pediatric management and understanding its impact on immunity and the microbiome.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori infection in children and adolescents has distinct epidemiological and clinical features compared to adults.
- Limited treatment options and increasing antibiotic resistance in pediatric populations necessitate further research.
- Understanding H. pylori pathogenesis in children is vital for optimal disease management.
Purpose of the Study:
- To review recent literature (April 2019-March 2020) on Helicobacter pylori infection in children and adolescents.
- To summarize findings on H. pylori epidemiology, host responses, and disease manifestations in the pediatric population.
- To highlight current research trends, including pathogenesis, microbiome interactions, and diagnostic recommendations.
Main Methods:
- Systematic review of publications from April 2019 to March 2020.
- Analysis of studies investigating H. pylori prevalence, immune responses, and gut microbiome.
- Evaluation of research on diagnostic strategies and treatment outcomes in pediatric H. pylori infection.
Main Results:
- Recent studies indicate a declining prevalence of H. pylori infection in pediatric populations, mirroring adult trends.
- Research explored serum immune responses and a potential inverse relationship between H. pylori infection and allergies.
- The impact of H. pylori and associated inflammation on the gut microbiome was a significant area of investigation.
Conclusions:
- Endoscopy-based testing is recommended for symptom evaluation, with noninvasive tests reserved for post-eradication follow-up.
- Continued research is essential to address the challenges of H. pylori management in children, including antibiotic resistance.
- The review underscores the importance of understanding H. pylori's complex interactions with the pediatric host and microbiome.
Abstract:
Helicobacter pylori infection in children and adolescents differs in comparison to adults with respect to epidemiology, host responses, and disease manifestations. Furthermore, treatment options are limited in this population and antibiotic resistance rates continue to increase. Therefore, ongoing research is vital to understand disease pathogenesis and provide optimal management of children with infection. This review summarizes relevant publications from April 2019 to March 2020. Similar to adults, recent studies show a decreasing prevalence of infection in the pediatric population. Studies of pathogenesis investigated serum immune responses and the potential inverse association of infection and allergy. Several studies investigated the effect of H pylori and related inflammation on the gut microbiome. The recommendation of endoscopy-based testing to identify the cause of symptoms and not just H pylori, reserving noninvasive UBT or stool antigen tests for post-eradication follow-up, was supported by the current literature.
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