Helicobacter pylori infection in children in Kazan and factors influencing the effectiveness of eradication therapy



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Abstract

The effectiveness of H. ру/ог/ eradication therapy depends on many factors, including the patients' compliance, H. ру/ог/ sensitivity to antibiotics, the rate of proton pump inhibitors metabolism in the liver. The Aim of this study was to investigate the frequency of mutations underlying the development of H. ру/ог/ resistance to clarithromycin and CYP2C19 genetic polymorphism in children with gastroduodenal pathology. The study included 91 patients with different types of gastroduodenal pathology. H. ру/ог/ was revealed using urease breath test (Helic-test, Russia), polymerase chain reaction (PCR), and cytology. In 26 children in whom the presence of H. ру/ог/ was confirmed by PCR, the presence of mutations (for three sites - A2142G, A2143G, T2717C) in the 23S RNA causing H. ру/ог/ resistance to clarithromycin was analysed. In 80 patients cytochrome P450 2C19 polymorphism was studied as well. H. ру/ог/ was detected by urease breath test in 80 children (87.9%); by PCR - in 54 out of 91 (59.3%). A2143G mutation in the 23S RNA gene was found in 2 out of 26 children (7.7%). A2142G and T2717C mutations were not detected in any case. It was shown that 61 patients out of 80 (76.3%) were CYP2C19*1/*1 genotype carriers; 19 (23.8%) had CYP2C19*1/*2 or CYP2C19*1/*3 genotype. CYP2C19*2/*2, CYP2C19*3/*3 and CYP2C19*2/*3 genotypes weren't found in any patients. The level of H. ру/ог/ clarithromycin resistance in children is 7.7%. The phenotypic group referring to the rapid proton pump inhibitors metabolizers is predominant (76.3%) in children with H. ру/ori-associated gastroduodenal pathology.

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About the authors

A. R Khalikova

Kazan State Medical University

R. A Faizullina

Kazan State Medical University

I. I Akhmetov

Kazan State Medical University; Volga Region State Academy of Physical Culture, Sports and Tourism

K. A Ivanovskaya

Kazan State Medical University

S. R Abdulkhakov

Kazan State Medical University; Kazan (Volga region) Federal University

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