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Updated: Feb 28, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Helicobacterpylori Infection and Antimicrobial Resistance Surveillance over 25 Years in Children in Gipuzkoa,
Itsaso Jimenez1, Iñigo Ansa1, Pedro Vallejo2
1Microbiology Department, Donostia University Hospital, Osakidetza Basque Health Service, Paseo Dr Beguiristain s/n, 20014 San Sebastián, Gipuzkoa, Spain.
Insights
Helicobacter pylori infection in children is a growing concern due to rising antibiotic resistance. This study found high primary resistance to clarithromycin and metronidazole in pediatric H. pylori cases, necessitating targeted treatment strategies.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Public Health
Background:
- * Helicobacter pylori infection is a significant global health issue in children.
- * Antibiotic resistance in H. pylori is an increasing concern, particularly in developed nations.
- * Understanding resistance patterns is crucial for effective pediatric treatment.
Purpose of the Study:
- * To analyze H. pylori infections in children under 15 in Gipuzkoa, Spain, over 25 years.
- * To describe primary and secondary antimicrobial resistance patterns.
- * To evaluate diagnostic and treatment outcomes for pediatric H. pylori.
Main Methods:
- * Retrospective review of diagnostic tests (urea breath test, biopsy culture, string test, stool antigen) from 2000-2024.
- * Antimicrobial susceptibility testing using the E-test gradient diffusion method on H. pylori isolates.
- * Analysis of infection rates, eradication control, and resistance profiles.
Main Results:
- * 26.9% of 2855 children investigated were infected with H. pylori.
- * All isolates were sensitive to amoxicillin and tetracyclines.
- * High primary resistance observed: clarithromycin (28.9%), metronidazole (19.4%), levofloxacin (8.9%). Secondary resistance was also significant.
Conclusions:
- * H. pylori infection remains a challenge in pediatric patients.
- * High observed resistance to clarithromycin and metronidazole underscores the need for susceptibility monitoring.
- * Targeted treatment approaches are essential for successful H. pylori eradication in children.
Abstract:
The diagnosis and treatment of Helicobacter pylori infection in children represent a major public health problem worldwide, and although prevalence in developed countries has declined, concern about antibiotic resistance continues to grow. This retrospective study aimed to analyze H. pylori infections in children under 15 years of age in Gipuzkoa (Basque Country, Spain) over a 25-year period and to describe patterns of primary and secondary antimicrobial resistance. All diagnostic tests received at a tertiary referral hospital between 2000 and 2024 were reviewed: urea breath test, gastric biopsy culture, string test, and stool antigen detection. Antimicrobial susceptibility testing was performed using the E-test gradient diffusion method. Out of 2855 children investigated, 26.9 were infected with H. pylori. Eradication control was performed in 62.5% (n = 480) of cases. Antimicrobial susceptibility testing was achieved in 96.5% out of the 400 isolates studied. All isolates were sensitive to amoxicillin and tetracyclines. Primary resistance to clarithromycin, metronidazole, and levofloxacin was 28.9%, 19.4%, and 8.9%, respectively, and secondary resistance was 38.7%, 29.7%, and 5.9%, respectively. H.pylori infection remains a challenge in pediatric patients, and the high resistance observed to clarithromycin and metronidazole makes it necessary to monitor the susceptibility of H.pylori and confirms the need for targeted treatment.
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