Helicobacter-pylori-Infektion

Zusammenfassung

Infektionen mit Helicobacter pylori zählen zu den häufigsten chronischen bakteriellen Infektionen bei Menschen. Es zeigen sich deutliche geografische Unterschiede in der Prävalenz. In den westlichen Industrienationen nimmt die Infektionsrate seit den letzten Jahrzehnten ab. Die Infektion mit H. pylori erfolgt meist in der ersten Lebensdekade. Die Infektion kann lebenslang persistieren, wenn keine antibiotische Eradikation erfolgt. H.-pylori-Infektionen können diverse Erkrankungen hervorrufen, dazu gehören das Ulkus ventrikuli, Ulkus duodeni, das Magenkarzinom und das Lymphom des Mukosa-assoziierten lymphatischen Gewebes (MALT-Lymphom). Die Gefahr der malignen Entartung ist bei Kindern wesentlich geringer als bei Erwachsenen. Ein großes Problem stellen die zunehmenden Antibiotikaresistenzen dar. Daher sollte die Therapie möglichst immer nach Sensibilitätstestung erfolgen. Eine Eradikationskontrolle mittels non-invasiver Testung empfiehlt sich binnen vier bis acht Wochen nach Therapieende.

Summary

Helicobacter pylori belongs to the most common causes of chronic bacterial infections in humans. There are clear geographical differences in prevalence. In the western countries the rate of infections decreased during the last decades. An infection with H. pylori is acquired mostly before the age of 10 years. It can persist lifelong if untreated with adequate antibiotics. Infection with H. pylori causes a variety of diseases such as ventricular and duodenal ulcer, carcinoma of the stomach and mucosa associated lymphoid tissue (MALT) lymphoma. However, the risk for these malignancies is much lower in children compared to adults. An upcoming problem is the increase of antibiotic resistance of H. pylori. So a therapy should be based on prior testing for antibiotic susceptibility. A reliable non-invasive test for eradication should be performed four to eight weeks following completion of therapy.

Schlüsselwörter

Helicobacter pylori - Infektion

Keywords

Helicobacter pylori - infection

• Literatur

• 1 Pacifico L, Anania C, Osborn JF. et al Consequences of Helicobacter pylori infection in children. World J Gastroenterol 2010; 16: 5181-5194.
• 2 Spee LA, Madderom MB, Pijpers M. et al Association between helicobacter pylori and gastrointestinal symptoms in children. Pediatrics 2010; 125: e651-669.
• 3 Fischbach W, Malfertheiner P, Hoffmann JC. et al Helicobacter pylori and gastroduodenal ulcer disease. Dtsch Arztebl Int 2009; 106: 801-808.
• 4 Koletzko S, Jones NL, Goodman KJ. et al Evidencebased guidelines from ESPGHAN and NASPGHAN for helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2011; 53: 230-243.
• 5 Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984; 1: 1311-1315.
• 6 Goodwin CS, Worsley BW. Microbiology of Helicobacter pylori. Gastroenterol Clin North Am1993 (022) 5-19.
• 7 Mobley HL. The role of Helicobacter pylori urease in the pathogenesis of gastritis and peptic ulceration. Aliment Pharmacol Ther 1996; 10 (Suppl. 01) (Suppl) 57-64.
• 8 Weeks DL, Eskandari S, Scott DR, Sachs G. A H+-gated urea channel: the link between Helicobacter pylori urease and gastric colonization. Science 2000; 287: 482-485.
• 9 Mobley HL. Defining Helicobacter pylori as a pathogen: strain heterogeneity and virulence. Am J Med 1996; 100 (05) A 2S-9S. discussion 9S-11S
• 10 Logan RP. Adherence of Helicobacter pylori. Aliment Pharmacol Ther 1996; 10 (Suppl. 01) (Suppl) 3-15.
• 11 Grimm W, Fischbach W. Helicobacter pylori infection in children and juveniles: an epidemiological study on prevalence, socio-economic factors and symptoms. Dtsch Med Wochenschr 2003; 128: 1878-1883.
• 12 Brenner H, Weyermann M, Rothenbacher D. Clustering of Helicobacter pylori infection in couples: differences between highand low-prevalence population groups. Ann Epidemiol 2006; 16: 516-520.
• 13 Porsch-Ozcurumez M, Doppl W, Hardt PD. et al Impact of migration on Helicobacter pylori seroprevalence in the offspring of Turkish immigrants in Germany. Turk J Pediatr 2003; 45: 203-208.
• 14 Tkachenko MA, Zhannat NZ, Erman LV. et al Dramatic changes in the prevalence of Helicobacter pylori infection during childhood: a 10-year follow-up study in Russia. J Pediatr Gastroenterol Nutr 2007; 45: 428-432.
• 15 Goodman KJ, Correa P. Transmission of Helicobacter pylori among siblings. Lancet 2000; 355: 358-362.
• 16 Graham DY, Malaty HM, Evans DG. et al Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology 1991; 100: 1495-1501.
• 17 Malaty HM, Graham DY, Isaksson I. et al Co-twin study of the effect of environment and dietary elements on acquisition of Helicobacter pylori infection. Am J Epidemiol 1998; 148: 793-797.
• 18 Rowland M, Daly L, Vaughan M. et al Age-specific incidence of Helicobacter pylori. Gastroenterology 2006; 130: 65-72. quiz 211
• 19 Koletzko S, Richy F, Bontems P. et al Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe. Gut 2006; 55: 1711-1716.
• 20 Ashorn M, Rago T, Kokkonen J. et al Symptomatic response to Helicobacter pylori eradication in children with recurrent abdominal pain: double blind randomized placebo-controlled trial. J Clin Gastroenterol 2004; 38: 646-650.
• 21 Crone J, Granditsch G, Huber WD. et al Helicobacter pylori in children and adolescents: increase of primary clarithromycin resistance, 1997-2000. J Pediatr Gastroenterol Nutr 2003; 36: 368-371.
• 22 Schwarzer A, Urruzuno P, Iwanczak B. et al New effective treatment regimen for children infected with a double-resistant Helicobacter pylori strain. J Pediatr Gastroenterol Nutr 2011; 52: 424-428.