The Prevalence of Helicobacter pylori Infection in Symptomatic Children: A 13-Year Observational Study in the Lower Silesian Region

BACKGROUND: Helicobacter pylori (H. pylori) infection is very common worldwide, with varying frequency. According to data from epidemiological reports, a third of the population of children in Poland are infected with H. pylori before the age of 18. In recent years, a decrease in the incidence of H. pylori infection in both children and adults has been observed in many countries. OBJECTIVES: The aim of the study was to assess the prevalence H. pylori and non-helicobacter pylori helicobacter (NHPH) infection in symptomatic children from 2000 to 2013, and to analyze the resistance of H. pylori strains to antibiotics over the 13-year study period. MATERIAL AND METHODS: The retrospective analysis was based on the results of cultures for H. pylori in 8661 untreated children undergoing their first upper gastroduodenal endoscopy because of clinical symptoms such as chronic abdominal pain/distress, epigastric pain, nausea or vomiting. Drug sensitivity to three antibiotics - amoxicillin (AM), clarithromycin (CH) and metronidazole (MZ) - was determined by the gradient diffusion method (E-test). RESULTS: Overall, among 8661 cultures analyzed, 16.05% were positive for H. pylori. The highest prevalence of infection was found in the year 2000 (23.06%) and the lowest in the year 2010 (8.90%). The prevalence of NHPH infection was low (0.2%). A three-fold increase in the number of strains resistant to both CH and MZ was noted, from 7.9% to about 22.7%. All strains were susceptible to AM. CONCLUSIONS: There has been a decline in the prevalence of H. pylori infection in symptomatic children, but this infection is still a common cause of upper gastrointestinal tract symptoms in children treated at the authors' center. Primary antibiotic resistance of H. pylori increased over the period analyzed, but primary resistance to metronidazole declined.