PT  - JOURNAL ARTICLE
AU  - Koletzko, S
AU  - Richy, F
AU  - Bontems, P
AU  - Crone, J
AU  - Kalach, N
AU  - Monteiro, M L
AU  - Gottrand, F
AU  - Celinska-Cedro, D
AU  - Roma-Giannikou, E
AU  - Orderda, G
AU  - Kolacek, S
AU  - Urruzuno, P
AU  - Martínez-Gómez, M J
AU  - Casswall, T
AU  - Ashorn, M
AU  - Bodanszky, H
AU  - Mégraud, F
TI  - Prospective multicentre study on antibiotic resistance of <em>Helicobacter pylori</em> strains obtained from children living in Europe
AID  - 10.1136/gut.2006.091272
DP  - 2006 Dec 01
TA  - Gut
PG  - 1711--1716
VI  - 55
IP  - 12
4099  - http://gut.bmj.com/content/55/12/1711.short
4100  - http://gut.bmj.com/content/55/12/1711.full
SO  - Gut2006 Dec 01; 55
AB  - Aim: To prospectively assess the antibacterial resistance rate in Helicobacter pylori strains obtained from symptomatic children in Europe. Methods: During a 4-year period, 17 paediatric centres from 14 European countries reported prospectively on patients infected with H pylori, for whom antibiotic susceptibility was tested. Results: A total of 1233 patients were reported from Northern (3%), Western (70%), Eastern (9%) and Southern Europe (18%); 41% originated from outside Europe as indicated by mother’s birth-country; 13% were <6 years of age, 43% 6–11 years of age and 44% >11 years of age. Testing was carried out before the first treatment (group A, n = 1037), and after treatment failure (group B, n = 196). Overall resistance to clarithromycin was detected in 24% (mean, A: 20%, B: 42%). The primary clarithromycin resistance rate was higher in boys (odds ratio (OR) 1.58; 1.12 to 2.24, p = 0.01), in children <6 years compared with >12 years (OR 1.82, 1.10 to 3.03, p = 0.020) and in patients living in Southern Europe compared with those living in Northern Europe (OR 2.25; 1.52 to 3.30, p<0.001). Overall resistance rate to metronidazole was 25% (A: 23%, B: 35%) and higher in children born outside Europe (A: adjusted. OR 2.42, 95% CI: 1.61 to 3.66, p<0.001). Resistance to both antibiotics occurred in 6.9% (A: 5.3%, B: 15.3%). Resistance to amoxicillin was exceptional (0.6%). Children with peptic ulcer disease (80/1180, 6.8%) were older than patients without ulcer (p = 0.001). Conclusion: The primary resistance rate of H pylori strains obtained from unselected children in Europe is high. The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance.