Pattern of Primary Resistance of <i>Helicobacter pylori</i> to Clarithromycin among Pediatric Patients from North-Eastern Romania

• Main Authors: Oana-Maria Rosu (Author), Nicoleta Gimiga (Author), Roxana Popescu (Author), Ileana Ioniuc (Author), Carmen Daniela Rusu (Author), Tatiana Clipa (Author), Diana-Maria Florea (Author), Doina-Anca Pleșca (Author), Alexandru Nemtoi (Author), Elena Tataranu (Author), Gabriela Stefanescu (Author), Smaranda Diaconescu (Author)
• Format: Book
• Published: MDPI AG, 2023-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: <i>Helicobacter pylori</i> antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with <i>Helicobacter pylori</i> by gastric biopsy. Methods: We studied 84 positive gastric samples for <i>Helicobacter pylori</i>. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. Results: Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6-17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. Conclusions: One in 2.4 children infected with <i>Helicobacter pylori</i> had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.

Item Description

10.3390/children10111752
2227-9067