Antimicrobial Resistance of Helicobacter pylori Isolated From Latin American Children and Adolescents (2008–2023): A Systematic Review
Loading...
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: Latin America has a high prevalence of Helicobacter pylori in children that may lead to peptic ulcer disease andeventually gastric cancer in adulthood. Successful eradication is hindered by rising antimicrobial resistance. We summarize H.pylori resistance rates in Latin American children from 2008 to 2023.Material and Methods: Systematic review following PRISMA guidelines and National Heart, Lung, and Blood Institute check-list to assess risk of bias (PROSPERO CRD42024517108) that included original cross-sectional observational studies reportingresistance to commonly used antibiotics in Latin American children and adolescents. We searched in PubMed, LILACS, andSciELO databases.Results: Of 51 studies, 45 were excluded. The quality of the six analyzed studies (297 H. pylori-positive samples) was satisfactory.Phenotypic methods (N = 3) reported higher resistance rates than genotypic studies (N = 3). Clarithromycin resistance rangedfrom 8.0% to 26.7% (6 studies; 297 samples), metronidazole from 1.9% to 40.2% (4 studies; 211 samples), amoxicillin from 0% to10.4% (3 studies; 158 samples), tetracycline resistance was not detected (3 studies; 158 samples), and levofloxacin resistance was2.8% (1 study; 36 samples).Conclusion: Scarce Latin American studies on H. pylori resistance, along with methodological heterogeneity, hinder conclusivefindings. Clarithromycin and metronidazole (first-line drugs) resistance is worrisome, likely impacting lower eradication rates.Urgent systematic surveillance or individual testing before treatment is necessary to enhance eradication.