|Title:||Recurrence of Intussusception in Childhood||Authors:||YANG, CHIN-MU
TSAO, PO- NIEN
|Keywords:||recurrence;intussusception;children||Issue Date:||2001||Journal Volume:||v.42||Journal Issue:||n.3||Start page/Pages:||158-61||Source:||ACTA PAEDIATRICA TAIWANICA||Abstract:||
Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infectio nin children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin - resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic- resistant H. pylori isolates. Methods. Enrolled were 245 children investigated for H. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR- RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12(18%) of them were clarithromycinresistant and 6 (9%) were metronidazole-resis- tant. No difference in histologic examinations was noted between the antibiotic-resistant and–susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations . Conclusions. The prevalence of clarithormy-cin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92 %) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.
|Appears in Collections:||醫學系|
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