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.
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Lyudmila
L
Boyanova
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Galina
G
Gergova
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Radka
R
Koumanova
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Christo
C
Jelev
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Elena
E
Lazarova
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Ivan
I
Mitov
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria 2Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Youlia
Y
Kovacheva
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