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Journal of Clinical Microbiology, April 2001, p. 1348-1352, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1348-1352.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Genotypic, Clinical, and Demographic Characteristics of Children Infected with Helicobacter pylori

Benjamin D. Gold,1,2,* Leen-Jan van Doorn,3 Jeannette Guarner,4 Marilyn Owens,1,2 Daphne Pierce-Smith,1 Qunsheng Song,1,2 Lori Hutwagner,5 Philip M. Sherman,6 Oscar Loret de Mola,7 and Steven J. Czinn8

Department of Pediatrics, Division of Pediatric Gastroenterology, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston,1 and Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases,2 Infectious Disease Pathology Activity, Division of Viral and Rickettsial Diseases,4 and Division of Public Health Surveillance and Informatics, Epidemiology Program Office,5 National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hospital for Sick Children, Toronto, Ontario, Canada6; Miami Children's Hospital, Miami, Florida7; Rainbow Babies and Children's Hospital, Cleveland, Ohio8; and Delft Diagnostic Laboratory, Delft, The Netherlands3

Received 15 November 2000/Returned for modification 4 January 2001/Accepted 31 January 2001

Helicobacter pylori isolates vary between geographic regions. Certain H. pylori genotypes may be associated with disease outcome. Thirty-eight children underwent diagnostic upper endoscopy at four medical centers and were retrospectively analyzed to determine if H. pylori virulence genes were associated with endoscopic disease severity, histologic parameters, and host demographics. The H. pylori virulence genotype was analyzed by a reverse hybridization line probe assay and type-specific PCR. Endoscopic ulcers or erosions were found in 17 (45%) patients, with 13 (34%) of these patients having antral nodularity. Histological gastritis, of varying severity, was present in all children. Four patients harbored more than one H. pylori strain: one subject had both cagA+ and cagA-negative strains, while three patients harbored either two different cagA-negative strains (two children) or two cagA+ strains (one child). There were 28 (74%) cagA+ isolates; 19 were associated with the vacA s1b genotype, 7 were associated with the vacA s1a genotype, 1 was associated with the vacA s1c genotype, and 1 was associated with the s2 genotype. Of 14 cagA-negative isolates, 6 were vacA s2 genotype, 4 were vacA s1b, 3 were vacA s1a, and 1 was vacA s1c. Nine of ten (90%) Hispanics had similar H. pylori strains (vacA s1b,m1), and all Asian-Canadian children were infected by strains with vacA s1c genotype. No correlation between H. pylori strain and endoscopic or histopathologic abnormalities was found. This study provides a baseline framework of North American children and their H. pylori strains, serving as a powerful epidemiological tool for prospective investigations to better understand the transmission and evolution of diverse disease outcomes.

* Corresponding author. Mailing address: Department of Pediatrics, Emory University School of Medicine, Division of Pediatric Gastroenterology and Nutrition, 2040 Ridgewood Dr., NE, Atlanta, GA 30322. Phone: (404) 727-1463. Fax: (404) 727-2120. E-mail: ben_gold{at}oz.ped.emory.edu.

Journal of Clinical Microbiology, April 2001, p. 1348-1352, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1348-1352.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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