The Sensitivity of H. Pylori in Gastric Tissue Samples of Children and Adolescents to Various Antibiotics in Center of Iran

Authors

1 Assistant Professor, Pediatric Gastroenterology and Hepatology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non- communicable Disease, Isfahan University of Medical Sciences AND Department of Pediatrics, Children Imam-Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Department of Pediatrics, Children Imam-Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran AND Assistant Professor of Pediatric Infectious Disease, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non- communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

3 MSc of Biostatistics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non- communicable disease, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Associate Professor of Pediatric Gastroenterology and Hepatology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non- communicable Disease, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran AND Department of Pediatrics, Children Imam-Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Helicobacter pylori (H. pylori), is the major known infectious cause of gastric diseases in children and adults. The rate of antibiotic resistance to H. pylori treatment regimens has rapidly increased. We aimed to determine the sensitivity of helicobacter pylori in gastric tissue samples of children and adolescents to various antibiotics in Isfahan, Center of Iran.
Materials and Methods: Data set included children and adolescents, aged 5 to 16 years, who have been referred to Imam Hossein Children Hospital in Isfahan, Iran,over 2015 to 2018 due to dyspepsia symptoms. Endoscopy was advised by Pediatric gastroenterologist. Then, Rapid Urease Test (RUT), and one biopsy specimen from antrum, body, andcardia were given and placed into the transfer medium. If RUT became positive, transfer media was transported to the laboratory and keep under 4oC temperature till adding to culture media (Colombia agar- Germany) under special conditions. After appearance of H. pylori on culture media, antibiogram was done. We used Epsilometer test (E-test) to determineH. pylori sensitivity and resistance to antibiotics as clarithromycin, amoxicillin, metronidazole, tetracyclin, ciprofloxacin and levofloxacin.
Results: Out of 102 patients, E-test of H. pylori was positive in 47.1% (n=48) of patients. The highest susceptibility rate was 89.6 % for tetracycline, and 75% for levofloxacin, respectively. Metronidazole had the lowest susceptibility to H. pylori (14.6%). Also, the sensitivity of amoxicillin was low (43.8%).
Conclusion: In this study resistance to primary antibiotic therapy for H.pylori eradication (Amoxicillin, Metronidazole, and Clarithromicin) was relatively high in children and adolescents in Center of Iran. Thus, it seems updated treatment strategies based on susceptibility tests are required.

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