The epidemiological characteristics of helicobacter pylori infections in gastroduodenal pathologies in childhood

Aim: In this study, it was aimed to determine the frequency of H. pylori infections of patients applied to Çukurova University Medicine Faculty Children Gastroenterology Polyclinic with dyspeptic complaints and indicate the distribution of virulence factors, the importance of intrafamilial transmission, and also resistance to macrolide and quinolon group antibiotics by identifying epidemiological characteristics of them at the genotype level. Material Method: A total of 110 patients with dyspeptic complaints referred to hospital between 13 January 2015-1 December 2016 were included in the study. Of the cases, those with H. pylori positivity and dyspeptic complaint and 7 parents whose upper gastrointestinal system endoscopy was conducted by adult gastroenterology department were also involved in the study. H. pylori was searched by means of histopathological, culture and glmM-PCR methods. In the patients whose PCR was identified as positive, the determination of vacA, cagA and cagE genes was performed; in addition, E-test was performed to establish the resistance of clarithromycin and levofloxacin of H. pylori strains isolated in culture. A2142G and A2143G point mutations held responsible for clarithromycin resistance were identified with PCR-RFLP method. The effect of H. pylori strains on the clinics of cases was investigated and the impact of intrafamilial H. pylori trasmission was evaluated. Findings: In he study, H. pylori was established as positive in 30 (27,3%) out of 110 pediatric patients. The average age of the cases was 12,2±4,39 (ranging from 3-18). 65,5% were female, 34,5% were male. In 40% of H. pylori positive patient samples vacAs1, in 56,6% vacAs2, in 36,7% cagA, in 23,3% cagE were positive. In 6,6% of the cases vacAs1+cagE association, in 16,6% vacAs1+cagA+cagE association and in 16,6% vacAs2+cagA association were determined. No significant relationship was identified between clinical findings and H. pylori strains in the study. Levofloxacin resistance was only observed in one (4,3%) of the patients that could produce H. pylori in the culture. In the patient involved, both genetic mutations of A2142G ve A2143G were found as positive. In 8 patients (34,7%), clarithromycin resistance was established. In all patients whose A2142G mutation was determined as positive and in 55% those whose A2143G mutation was identified as positive, clarithromycin resistance was observed. H. pylori strains determined in the parents of pediatric patients involved in the study were established as different from H. pylori strains in the children. Result: H. pylori infection was determined as positive in approximately one third of children with dyspeptic complaints. In children applying to hospital with dyspeptic complaints, it was observed that vacAs2 is the mostly seen genotype. Of the genetic mutations A2142G ve A2143G, even having at least one of them carries a potential for resistance to antibiotics. High resistance was identified for clarithromycin used in the standard triple treatment of H. pylori in children