Effects of primary duodenogastric reflux on Helicobacter pylori infection and drug resistance in children in Wuxi area / 中国小儿急救医学

ABSTRACT

Objective:To investigate the effect of primary duodenal bile reflux(DGR)on Helicobacter pylori(HP)infection and drug resistance in children in Wuxi area, and to provide the basis for the selection of anti-HP drugs in children with subsequent DGR.Methods:The clinical data of children who had received upper gastrointestinal endoscopy and HP examination because of abdominal pain, nausea, vomiting, gastrointestinal bleeding, dyspepsia and other upper gastrointestinal symptoms were collected from January 2020 to February 2022 in the Gastroenterology Department of Wuxi Children′s Hospital.According to the results of endoscopy, children were divided into DGR group (217 cases) and control group without DGR (1 252 cases), and their age, gender, HP infection rate and abdominal pain were analyzed.Results:A total of 1 469 children were included in this study, with a median age of 11(9, 14) years, 808(55.0%) males and 661(45.0%) females.HP infection was detected in 322(21.9%) cases.The median age of DGR group was higher than that in control group[13(11, 15) years vs. 11(8, 14) years, P<0.001], and the incidence of DGR was increased in the elder group( χ2=45.963, P<0.001). There was no significant difference between DGR group and control group in sex and whether abdominal pain was the first symptom ( P>0.05). There were 47(22.0%) cases positive for HP in DGR group and 275(22.0%)cases in control group, with no significant difference( P>0.05). A total of 256 cases were isolated and cultured positive of HP.And in vitro susceptibility tests of strains, there was no significant difference between DGR group and control group in the single and combined resistance rates of HP to metronidazole, clarithromycin, levofloxacin, amoxicillin, furazolidone and tetracycline hydrochloride( P>0.05). Conclusion:Elder children are more likely to have primary DGR.The occurrence of primary DGR has no significant effect on HP infection and drug resistance.