Helicobacter pylori Infection in Pediatric Patients Living in Europe: Results of the EuroPedHP Registry 2013 to 2016.

Autor: Kori M; Pediatric Gastroenterology, Kaplan Medical Centre, Rehovot, Israel., Le Thi TG; Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum of the Universtiy Munich, Munich, Germany., Werkstetter K; Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum of the Universtiy Munich, Munich, Germany., Sustmann A; Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum of the Universtiy Munich, Munich, Germany., Bontems P; Université Libre de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium., Lopes AI; Pediatrics Department, Gastroenterology Unit, Hospital Santa Maria, Medical Faculty, University of Lisbon., Oleastro M; Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal., Iwanczak B; Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland., Kalach N; Saint Antoine Pediatric clinic, Saint Vincent de Paul Hospital, Catholic University, Lille-France., Misak Z; Referral Centre for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia., Cabral J; Pediatric Gastroenterology Unit, Dona Estefânia Hospital, University Hospital Centre of Central Lisbon, Lisbon, Portugal., Homan M; Pediatric Gastroenterology Unit, Dona Estefânia Hospital, University Hospital Centre of Central Lisbon, Lisbon, Portugal., Cilleruelo Pascual ML; Department of Gastroenterology, Hepatology, and Nutrition, University Children's Hospital, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Pehlivanoglu E; Pediatrics Department, Gastroenterology Unit, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain., Casswall T; Department of Child health & development, Istanbul Kent University, Turkey., Urruzuno P; Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Clintec, Karolinska Institutet, Stockholm, Sweden., Martinez Gomez MJ; Pediatric Gastroenterology Unit. Hospital 12 de Octubre., Papadopoulou A; Gastroenterology and Nutrition Department, Niño Jesús University Children Hospital, Madrid, Spain., Roma E; Division of Pediatric Gastroenterology and Hepatology, First Department of Pediatrics, University of Athens, Athens Children's Hospital 'Agia Sofia', Athens, Greece., Dolinsek J; University Medical Centre Maribor, Department of Pediatrics, Gastroenterology, Hepatology and Nutrition Unit, Medical Faculty, Department of Pediatrics, University of Maribor, Maribor, Slovenia., Rogalidou M; Pediatrics Department & Pediatric Gastroenterology, University Hospital of Ioannina, Greece., Urbonas V; Clinic of Children's Diseases of Vilnius University Faculty of Medicine, Vilnius, Lithuania., Chong S; Queen Mary Hospital for Children, Epsom & St Helier NHS Trust, Carshalton, Surrey, UK., Kindermann A; Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Miele E; Department of Translational Medical Science, Section of Pediatrics, University of Naples 'Federico II', Italy., Rea F; Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, Rome, Italy., Cseh Á; First Department of Pediatrics, Semmelweis University, Budapest, Hungary., Koletzko S; Pediatric Gastroenterology, Kaplan Medical Centre, Rehovot, Israel.; Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU Klinikum of the Universtiy Munich, Munich, Germany.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2020 Oct; Vol. 71 (4), pp. 476-483.
DOI: 10.1097/MPG.0000000000002816
Abstrakt: Objectives: The aim of the study was to assess clinical presentation, endoscopic findings, antibiotic susceptibility and treatment success of Helicobacter pylori (H. pylori) infected pediatric patients.
Methods: Between 2013 and 2016, 23 pediatric hospitals from 17 countries prospectively submitted data on consecutive H. pylori-infected (culture positive) patients to the EuroPedHP-Registry.
Results: Of 1333 patients recruited (55.1% girls, median age 12.6 years), 1168 (87.6%) were therapy naïve (group A) and 165 (12.4%) had failed treatment (group B). Patients resided in North/Western (29.6%), Southern (34.1%) and Eastern Europe (23.0%), or Israel/Turkey (13.4%). Main indications for endoscopy were abdominal pain or dyspepsia (81.2%, 1078/1328). Antral nodularity was reported in 77.8% (1031/1326) of patients, gastric or duodenal ulcers and erosions in 5.1% and 12.8%, respectively. Primary resistance to clarithromycin (CLA) and metronidazole (MET) occurred in 25% and 21%, respectively, and increased after failed therapy. Bacterial strains were fully susceptible in 60.5% of group A, but in only 27.4% of group B. Primary CLA resistance was higher in Southern and Eastern Europe (adjusted odds ratio [ORadj] = 3.44, 95% confidence interval [CI] 2.22-5.32, P < 0.001 and 2.62, 95% CI: 1.63-4.22, P < 0.001, respectively) compared with Northern/Western Europe. Children born outside Europe showed higher primary MET resistance (ORadj = 3.81, 95% CI: 2.25-6.45, P < 0.001). Treatment success in group A reached only 79.8% (568/712) with 7 to 14 days triple therapy tailored to antibiotic susceptibility.
Conclusions: Peptic ulcers are rare in dyspeptic H. pylori-infected children. Primary resistance to CLA and MET is markedly dependent on geographical regions of birth and residence. The ongoing survey will show whether implementation of the updated ESPGHAN/NASPGHAN guidelines will improve the eradication success.
Databáze: MEDLINE
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