ABSTRACT
This review includes the main pediatric studies published from April 2011 to march 2016. The important studies involving H. pylori genomes, especially those pertaining to genomic diversity, disease outcome, H. pylori population structure and evolution are reviewed. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. The antigen stool test is becoming the "gold standard" in prevalence studies, and according to the epidemiologic studies, the prevalence of H. pylori in childhood is not decreasing any more in the developed world. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura. The prevalence of H. pylori was higher in chronic urticaria patients and following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates