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Increased Antibiotic Resistance in Children with Helicobacter pylori Infection: A Retrospective Study
Luca Helmbold1, Beniam Ghebremedhin2, Aliyah Bellm3
1Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany.
Insights
Children with recurrent abdominal pain may have Helicobacter pylori (HP) infection. High rates of antibiotic resistance to amoxicillin, clarithromycin, and metronidazole were found, potentially impacting treatment success.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Recurrent abdominal pain in children can indicate Helicobacter pylori (HP) infection.
- Diagnosis typically involves esophagogastroduodenoscopy (EGD) with histological and microbiological analysis.
- Understanding antibiotic resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To analyze HP positive cultures and antibiograms in pediatric patients.
- To correlate microbiological findings with clinical and histopathological data.
- To assess antibiotic resistance prevalence in HP isolates from children.
Main Methods:
- Retrospective analysis of data from 124 children undergoing EGD.
- Collection and analysis of HP cultures and antibiograms.
- Evaluation of clinical symptoms and histopathological findings.
Main Results:
- HP gastritis diagnosed in 54% of patients.
- High prevalence of antibiotic resistance: 40% resistant to at least one antibiotic.
- Specific resistances noted: amoxicillin (20%), clarithromycin (45%), metronidazole (59%).
- 16% of isolates showed resistance to two or more antibiotics.
Conclusions:
- Remarkably high antibiotic resistance rates to amoxicillin, metronidazole, and clarithromycin in the study cohort.
- Increased multi-antibiotic resistance in HP-infected children.
- Antibiotic resistance may negatively impact HP eradication therapy outcomes.
Abstract:
Children with recurrent abdominal pain may be suffering from a Helicobacterpylori (HP) infection. The gold standard for confirming HP gastritis is histological evaluation and microbiological tests performed on specimens collected by esophagogastroduodenoscopy (EGD). The aim of this study was to analyze HP positive cultures and antibiograms with regard to clinical and histopathological correlates. The data of 124 subjects with frequent gastrointestinal symptoms who underwent an EGD were retrospectively collected and analyzed. The mean age of the patients was 13 ± 3.6 years. The most frequent complaints were epigastric pain (84%; n = 100/119) and dyspepsia (79%; n = 94/119). HP gastritis was diagnosed in 54% (n = 67). Interestingly, 40% (n = 49) of the isolates were resistant to at least one antibiotic: amoxicillin (20%; n = 10/49), clarithromycin (45%; n = 22/49), or metronidazole (59%; n = 29/49). Isolates were resistant to two or more antibiotics in 16% (n = 20) of cases. In conclusion, we revealed remarkably high resistance rates to amoxicillin, metronidazole, and clarithromycin in our cohort. The presence of antibiotic resistance to more than one antibiotic was substantially increased in our HP-infected patients and this may negatively affect eradication treatment.
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