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Risk factors for primary Helicobacter pylori resistance in Bulgarian children

¹Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria ²Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria

Correspondence Lyudmila Boyanova lboyanova{at}hotmail.com

Received February 25, 2004
Accepted May 21, 2004

Risk factors for primary Helicobacter pylori resistance in 186 children with gastroduodenal diseases (44 from villages/small towns and 130 from large towns/cities) in 2000–2003 were tested. Susceptibility was tested by a limited agar dilution method. Overall resistance rates to metronidazole, clarithromycin, tetracycline and both metronidazole and clarithromycin were 14.5, 11.9, 3.3 and 4.3 %, respectively. No amoxycillin resistance was observed. Tetracycline resistance was found in six children aged 7–18 years. Clarithromycin resistance was more common in children from small towns/villages (22.7 %) than in those from large towns/cities (8.5 %, P < 0.05). There were no significant differences (P > 0.05) in resistance rates between children from northern Bulgaria and those from southern regions. Resistance rates in duodenal ulcer patients and other children were, respectively, 10.5 and 15 % (P > 0.20) for metronidazole and 10.5 and 12 % (P > 0.20) for clarithromycin. No combined resistance to metronidazole and clarithromycin was found in 22 children aged 1–7 years and in 34 children living in northern Bulgaria. There were no significant associations of resistance with sex and age group (1–7- versus 8–18-year-old children) for all antibacterial agents tested. In conclusion, primary H. pylori resistance was absent (for metronidazole + clarithromycin) or low (4.5 % for clarithromycin) in children aged 1–7 years. Place of residence was associated with clarithromycin resistance rates.

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