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Helicobacter pylori Infection in Pediatric Patients Living in Europe: Results of the EuroPedHP Registry 2013 to 2016

2020-10-07Artigo científico Acesso aberto
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dc.contributor.authorKori, Michal
dc.contributor.authorLe Thi, Thu Giang
dc.contributor.authorWerkstetter, Katharina
dc.contributor.authorSustmann, Andrea
dc.contributor.authorBontems, Patrick
dc.contributor.authorLopes, Ana Isabel
dc.contributor.authorOleastro, Monica
dc.contributor.authorIwanczak, Barbara
dc.contributor.authorKalach, Nicolas
dc.contributor.authorMisak, Zrinjka
dc.contributor.authorCabral, José
dc.contributor.authorHoman, Matjaž
dc.contributor.authorCilleruelo Pascual, Maria Luz
dc.contributor.authorPehlivanoglu, Ender
dc.contributor.authorCasswall, Thomas
dc.contributor.authorUrruzuno, Pedro
dc.contributor.authorMartinez Gomez, Maria José
dc.contributor.authorPapadopoulou, Alexandra
dc.contributor.authorRoma, Eleftheria
dc.contributor.authorDolinsek, Jernej
dc.contributor.authorRogalidou, Maria
dc.contributor.authorUrbonas, Vaidotas
dc.contributor.authorChong, Sonny
dc.contributor.authorKindermann, Angelika
dc.contributor.authorMiele, Erasmo
dc.contributor.authorRea, Francesca
dc.contributor.authorCseh, Áron
dc.contributor.authorKoletzko, Sibylle
dc.contributor.authorHelicobacter pylori Working Group of ESPGHAN
dc.date.accessioned2022-01-31T16:13:23Z
dc.date.available2022-01-31T16:13:23Z
dc.date.issued2020-10-07
dc.description.abstractObjectives: The aim of the study was to assess clinical presentation, endoscopic findings, antibiotic susceptibility and treatment success of Helicobacter pylori (H. pylori) infected pediatric patients. Methods: Between 2013 and 2016, 23 pediatric hospitals from 17 countries prospectively submitted data on consecutive H. pylori-infected (culture positive) patients to the EuroPedHP-Registry. Results: Of 1333 patients recruited (55.1% girls, median age 12.6 years), 1168 (87.6%) were therapy naïve (group A) and 165 (12.4%) had failed treatment (group B). Patients resided in North/Western (29.6%), Southern (34.1%) and Eastern Europe (23.0%), or Israel/Turkey (13.4%). Main indications for endoscopy were abdominal pain or dyspepsia (81.2%, 1078/1328). Antral nodularity was reported in 77.8% (1031/1326) of patients, gastric or duodenal ulcers and erosions in 5.1% and 12.8%, respectively. Primary resistance to clarithromycin (CLA) and metronidazole (MET) occurred in 25% and 21%, respectively, and increased after failed therapy. Bacterial strains were fully susceptible in 60.5% of group A, but in only 27.4% of group B. Primary CLA resistance was higher in Southern and Eastern Europe (adjusted odds ratio [ORadj] = 3.44, 95% confidence interval [CI] 2.22–5.32, P < 0.001 and 2.62, 95% CI: 1.63–4.22, P < 0.001, respectively) compared with Northern/Western Europe. Children born outside Europe showed higher primary MET resistance (ORadj = 3.81, 95% CI: 2.25–6.45, P < 0.001). Treatment success in group A reached only 79.8% (568/712) with 7 to 14 days triple therapy tailored to antibiotic susceptibility. Conclusions: Peptic ulcers are rare in dyspeptic H. pylori-infected children. Primary resistance to CLA and MET is markedly dependent on geographical regions of birth and residence. The ongoing survey will show whether implementation of the updated ESPGHAN/NASPGHAN guidelines will improve the eradication success.pt_PT
dc.description.abstractWhat Is Known: Antibiotic susceptibility and treatment adherence are crucial for successful Helicobacter pylori eradication. In 2006, we reported antibiotic resistance in 1233 infected children (1033 treatment-naïve) living in 14 European countries. Primary resistance rates to clarithromycin and metronidazole were 20% and 23%, respectively. What Is New: This second survey in 1333 culture-positive children revealed increasing primary resistance for clarithromycin (25%), but not for metronidazole (21%). Antibiotic resistance significantly depended on geographical regions and migration status, questioning country-based recommendations. Prescribed drug doses were too low, particularly for protein pump inhibitors (PPI). Improved eradication rates can be expected if current European Society of Pediatric Gastroenterology, Hepatology and Nutrition/North American Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines are followed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Pediatr Gastroenterol Nutr. 2020 Oct;71(4):476-483. doi: 10.1097/MPG.0000000000002816.pt_PT
dc.identifier.doi10.1097/MPG.0000000000002816pt_PT
dc.identifier.issn0277-2116
dc.identifier.urihttp://hdl.handle.net/10400.18/7894
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherLippincott, Williams & Wilkins/ European Society for Paediatric Gastroenterology Hepatology and Nutritionpt_PT
dc.relation.publisherversionhttps://journals.lww.com/jpgn/Fulltext/2020/10000/Helicobacter_pylori_Infection_in_Pediatric.12.aspxpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAbdominal Painpt_PT
dc.subjectClarithromycinpt_PT
dc.subjectEndoscopypt_PT
dc.subjectHelicobacter pyloript_PT
dc.subjectMetronidazolept_PT
dc.subjectPediatric Gastroenterologypt_PT
dc.subjectPeptic Ulcer Diseasept_PT
dc.subjectInfecções Gastrointestinaispt_PT
dc.titleHelicobacter pylori Infection in Pediatric Patients Living in Europe: Results of the EuroPedHP Registry 2013 to 2016pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage483pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage476pt_PT
oaire.citation.titleJournal of Pediatric Gastroenterology and Nutritionpt_PT
oaire.citation.volume71pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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