J Pediatr Infect Dis 2007; 02(03): 135-139
DOI: 10.1055/s-0035-1557038
Original Article
Georg Thieme Verlag KG Stuttgart – New York

Helicobacter pylori infection in children: Utility of culture in diagnosis and study of resistance to metronidazole, clarithromycin and amoxicillin

Marta Argentieri
a  Microbiology Laboratory "Bambino Gesù", Pediatric Hospital, Rome, Italy
,
Tamara Sabbi
b  Pediatric Unit Belcolle Hospital, Viterbo, Rome, Italy
,
Laura Pansani
a  Microbiology Laboratory "Bambino Gesù", Pediatric Hospital, Rome, Italy
,
Filippo Torroni
c  Digestive Surgery and Endoscopic Unit, "Bambino Gesù", Pediatric Hospital, Rome, Italy
,
Paola Francalanci
d  Department of Pathology "Bambino Gesù" Pediatric Hospital, Rome, Italy
,
Paola De Angelis
c  Digestive Surgery and Endoscopic Unit, "Bambino Gesù", Pediatric Hospital, Rome, Italy
,
Luigi Dall'Oglio
c  Digestive Surgery and Endoscopic Unit, "Bambino Gesù", Pediatric Hospital, Rome, Italy
,
Donato Menichella
a  Microbiology Laboratory "Bambino Gesù", Pediatric Hospital, Rome, Italy
› Institutsangaben

Verantwortlicher Herausgeber dieser Rubrik:
Weitere Informationen

Publikationsverlauf

20. November 2006

23. April 2007

Publikationsdatum:
28. Juli 2015 (online)

Abstract

Resistance to antibiotics frequently used to treat Helicobacter pylori infection is one of the most important factors in treatment failure. The aims of this study were to determine the accuracy of culture and other invasive and non-invasive tests for diagnosis of H. pylori infection in children, using histological examination as the gold standard, and to evaluate rates of resistance to metronidazole, clarithromycin and amoxicillin. Between March 2003 and December 2004, gastric biopsies from 215 children were tested by histological examination, a rapid urease test and culture. In addition, stool samples were obtained from all children for H. pylori antigen testing. Sixty-four (30%) patients were positive for H. pylori by histological examination. The H. pylori fecal antigen test revealed a sensitivity of 57.8%, a specificity of 93.4%, a positive predictive value of 78.7% and a negative predictive value of 83.9%; rapid urease test had a sensitivity of 70.3%, a specificity of 94.7%, and positive and negative predictive values of 83.3% and 88.2%; culture had a sensitivity of 90.6%, a specificity of 100%, and positive and negative predictive values of 100% and 96.2%. All positive cultures were tested for susceptibility to amoxicillin, metronidazole and clarithromycin by the E-test method. Resistance rates to clarithromycin and metronidazole were 20.7% and 27.6% respectively; no resistance to amoxicillin was observed. This study confirms the place of histological examination as the definitive test for H. pylori, and shows the importance of H. pylori culture in allowing evaluation of antibiotic resistance profiles in pediatric patients.