Detection of virulent strains of Helicobacter pylori and its relation to symptoms and signs in children

Objective:To detect the prevalence of Helicobacter polori(H.pylori) in a group of pediatric patients complaining of gastrointestinal disorders,and to identify the virulent strains of H. pylori and its relation to peptic disease.Methods:The study included 60 patients(41 males and 19 females),aged from 6 months to 14 years,with complaining of different gastrointestinal troubles.Anti-H.pylori IgG antibodies were used.Thorough examination of the oesophagus, stomach and duodenum was done in all patients using a fibreoptic endoscopy.In addition, gastric antral biopsies were taken for diagnosis of H.pylori infection in the following test: rapid urease test,histopathologic examination and culture.And cytotoxin assay of virulent strains was employed.H.pylori infection was diagnosed if 3 or more tests for diagnosis were found to be positive.Results:33 out of 60 patients(55%) was positive.12(20%) patients had positive toxin producing strains(virulent strains).Virulent strain had a significantly closer relationship with recurrent abdominal pain,while no difference was found in other symptoms. Age of patients showed a highly significant positive correlation with virulent H.pylori strain. Histopathological finding revealed that oesophagitis was significandy common in patients with negative H.pylori.Endoscopy and histopathological findings revealed that virulent strain had a significandy higher gastritis and oesophagitis rates.Conclusion:Infection by virulent strains of H.pylori in children is not uncommon:It is associated with endoscopic and histopathologic changes.All cases infected with virulent strain showed positive results by using rapid urease test,culture and IgG antibodies.