Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe. Issue 12 (7th April 2006)

• Record Type: Journal Article
• Authors: Koletzko, S; Richy, F; Bontems, P; Crone, J; Kalach, N; Monteiro, M L; Gottrand, F; Celinska-Cedro, D; Roma-Giannikou, E; Orderda, G; Kolacek, S; Urruzuno, P; Martínez-Gómez, M J; Casswall, T; Ashorn, M; Bodanszky, H; Mégraud, F
• Other Names: group-author.
• Is Part Of: Gut. Volume 55:Issue 12(2006)
• Page Start: 1711
• Page End: 1716
• Publication Date: 2006-04-07
• Subjects: MIC, minimal inhibitory concentration; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2006.091272
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Aim: To prospectively assess the antibacterial resistance rate in Helicobacter pylori strains obtained from symptomatic children in Europe. Methods: During a 4-year period, 17 paediatric centres from 14 European countries reported prospectively on patients infected with H pylori, for whom antibiotic susceptibility was tested. Results: A total of 1233 patients were reported from Northern (3%), Western (70%), Eastern (9%) and Southern Europe (18%); 41% originated from outside Europe as indicated by mother's birth-country; 13% were <6 years of age, 43% 6–11 years of age and 44% >11 years of age. Testing was carried out before the first treatment (group A, n = 1037), and after treatment failure (group B, n = 196). Overall resistance to clarithromycin was detected in 24% (mean, A: 20%, B: 42%). The primary clarithromycin resistance rate was higher in boys (odds ratio (OR) 1.58; 1.12 to 2.24, p = 0.01), in children <6 years compared with >12 years (OR 1.82, 1.10 to 3.03, p = 0.020) and in patients living in Southern Europe compared with those living in Northern Europe (OR 2.25; 1.52 to 3.30, p<0.001). Overall resistance rate to metronidazole was 25% (A: 23%, B: 35%) and higher in children born outside Europe (A: adjusted. OR 2.42, 95% CI: 1.61 to 3.66, p<0.001). Resistance to both antibiotics occurred in 6.9% (A: 5.3%, B: 15.3%). Resistance to amoxicillin was exceptional (0.6%). Children with peptic ulcer disease (80/1180, 6.8%) were older than patients without ulcer (p = 0.001). Conclusion: The primary resistance rate of H pylori strains obtained from unselected children in Europe is high. The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance.