Dataset HP 2018

Highly clarithromycin-resistant Helicobacter pylori infection in children from a rural community of Cajamarca (Peru)

Background: The prevalence of Helicobacter pylori is greater than 50% in low income countries. In children, the infection with H. pylori has been associated with short height and growth impairment. It is also a major cause of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Polymerase Chain Reaction (PCR) has shown a high sensitivity and specificity for stool pathogenic agents detection, compared to other invasive methods. The objective of this study was to determine the prevalence of H. pylori clarithromycin-resistant in asymptomatic children in a rural community of Cajamarca (northern Peru).

Methods: A cross-sectional study was performed in 285 children from 6 to 14 years old in the San Pablo district in Cajamarca. DNA was extracted from stool samples, followed by H. pylori PCR detection, and evaluation of clarithromycin resistance by sequencing of the 23S rRNA gene.

Results: H. pylori was detected in 17.2% (49/285) of samples. Unboiled water consumption the most frequent risk factor in patients with positive PCR for H. pylori infection (93.9%). Clarithromycin resistant mutations were found in 79.6% (39/49) of the positive samples for H. pylori. The most frequent mutation (46.9%) was A2142G, followed by the double-mutation A2142G-A2143G (28.6%).

Conclusion: There is a high frequency of H. pylori in children from rural region of Cajamarca (Peru). The majority of positive cases correspond to bacteria with genetic resistance to clarithromycin, which could make it more difficult to eradicate them.

Keywords: Helicobacter pylori, PCR, clarithromycin, gastric disease, duodenal peptide ulcer disease.