Description
Introduction :Helicobacter pylori (H. pylori) infection is a public health problem because it is generally procured in early childhood and the infection remains with the affected child throughout life unless appropriate treatment is applied . It has been estimated that around one-third of the world's children are carriers of the bacterium . Metronidazole belongs to the class of nitroimidazoles, it is used extensively as a first-line antibiotic for H. pylori therapy but increasing resistance has severely compromised its therapeutic performance .In Moroccan children Data on antimicrobial susceptibility of Helicobacter pylori are not two much available In Moroccan children, data on metronidazole sensitivity of Helicobacter pylori are not very available, as well as its association with environmental factors.
Objectives :Our study aims to investigate the prevalence of H. pylori resistance to metronidazole among children in Morocco and to examine the risk factors associated with metronidazole resistance.
Methodology :The study involved 132 children (aged between 2 and 17 years old) referred to endoscopy for digestive symptoms. A questionnaire was used to collect information of participants.This study was approved by the committee of the Pasteur Institute of Morocco and conducted according to the ethical standards of Helsinki. Four gastric biopsies were obtained from each patient, Two from the antrum and two from the fundus. The Detection of H. pylori metronidazole resistance was performed by Molecular test and Rstudio for Windows version 4.3.1 was used for statistical analyses.
Results and discussions :The prevalence of H. pylori resistance to metronidazole was 71.02% % which is a high resistance rate. Metronidazole resistance was significantly more frequent in pediatric patients living in urban areas (p value=0.01). The highest metronidazole resistance rate was observed in females (76%) and older children aged 7 to 17 years old (77.8%) with no significant differences.
Conclusion :The rate of primary resistance to metronidazole was high among Moroccan children living in urban areas. It is therefore essential to manage this infection and to include antimicrobial susceptibility testing in the H. pylori diagnostic protocol in order to limit the problem of resistance in children.
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