[Analysis of the importance of Helicobacter pylori strains in children with gastric and duodenal mucosal inflammatory changes].
The role of Helicobacter pylori (H. pylori) infection in etiopathogenesis of gastritis and/or duodenitis is well recognized and proven. H. pylori infection also concerns children and youth. It was proven that CagA(+) strains of H. pylori cause inflammatory changes and can lead to ulcer disease of ventriculum and/or duodenum.


OBJECTIVE
The purpose of the study was to determine the prevalence of urease A and cytotoxicity genes in children with diagnosed H. pylori infection and concomitant gastritis and/or duodenitis as well as to determine the kind and stadium of inflammatory changes in relation to particular strains.


METHODS
The study was performed in 76 patients aged from 3 to 20 years (average age 12.6), who were qualified for endoscopy of the upper GI tract because of recurrent abdominal pain complaints. The H. pylori infection and accompanying gastritis and/or duodenitis were diagnosed according to the Sydney classification.


RESULTS
In 57/76 (75%) of diagnosed patients the H. pylori infection was proven with the PCR method (ureA (+)). The following strains were found: CagA(+) in 19 (33% infected subjects). Gastritis and/or duodenitis occurred in all subjects infected with CagA (+) strains and in 54/57 of those with H. pylori infection ureA (+). In subjects without infection, gastritis and/or duodenitis was found in 12 persons, and this result was significantly lower.


CONCLUSIONS
In diagnosis it is important to confirm H. pylori presence by CagA gene typing because it relates to the inflammatory changes of the stomach and/or duodenum.
Mierzwa
Grazyna
G
Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii, Collegium Medicum im. L. Rydygiera, ul. M. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland. klped@cm.umk.pl
Bała
Grazyna
G
Czarny
Jakub
J
Woźniak
Marcin
M
Miścicka-Sliwka
Danuta
D
Czerwionka-Szaflarska
Mieczysława
M
D015746:Abdominal Pain / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002648:Child; D002675:Child, Preschool; D004382:Duodenitis / Q000175:diagnosis / Q000382:microbiology*; D004386:Duodenum / Q000382:microbiology; D004947:Esophagus / Q000382:microbiology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000382:microbiology*; D016480:Helicobacter pylori / Q000145:classification* / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D013045:Species Specificity; D014510:Urease / Q000235:genetics
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori; D014510:Urease