Abstract:
Objectives: There are limited data regarding the pattern of Helicobacter
pylori (Hp) antibiotic resistance and virulence factors in children. Evaluation
of prevalence of drug resistance and virulence-factor genotype in children
with Hp gastritis and to investigate whether there is any relation between
drug resistance and genotype were our aims in this study.
Methods: Ninety-eight children with polymerase chain reaction–positive
Hp gastritis were included. Antimicrobial susceptibility was tested by
disc diffusion method and polymerase chain reaction assays were used
for the determination of virulence factors.
Results: The resistance rates to clarithromycin, metronidazole, and
amoxicillin were 23.5%, 11.7%, and 3.9%, respectively. All strains
carried vacA genotype, and 51%, 70.4%, 49%, 34.7%, and 25.5% were
cagA-, cagE-, babA2-, iceA1-, and iceA2-positive, respectively. Of those
98 specimens, 81.6%, 19.4%, 38.8%, and 63.3% carried vacAs1, vacAs2,
vacAm1, and vacAm2, respectively. Dominant vacA type was s1am2
(32.7%), followed by s1am1 (14.3%) and s2m2 (12.2%). Significant rates
of clarithromycin resistance were observed in cagE-, iceA1-, babA2-, and
vacAs1c-positive groups. In those with metronidazole resistance, vacAs1
and vacAs1c were more common (P < 0.05).
Conclusions: The cagE-positive and vacA s1a/m2 genotypes, which are
correlated with increased antibiotic resistance, were predominant in our
population. In countries where Hp infection is prevalent, studies focusing
on virulence factors and antibiotic susceptibility may provide anticipation
of the prognosis and may be helpful to reduce morbidity and mortality.
