Risk factors for primary Helicobacter pylori resistance in Bulgarian children.
Risk factors for primary Helicobacter pylori resistance in 186 children with gastroduodenal diseases (44 from villages/small towns and 130 from large towns/cities) in 2000-2003 were tested. Susceptibility was tested by a limited agar dilution method. Overall resistance rates to metronidazole, clarithromycin, tetracycline and both metronidazole and clarithromycin were 14.5, 11.9, 3.3 and 4.3 %, respectively. No amoxycillin resistance was observed. Tetracycline resistance was found in six children aged 7-18 years. Clarithromycin resistance was more common in children from small towns/villages (22.7 %) than in those from large towns/cities (8.5 %, P < 0.05). There were no significant differences (P > 0.05) in resistance rates between children from northern Bulgaria and those from southern regions. Resistance rates in duodenal ulcer patients and other children were, respectively, 10.5 and 15 % (P > 0.20) for metronidazole and 10.5 and 12 % (P > 0.20) for clarithromycin. No combined resistance to metronidazole and clarithromycin was found in 22 children aged 1-7 years and in 34 children living in northern Bulgaria. There were no significant associations of resistance with sex and age group (1-7- versus 8-18-year-old children) for all antibacterial agents tested. In conclusion, primary H. pylori resistance was absent (for metronidazole + clarithromycin) or low (4.5 % for clarithromycin) in children aged 1-7 years. Place of residence was associated with clarithromycin resistance rates.
Boyanova
Lyudmila
L
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Gergova
Galina
G
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Koumanova
Radka
R
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Jelev
Christo
C
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Lazarova
Elena
E
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Mitov
Ivan
I
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Kovacheva
Youlia
Y
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002031:Bulgaria; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004381:Duodenal Ulcer / Q000382:microbiology*; D005260:Female; D005756:Gastritis / Q000382:microbiology*; D016481:Helicobacter Infections / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D012307:Risk Factors
D000900:Anti-Bacterial Agents