Helicobacter pylori status and symptom assessment two years after eradication in pediatric patients from a high prevalence area.
OBJECTIVE
To establish the rate of Helicobacter pylori reinfection in children from an H. pylori high prevalence area, possible clinical features predictive of reinfection and the usefulness of re-treatment.


METHODS
65 consecutive children attending the authors' department between 1998 and 2000 who had proven successful H. pylori eradication were enrolled; 52 took part. Patients and family members were invited to undergo C-urea breath testing and to complete a simple questionnaire regarding symptoms and socioeconomic status. Patients with H. pylori reinfection were offered treatment; eradication was assessed by C-urea breath test 8 weeks after completion of treatment.


RESULTS
Of 52 children, 15 (28.8%) were H. pylori positive. Variables predictive of reinfection were age at primary infection and presence of an infected sibling. Although reinfected children were more frequently symptomatic than non-reinfected patients, no specific symptom was associated with reinfection. Of the nine re-treated patients who returned 8 weeks after completing therapy, the bacterium was eradicated in five (56%).


CONCLUSIONS
The 12.8% per year reinfection rate in childhood at 2 years that we observed should prompt a re-evaluation of H. pylori status even after a successful eradication. Living in an H. pylori high prevalence area increases the annual risk of reinfection by approximately fourfold over the annual risk in H. pylori low prevalence areas.
Magistà
Anna Maria
AM
Dipartimento di Biomedicina Età Evolutiva, University of Bari, Italy.
Ierardi
Enzo
E
Castellaneta
Stefania
S
Miniello
Vito Leonardo
VL
Lionetti
Elena
E
Francavilla
Antonio
A
Ros
Philippe
P
Rigillo
Nicola
N
Di Leo
Alfredo
A
Francavilla
Ruggiero
R
D000293:Adolescent; D000367:Age Factors; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use; D018562:Disease Transmission, Infectious; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D005190:Family; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D055502:Secondary Prevention; D012923:Social Class; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole