Review: Helicobacter pylori infection in paediatrics

Abstract

The prevalence of Helicobacter pylori infection in children and adults is still decreasing in many countries but remains very high in countries like Vietnam, where more than 80% of school-aged children are contaminated. Additional reports on the potential role of the infection in some extra-intestinal diseases have been published. Interesting associations are underlined, but causality is difficult to prove. Antimicrobial resistance rates continue to increase in many countries, especially the frequency of multidrug resistance. Different publications report an increasing rate of resistance of Helicobacter pylori to amoxicillin, but some additional proof is needed, particularly whole genome sequencing of these strains to characterize them better. This would threaten the possibility of eradication in children in the future, and adequate stewardship of antibiotic use is urgently needed. When tailored to antimicrobial susceptibility, triple therapies for 14 days perform very well – an eradication rate of 90% has been reached in a multicenter registry with data collected within Europe. However, the same treatments seem less efficient in other regions. Finally, eradication could be improved if the regimen is tailored to genotypic methods (PCR-based) instead of phenotypic (culture-based) susceptibility profiles.

Keywords

• h. pylori
• children
• epidemiology
• diagnosis
• treatment.