• Asthma
• Child
• Helicobacter pylori

• IMET2000-Pal

• Children
• Diagnosis
• Helicobacter pylori

• Gene expression level
• Helicobacter pylori
• Viable bacteria assay
• cgt gene

• Helicobacter pylori/genetics
• Helicobacter pylori/drug effects
• Helicobacter pylori/isolation & purification
• Clarithromycin/pharmacology
• Glucosyltransferases/genetics
• Anti-Bacterial Agents/pharmacology
• Drug Resistance, Bacterial/genetics
• Bacterial Proteins/genetics
• Microbial Sensitivity Tests
• Helicobacter Infections/microbiology
• Helicobacter Infections/drug therapy

• Helicobacter pylori
• bacteriophages
• biosensors
• diagnostic methods
• fluorescence in vivo hybridization
• histology
• molecular methods

• Humans
• Helicobacter pylori/genetics
• Sensitivity and Specificity
• Helicobacter Infections/diagnosis
• Urease
• Feces

• Helicobacter pylori
• gastritis
• immigrant
• peptic ulcer disease

• H. pylori
• antibiotics therapy
• children
• chronic gastritis
• diagnostics test

• Helicobacter pylori
• RT-PCR
• antimicrobial resistance
• laboratory diagnosis
• rapid urease test
• stool antigen test
• urea breath test

• Anti-Bacterial Agents/pharmacology
• Anti-Bacterial Agents/therapeutic use
• Breath Tests/methods
• Clinical Laboratory Techniques
• Drug Resistance, Bacterial
• Helicobacter Infections/complications
• Helicobacter Infections/diagnosis
• Helicobacter Infections/drug therapy
• Helicobacter pylori
• Humans
• Sensitivity and Specificity

• R01 DK062813 NIDDK NIH HHS
• MEXT | Japan Society for the Promotion of Science (JSPS)
• Ministry of Education, Culture, Sports, Science and Technology (MEXT)
• National Institutes of Health (NIH)
• Japan Agency for Medical Research and Development (AMED)
• Japan Agency for Medical Research and Development (AMED) and Japan International Cooperation Agency (JICA)

• Child
• H. pylori infection
• NODULAR gastritis

• Child
• Endoscopy, Gastrointestinal
• Female
• Gastritis/diagnosis
• Gastritis/epidemiology
• Gastritis/microbiology
• Helicobacter Infections/complications
• Helicobacter Infections/diagnosis
• Helicobacter Infections/epidemiology
• Helicobacter pylori
• Humans
• Male
• Retrospective Studies

Helicobacter pylori detection in asymptomatic children with suspected infection or with symptoms that suggest gastric pathology is problematic, since most of the methods depend on the endoscopic study, an invasive and expensive method. Non-invasive methods can be a feasible alternative but must be validated. The purpose of this study was to evaluate the concordance between H. pylori DNA detection in saliva and dental plaque by PCR, with antigen detection in stool by immunochromatography, among asymptomatic children in the state of Guerrero, Mexico.

Dental plaque, saliva, and stool samples were obtained from 171 children between 6 and 12 years old. H. pylori detection in saliva and dental plaque was performed by PCR using specific primers for the 16S rRNA gene, while the detection in stool samples was performed by immunochromatography using the CerTest kit.

We found an overall H. pylori prevalence of 59.6% (102/171). Of the H. pylori positive children 18% (20/111) were positive in saliva samples, 28.1% (34/121) in dental plaque samples, and 50.4% (71/141) in stool samples. A higher prevalence was found in girls (64.7%, p = 0.002). Although some of the children declared some dyspeptic symptoms, these were no related to H. pylori. In conclusion, we found a high prevalence of H. pylori in asymptomatic children and the highest proportion was detected by stool antigen test, which was the most feasible method to detect H. pylori infection.

• Children
• H. pylori
• Mexico
• Non-invasive methods
• Prevalence

Helicobacter pylori infection remains one of the most prevalent infections worldwide, especially in low-resource countries, and the major risk factor for peptic ulcer and gastric cancer. The “test-and-treat” strategy is recommended by several guidelines and consensus. The choice of testing method is based on patient age, presence of alarm signs and/or symptoms, use of non-steroidal anti-inflammatory drugs, as well as local availability, test reliability, and cost. Culture is the gold standard to detect H. pylori and, possibly, to perform susceptibility testing, however, it requires upper endoscopy and dedicated labs. Recent advances in molecular biology have provided new strategies in detecting infection and antimicrobial resistance without invasive tests. In this review we attempt to offer a comprehensive panorama on the new diagnostic tools and their potential use in clinical settings, in order to accomplish specific recommendations.

• Helicobacter pylori
• antibiotic resistance
• artificial intelligence
• molecular techniques
• testing

• Helicobacter pylori
• antibiotic resistance
• child
• eradication therapy
• gastric cancer

• Adolescent
• Amoxicillin/therapeutic use
• Anti-Bacterial Agents/therapeutic use
• Biopsy/methods
• Child
• Child, Preschool
• Clarithromycin/therapeutic use
• Delphi Technique
• Drug Resistance, Bacterial
• Drug Therapy, Combination
• Gastroenterology
• Helicobacter Infections/diagnosis
• Helicobacter Infections/drug therapy
• Helicobacter pylori/isolation & purification
• Humans
• Infant
• Japan
• Microbial Sensitivity Tests/methods
• Proton Pump Inhibitors/therapeutic use
• Stomach Neoplasms/epidemiology

• JSPGHAN

• H. pylori among children
• Sydney classification

• Bariatric surgery
• Esophagogastroduodenoscopy
• Laparoscopic sleeve gastrectomy
• Preoperative

• Bariatric Surgery
• Endoscopy, Digestive System
• Humans
• Obesity, Morbid/surgery
• Preoperative Care
• Prospective Studies
• Retrospective Studies

• Hamad Medical Corporation

• Helicobacter pylori
• Jordan
• children
• histology

• Bariatric
• Esophagogastroduodenoscopy
• Metanalysis
• Preoperative
• Systematic review

• H. pylori stool antigen test
• Helicobacter pylori
• Prevalence
• Taiwan

• Children
• Diagnosis
• Elderly
• Helicobacter pylori
• Treatment

• Environment
• Familial factors
• Invasive and non-invasive methods
• Life habits
• Prevalence

• Breath Tests
• Helicobacter Infections/diagnosis
• Helicobacter Infections/epidemiology
• Helicobacter pylori
• Humans
• Prevalence
• Risk Factors

The correlation between Helicobacter pylori (H. pylori) and gastroesophageal reflux disease (GERD) is complex. Some studies showed a protective role of H. pylori infection against GERD. This study was aimed at assessing the role of H. pylori infection in GERD utilizing a large cohort of patients diagnosed with GERD.

All patients who underwent gastroscopy for an indication of GERD during the study period between 2015 and 2017 at the EMMS Nazareth Hospital were considered eligible for the study and therefore were included. H. pylori infection was determined by the rapid urease test or histology. Severity of esophagitis was assessed using the Los Angeles classification. Univariate analysis was performed to figure out differences between patients according to H. pylori infection status. Multivariate regression analysis was conducted to illustrate the predictors of positivity for H. pylori infection.

2,508 GERD patients were included with a median age of 49.42 ± 17.96 years. H. pylori infection was detected in 299 (11.9%) patients. GERD patients with H. pylori infection were found to be younger (48.83 ± 17.42 years versus 44.57 ± 17.69 years, p < 0.001), have the tendency to smoke more (1406 (63.6%) versus 266 (89.0%), p < 0.001), and use more proton pump inhibitors or PPIs (1314 (59.5%) versus 242 (80.9%), p < 0.001). In multivariate regression analysis, age (OR 0.987, p < 0.001), smoking status (OR 0.190, p < 0.001), use of ASA/NSAIDs (OR 1.652, p = 0.004), and use of statins (OR 0.499 (95%CI 0.295-0.846), p = 0.010) were found significant among H. pylori-positive individuals. H. pylori-positive subjects have less severe esophagitis and more hiatus hernia.

Patients with GERD and H. pylori infection were significantly younger, tended to smoke more, and used more PPIs and had significantly lower grades of esophagitis compared to noninfected ones.

• Helicobacter pylori
• children
• diagnosis
• noninvasive
• stool antigen

• Children
• Diagnosis
• Helicobacter pylori

• iron deficiency anaemia
• prevalence
• recurrent abdominal pain
• treatment

• ELISA
• biopsy
• culture
• diagnosis
• histology
• rapid urease test

• Children
• Helicobacter pylori
• diagnostic methods

• Diagnosis
• Guideline
• Helicobacter pylori

• Antigens, Bacterial/analysis
• Breath Tests
• DNA, Bacterial/genetics
• DNA, Bacterial/metabolism
• Feces/chemistry
• Feces/microbiology
• Gastroscopy
• Helicobacter Infections/diagnosis
• Helicobacter Infections/microbiology
• Helicobacter Infections/pathology
• Helicobacter pylori/genetics
• Helicobacter pylori/immunology
• Helicobacter pylori/isolation & purification
• Humans

• CagA
• acquisition
• breast feeding
• developing countries
• epidemiology
• seroconversion
• serological diagnostic testing
• seroprevalence
• transmission

• Helicobacter pylori
• children
• cytotoxin-associated gene A
• enzyme immunoassay
• q-PCR
• stool samples

• Counseling
• Diagnosis
• Functional abdominal pain
• Functional gastrointestinal disorders
• Irritable bowel syndrome
• Management
• Treatment

• Abdominal Pain/etiology
• Abdominal Pain/therapy
• Child Psychiatry
• Gastrointestinal Diseases/diagnosis
• Gastrointestinal Diseases/physiopathology
• Humans
• Pediatrics
• Stress, Psychological/diagnosis

H. pylori in dental plaque was detected with a DNA biosensor with results correlating well with the ¹³C urea breath test.

• Helicobacter pylori
• Paediatric infections
• Reference methods
• Stool antigen test
• Upper gastrointestinal tract disease

• Crohn’s disease
• Developed countries
• Gastrointestinal infection
• H. pylori prevalence
• Hygiene hypothesis
• Incidence and prevalence

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children.

How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

• Children
• Diagnostic tests
• Epidemiology
• Helicobacter pylori.

• Children
• Epigastric pain
• Helicobacter pylori infection
• Sensitivity
• Specificity

The infection of Helicobacter pylori (H. pylori) is acquired in childhood and the prevalence vary greatly in different countries and regions. The study aimed to investigate the characteristics of H. pylori infection among children with gastrointestinal symptoms in Hangzhou, a representative city of eastern China.

A systematic surveillance of H. pylori infection according to the ¹³C-urea breath test was conducted from January 2007 to December 2014 in the Children’s hospital, Zhejiang University School of Medicine. The demographic information and main symptoms of every subject were recorded.

A total of 12,796 subjects were recruited and 18.6% children evaluated as H. pylori positive. The annual positive rates decreased from 2007 to 2014 (χ² = 20.461, p < 0.01). The positive rates were 14.8%, 20.2% and 25.8% in 3–6, 7–11 and 12–17 years age group respectively, which increased with age (χ² = 116.002, p < 0.01). And it was significantly higher in boys than girls (χ² = 15.090, p < 0.01). Multivariate logistic regression identified possible risk factors for H. pylori infection. Age, gender, gastrointestinal symptoms and history of H. pylori infected family member were all significantly associated with H. pylori infection (all p < 0.05).

H. pylori infection rates in children with gastrointestinal symptoms were lower than most of those reported in mainland China. Further studies are required to determine the prevalence in the general population. Comprehensively understanding of the characteristics and the possible risk factors of H. pylori infection will be helpful to its management strategies in children in China.

• 13C-urea breath test (13C-UBT)
• Age
• Children
• Gastrointestinal symptoms
• Gender
• Helicobacter pylori (H. pylori)

• Bleeding
• Diagnosis
• Eradication
• Gastrectomy
• Helicobacter pylori
• Invasive
• Noninvasive
• Oral specimen

• Child
• Diagnosis
• Endoscopy
• Helicobacter pylori
• Stool antigen test
• Urea breath test

The diagnosis of Helicobacter pylori (H. pylori) infection is usually based on the results of urease test and histology. The urease test known as a simple and cheap method does not need special skills to perform or to read the result. The time needed for the test to turn positive depends on the concentration of bacteria, and the accuracy is up to the density of H. pylori density in the biopsy sample, which is generally lower in children than adolescents and adults. Therefore, there are debates about the sensitivity of the urease test in children. The reason for lower sensitivity of the urease test in children was not identified, but might be related to the low density and patchy distribution of bacteria. In this review, we discuss the limitations of the urease test in children according to age, histology, number of biopsy samples, and biopsy site. In children under 5 years old, the differences in positivity rate when the urease test used one or three biopsy samples, and samples from the antrum or the gastric body, were larger than those in children aged 5-15 years. Thus, three or more biopsy samples from both the antrum and body would improve the sensitivity of H. pylori infection diagnosis in children under 5 years old.

• Helicobacter pylori infection
• Urease test
• Children

• Bleeding
• Diagnosis
• Eradication
• Gastrectomy
• Helicobacter pylori
• Invasive
• Noninvasive
• Oral specimen

• Antibodies, Bacterial/blood
• Antigens, Bacterial/analysis
• Bacteriological Techniques
• Biomarkers/blood
• Biopsy
• Breath Tests
• Endoscopy, Gastrointestinal
• Feces/microbiology
• Helicobacter Infections/diagnosis
• Helicobacter Infections/microbiology
• Helicobacter Infections/therapy
• Helicobacter pylori/genetics
• Helicobacter pylori/immunology
• Helicobacter pylori/isolation & purification
• Humans
• Molecular Diagnostic Techniques
• Predictive Value of Tests
• Prognosis
• Reproducibility of Results
• Serologic Tests

• clinical performance; Helicobacter pylori
• limit of detection
• loop-mediated isothermal amplification
• sensitivity
• stool antigen test

In developing countries, Helicobacter pylori (H. pylori) infection is mainly acquired during childhood and may be a predisposing factor for peptic ulcer or gastric cancer later in life. Noninvasive diagnostic tools are particularly useful in children for screening tests and epidemiological studies. Data on serologic testing of children are lacking. Accurate noninvasive tests for diagnosing Helicobacter pylori infection in children are strongly required.

The aim of this study was to evaluate the performance of a serological test (serum IgG antibody for H. pylori) in Egyptian children with recurrent abdominal pain necessitating endoscopy.

One hundred children, referred to the endoscopy unit at Mansoura University. Upper endoscopy was done for each with rapid urease test (RUT) and histological examination as the gold standard test for detection of H. pylori infection. Serum samples were collected for detecting IgG for H. pylori infection.

The mean age of the subjects included in the study was 7.23 ± 1.94 year. Serological test (IgG to H. pylori) was positive in 60% of all cases. A highly significant association between the standard test and the serological test at a cutoff > 10 U/ml at p = 0.001 were detected for the diagnosis of H. pylori infection. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the IgG antibody a cutoff > 10 U/ml, were 96.5%, 93%, 13.83, 0.038 respectively.

Serum IgG antibody to H. pylori infection has a high diagnostic value and can be considered as a suitable and reliable noninvasive test for detection of H. pylori infection.

• Egypt
• Helicobacter pylori
• children
• serologic test

AIM: To investigate the performance of the microcapillary culture method (MCM) in Helicobacter pylori (H. pylori) isolation and diagnosis.

METHODS: Microcapillary culture (MC), classical culture (CC), rapid urease (CLO) test, and histopathologic examination (HE) were performed with biopsy samples. Homogenized biopsy samples were loaded into capillary tubes and incubated for 48 h at 37 °C without providing a microaerophilic environment. Additionally, three or four loops of the homogenized sample were inoculated in a ready-to-use selective medium (Becton Dickinson, Helicobacter Agar, Modified) specific for the isolation of H. pylori and incubated at 37 °C in a microaerophilic atmosphere provided by CampyGen (Becton Dickinson, GasPack). Bacteria reproducing in microcapillary tubes were evaluated in an inverted microscope and also were evaluated after performing a CC with the content. Results obtained by CC, CLO test, and HE were compared with those of MC. The diagnostic performances of the methods used in this study were evaluated for specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and CI.

RESULTS: H. pylori was found positive by CLO test + HE and/or CC culture in 26 patient antrum and corpus biopsy samples. In 25 (25/26) patient biopsy samples, H. pylori was isolated by MCM, whereas in only 14 (14/26) patient biopsy samples, H. pylori was isolated by CC. CLO test and HE were found positive in 17 (17/26) patient biopsy samples. Comparing the results of the isolation of H. pylori by MCM, CC, CLO test, and HE, the sensitivity of the MCM was found as 96%, the specificity as 80%, the PPV as 83%, the NPV as 95%, and the 95%CI as 0.76 (χ² = 31.51, P < 0.01) whereas the sensitivity of the CC was found as 54% (χ² = 19.15, P < 0.01), and the sensitivity of the CLO test and HE were found as 65% (χ² = 25.26, P < 0.01).

CONCLUSION: This new microcapillary cultivation method for H. pylori has high diagnostic sensitivity compared with CC, HE, and CLO tests.

• Microcapillary culture
• Classical culture
• New method
• Isolation of Helicobacter pylori
• Comparison

• Bacteriological Techniques
• Biopsy
• Breath Tests
• Case-Control Studies
• Chi-Square Distribution
• Dyspepsia/diagnosis
• Dyspepsia/microbiology
• Helicobacter Infections/diagnosis
• Helicobacter Infections/microbiology
• Helicobacter pylori/growth & development
• Helicobacter pylori/isolation & purification
• Helicobacter pylori/metabolism
• Humans
• Predictive Value of Tests
• Reproducibility of Results
• Stomach/microbiology