Helicobacter pylori Antibiotic resistance patterns among Egyptian children and predictors of resistance

Abstract Background Most individuals are infected by Helicobacter pylori during early childhood; in developing countries, 50% of children are infected by the age of 5 years. Successful eradication is important to prevent the development of antibiotic resistance, as well as to reduce the number of treatments and procedures. Among children receiving the standard triple therapy regimen, eradication rates are declining. Thus, national/ regional antibiotic resistance data could be used to guide treatment regimens for H pylori infection Aim of the work to evaluate the antibiotic resistance patterns of Helicobacter pylori strains among pediatric patients and the predictors of this resistance. Patients and Methods Cross sectional, carried out on 30 pediatric patients who presented to gastroenterology unit Ain Shams University for endoscopic evaluation of their upper GI symptoms including hematemesis, vomiting and abdominal pain. Five gastric biopsies were taken, two from the corpus for histopathology and culture, and 3 from the antrum, where one of them was sent for histopathology, and the second one for rapid urease test, and the third one was sent for culture and sensitivity. Results Results of culture and sensitivity has shown that resistance to amoxicillin was 20%, to clarithromycin was 50%, metronidazole resistance was 86.7%, tetracycline resistance showed to be 13.3%, finally levofloxacin resistance was 6.7%. Excess intake of fat was associated with resistance to amoxicillin and clarithromycin. While, duodenal ulcer and duodenal nodularity were associated with resistance to tetracycline and levofloxacin respectively. Conclusion The eradication regimen in Egypt should be revised according to our national antibiotic resistance data. Further studies are needed to assess predictors of resistance to antibiotics.