Helicobacter pylori culture and antimicrobial susceptibility from pediatric patients in Michigan

Vasundhara Tolia, William Brown, Mohammed El-Baba, Chaun Hau Lin

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Background. We recently observed a high failure rate in the eradication of Helicobacter pylori infection in children with 2-week triple therapy using lansoprazole, amoxicillin and clarithromycin. We performed a prospective evaluation of antral biopsies of all children subsequently diagnosed with H. pylori gastritis for culture and antimicrobial susceptibility assessment. Methods. All children with antral nodularity and/or an elevated anti-H. pylori IgG titer underwent antral biopsies for histology, urease test and culture while undergoing an upper endoscopy for routine indications. All positive cultures were tested for antimicrobial susceptibility by E-test for clarithromycin, amoxicillin, tetracycline and metronidazole. Results. Thirty-one children (16 male, 15 female) between 2 and 19 years of age were diagnosed with H. pylori gastritis by histology. However, culture was positive in only 22 of 31 (71%) patients. The E-test in vitro antimicrobial susceptibility testing revealed that 95.6% of the isolates were susceptible to amoxicillin, 59% to clarithromycin and 54.6% to metronidazole. There was no resistance to tetracycline. Conclusion. Evaluation of antibiotic resistance profiles from pediatric patients from different geographic areas can help in optimizing therapeutic regimen to prevent treatment failures. Metronidazole and clarithromycin resistance is much higher in our pediatric population than reported in adults and could be a major contributor to failure of H. pylori eradication.

Original languageEnglish
Pages (from-to)1167-1171
Number of pages5
JournalPediatric Infectious Disease Journal
Issue number12
StatePublished - 2000
Externally publishedYes


  • Antimicrobial susceptibility
  • Children
  • Culture
  • Helicobacter pylori


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