High prevalence of clarithromycin resistant Helicobacter pylori in Turkish children with gastric disorders

Objectives: Helicobacter pylori (H. pylori) is one of the leading cause of most gastroduodenal diseases. Commonly, clarithromycin is prescribed to treat H. pylori infections. Increasing resistance to clarithromycin is now one of the main problems of health worldwide. This study is aimed to survey clarithromycin resistant H. pylori infection in children with gastric disorders in Turkey. Patients and methods: A total of 110 biopsy samples were collected from the gastric antral of children referred to Balcali Hospital in Adana city, Turkey from October 2015 to November 2016. After the DNA extraction, a PCR reaction was performed for the detection of glmM gene as a diagnostic marker for Helicobacter. To examine resistance to clarithromycin, RFLP-PCR was performed to detect A2142G and A2143G point mutations in the 23SrRNA amplification product. Results: Based on histopathological and RUT tests and PCR, H. pylori was detected in 26.4% (29/110), 23.6% (26/ 110), and 33.6% (37/110) of the pediatric patients respectively. The frequency of H. pylori infection was dependent on age but independent of gender. The A2143G and A2142G point mutations were found in (n: 13, 61.90%) and (n: 8, 38.09%) of H. pylori isolates. Conclusion: Our findings highlight a high rate of resistance to clarithromycin in Turkish children with H. pylori infection. Hence, it is essential to note other classes of antibiotics except clarithromycin for the effective treatment of H. pylori infection in children younger than 18 years in the study region.