Τίτλος:
Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
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.
Λέξεις-κλειδιά:
amoxicillin; clarithromycin; metronidazole, antibiotic resistance; antibiotic sensitivity; article; child; clinical trial; controlled clinical trial; controlled study; Europe; female; gastritis; Helicobacter infection; Helicobacter pylori; human; major clinical study; male; multicenter study; peptic ulcer; priority journal; risk factor; treatment failure, Adolescent; Age Distribution; Amoxicillin; Anti-Infective Agents; Child; Child, Preschool; Clarithromycin; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Europe; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Peptic Ulcer; Prospective Studies; Sex Distribution; Treatment Failure
DOI:
10.1136/gut.2006.091272
