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Updated: Oct 17, 2025
Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Helicobacter pylori and the intestinal microbiome among healthy school-age children
Yelena Lapidot1, Leah Reshef2, Dani Cohen1
1The Sackler Faculty of Medicine, Department of Epidemiology and Preventive Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel.
Insights
Helicobacter pylori (H. pylori) infection in children is linked to changes in gut bacteria composition, not richness. Socioeconomic status also significantly impacts the gut microbiome in children.
Area of Science:
- Pediatric Gastroenterology
- Microbiome Research
- Infectious Diseases
Background:
- Helicobacter pylori (H. pylori) infection, common in childhood, leads to chronic gastritis and alters gastric microbiota.
- While H. pylori's effects on the stomach are known, its impact on the gut microbiome in asymptomatic children is not well understood.
Purpose of the Study:
- To investigate the association between H. pylori infection and the intestinal microbiome in healthy children.
- To account for interpersonal and environmental factors influencing the gut microbiome.
Main Methods:
- Cross-sectional study of 163 Israeli Arab children (aged 6-9 years) from diverse socioeconomic backgrounds.
- H. pylori infection diagnosed via stool antigen test.
- Gut microbiome analyzed using 16S rRNA gene sequencing (V4 region) with multivariate analysis.
Main Results:
- H. pylori infection detected in 57% of participants, significantly associated with lower socioeconomic status.
- No significant link found between H. pylori infection and fecal bacterial richness.
- H. pylori infection significantly altered intestinal bacterial composition, notably associated with Prevotella copri and Eubacterium biforme.
Conclusions:
- H. pylori infection in children is associated with a modified intestinal microbiome structure.
- Socioeconomic status is a major determinant influencing both H. pylori infection and gut microbiome composition in childhood.
- Findings highlight the clinical importance of H. pylori and gut microbes in pediatric health and disease.
Background:
Helicobacter pylori (H. pylori) infection is acquired during childhood and causes chronic gastritis that remains asymptomatic in most infected people. H. pylori alters the gastric microbiota and causes peptic ulcer disease. Evidence on the relationship between asymptomatic H. pylori infection and children's gut microbiota remains elusive.
Aim:
We characterized the relationship between H. pylori infection and the intestinal microbiome of healthy children, adjusting for known inter-personal and environmental exposures.
Materials And Methods:
This cross-sectional study included stool samples obtained from 163 Israeli Arab children aged 6-9 years from different socioeconomic strata. Sociodemographic information was collected through maternal interviews. H. pylori infection was determined using monoclonal antigen detection stool enzyme immunoassay. The gut microbiome was characterized by implementing 16S rRNA gene sequencing of the V4 region and a multivariate downstream analysis.
Results:
Overall, 57% of the participants were positive for H. pylori infection and it was significantly associated with low socioeconomic status. There was no significant association between H. pylori infection and bacterial richness of fecal microbiome. H. pylori infection was significantly associated with intestinal bacterial composition, including a strong association with Prevotella copri and Eubacterium biforme. Moreover, socioeconomic status was strongly associated with bacterial composition.
Discussion And Conclusions:
H. pylori infection in healthy children was significantly associated with altered intestinal microbiome structure. Socioeconomic determinants exhibit a strong effect, related to both H. pylori infection and intestinal diversity and composition in childhood. These findings are clinically important to the understanding of the role of H. pylori infection and other intestinal microbes in health and disease.
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