Children Clinical Trial
Official title:
Resistance of Helicobacter Pylori to Antibiotics in Children
Helicobacter Pylori (HP) is one of the most common pathogens in humans. This infection can present in children with abdominal pain, vomiting and iron deficiency. The treatment is usually empiric and includes antibiotic treatment usually Amoxycillin and Clarithromycin or Metronidazole. Between 40 to 70 % of the pathogens are resistant to those drugs, and it is important to characterize the specific sensitivity of the pathogens in any specific area and in pediatric population. The aims of this study is to assess the sensitivity of HP in pediatric population in Northern Israel.
The aim of our prospective study is to investigate the rate of H pylori resistant strains to
antibiotic treatment including Amoxicillin, Clarithromycin, Metronidazole, Tetracycline and
Quinolones in pediatric population in Ha-Emek medical center, Afula. The second aim was to
determine if in vitro resistance is being reflected in vivo too.
Should the investigators find high rates of H pylori resistance to Clarithromycin, the
investigators will have to reconsider the recommendation to use Clarithromycin as the first
line treatment for H pylori.
Our research group will conclude 100 children in the ages of 1-18 years, evaluated for
recurrent abdominal pain, iron deficiency anemia, failure to thrive by an upper endoscopy,
biopsy specimens taken for a rapid urease test, for histology, for culture and for
antibiotic susceptibility testing.
Biopsy specimens for histology will be fixed in formalin, embedded in paraffin and sectioned
and stained with hematoxylin and eosin.
The microbiological workup will include an imprint of the biopsy on a slide followed by a
gram stain for the purpose of demonstrating H. pylori in situ. Further the biopsies will be
streaked out on chocolate agar, Sheep blood agar and H. pylori selective agar supplemented
with Polymixin to suppress possible contaminants.
4 days of incubation in a micro aerophilic atmosphere will follow . Susceptibility testing
of H pylori will be performed with E test on Mueller Hinton agar supplemented with
defibrinated sheep blood using a MacFalrland 3.0 density of a bacterial suspension. Reading
the susceptibility will take place following 72 hours of incubation in a micro aerophilic
atmosphere.
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