Helicobacter pylori and Helicobacter heilmannii in children. A Bulgarian study.
The aim of the study was to evaluate the prevalence of Helicobacter pylori and Helicobacter heilmannii among 321 children. Gram staining, urease test and culture were performed. Of all patients, 52.6% were H. pylori positive and 0.3% were H. heilmannii positive. H. pylori infection was associated with chronic gastritis in 57.1%, with duodenal ulcer in 75% and with non-ulcer dyspepsia in 25.6%. This infection was more frequent in children aged 11-18 years than in younger patients. Rapid urease test, culture and direct Gram staining showed 42.3, 96.5 and 78.2% sensitivity and 93.2, 100 and 84.6% specificity, respectively. H. pylori was detected in 60.2% of fresh versus 52.8% of frozen specimens and in 64.8% in gastric biopsy versus 25% in gastric mucus specimens. H. pylori growth was detected after nine to 10 days in 6.2% and after 11 days in 1.2%. Culture exhibited the best accuracy of the three diagnostic methods. Frozen biopsy specimens gave reliable H. pylori detection unlike gastric mucus specimens. Eleven days of incubation for H. pylori is recommended. The study confirms an early acquisition of H. pylori infection in Bulgaria. The incidence of H. heilmannii infection in childhood is uncommon but clinically important.
Boyanova
Lyudmila
L
Department of Microbiology, Medical University of Sofia, Sofia, Bulgaria. lboyanova@hotmail.com
Koumanova
Radka
R
Lazarova
Elena
E
Jelev
Christo
C
D000293:Adolescent; D017677:Age Distribution; D001944:Breath Tests; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005840:Gentian Violet; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D018247:Helicobacter heilmannii / Q000302:isolation & purification*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D010619:Phenazines; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution
C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet