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Time trend prevalence of helicobacter pylori infection and endoscopic findings in symptomatic children in Portugal: A retrospective study based on three time points in 2009, 2014, and 2019

2023-03-10Journal article Restricted access
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dc.contributor.authorAntunes, Raquel
dc.contributor.authorOleastro, Monica
dc.contributor.authorNogueira, João Paulo
dc.contributor.authorLopes, Ana Isabel
dc.date.accessioned2024-01-24T16:41:03Z
dc.date.available2024-01-24T16:41:03Z
dc.date.issued2023-03-10
dc.description.abstractBackground: Helicobacter pylori infection acquisition occurs mainly in childhood and may be a critical factor in developing long-term complications. In contrast to other developed countries, previous studies have reported a relatively high H. pylori infection prevalence in Portugal, both in children and adults. However, there are no recent data concerning pediatric population. Materials and Methods: We performed a retrospective observational study concerning an 11 years period (2009, 2014, 2019), that included patients under 18 years old who underwent upper endoscopy at a pediatric tertiary center. Demographic, clinical-pathological, and microbiological data were collected. Results: Four hundred and sixty one children were included. The average age was 11.7 ± 4.4 years. In total, H. pylori infection was confirmed in 37.3% of cases (histology and/or culture) and a decreasing infection trend was observed (p = .027). The most common indication for endoscopy was abdominal pain, which was a good predictor of infection. Antral nodularity was present in 72.2% of the infected children (p < .001). In the oldest age groups, moderate/severe chronic inflammation, H. pylori density and lymphoid aggregates/follicles were positive predictors for the presence of antral nodularity. For all ages, the presence of antral nodularity, neutrophilic activity in the antrum and corpus and lymphoid follicles/aggregates in the antrum were positive predictors for the presence of H. pylori infection. Among the 139 strains tested for antibiotic susceptibility, 48.9% were susceptible to all tested antibiotics. Resistance to clarithromycin, metronidazole, and both was detected in 23.0%, 12.9%, and 6.5% of the strains, respectively; furthermore, resistance to ciprofloxacin and to amoxicillin was observed in 5.0% and 1.4% of the strains, respectively. Conclusions: The present study reports (for the first time in Portugal) a significant decreasing trend in the prevalence of pediatric H. pylori infection, although it remains relatively high compared to the recently reported prevalence in other South European countries. We confirmed a previously recognized positive association ofsome endoscopic and histological features with H. pylori infection, as well as a high prevalence rate of resistance to clarithromycin and to metronidazole. The clinical relevance of these findings requires confirmation with further studies at a national level, taking into account the high incidence rate of gastric cancer in Portugal and the potential need for country-specific intervention strategies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHelicobacter. 2023 Aug;28(4):e12963. doi: 10.1111/hel.12963. Epub 2023 Mar 10.pt_PT
dc.identifier.doi10.1111/hel.12963pt_PT
dc.identifier.issn1083-4389
dc.identifier.urihttp://hdl.handle.net/10400.18/8974
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/doi/10.1111/hel.12963pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectHelicobacter pyloript_PT
dc.subjectAntral Nodularitypt_PT
dc.subjectChildrenpt_PT
dc.subjectHelicobacter pylori Infectionpt_PT
dc.subjectEndoscopic Findingspt_PT
dc.subjectPrevalencept_PT
dc.subjectInfecções Gastrointestinaispt_PT
dc.subjectPortugalpt_PT
dc.titleTime trend prevalence of helicobacter pylori infection and endoscopic findings in symptomatic children in Portugal: A retrospective study based on three time points in 2009, 2014, and 2019pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue4pt_PT
oaire.citation.startPagee12963pt_PT
oaire.citation.titleHelicobacterpt_PT
oaire.citation.volume28pt_PT
rcaap.embargofctAcesso de acordo com a política editorial da revista.pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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