New insights regarding Helicobacter pylori infection in children

Q4 Medicine Revista Romana de Pediatrie Pub Date : 2022-09-30 DOI:10.37897/rjp.2022.3.2
A. Dincă, L. Meliț, C. Mărginean
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Abstract

Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.
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儿童幽门螺杆菌感染的新认识
幽门螺杆菌(h.p ylori)是儿童时期最常见的感染之一,如果不及时治疗,它可能会持续一生,导致严重的并发症,如胃恶性肿瘤。这种感染的流行病学在各大洲、国家和分区域有很大差异,主要与社会经济地位、卫生和卫生条件有关。然而,在过去的几十年里,幽门螺杆菌的患病率在世界范围内呈下降趋势,这一事实可能会随着时间的推移而降低成人胃癌的发病率。这种感染的诊断在儿童中仍然很棘手,选择最有效的诊断工具对于早期诊断幽门螺杆菌相关胃病和肠外表现至关重要。尽管幽门螺杆菌感染没有症状,特别是在儿童中,但可能导致胃粘膜严重损伤,并在根除方案后需要密切监测进一步的并发症。因此,设计了多种非侵入性和侵入性方法来正确识别个体胃内是否存在这种细菌,使临床医生能够根据其敏感性和特异性,同时根据具体的临床情况,使用最适当的方法。除了众所周知的用于根除这种感染的标准三联疗法外,最近还提出了多种其他方案,以防止根除失败。此外,益生菌最近被证明可以提高根除率,同时减少抗生素治疗的副作用。儿童期适当根除幽门螺杆菌感染仍然是预防成年期胃癌的基石。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.10
自引率
0.00%
发文量
15
审稿时长
4 weeks
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