Primary Antibiotic Resistance to Helicobacter pylori Strains Isolated From Children in Northern Iran: A Single Center Study

Background: Initial resistance to antibiotics is the main reason for the failure of Helicobacter pylori (H. pylori) eradication in children. Objectives: As we commonly face high antibiotic resistance rates in children, we aimed to determine the susceptibility of H. pylori to common antibiotics. Patients and Methods: In this cross-sectional in vitro study, 169 children younger than 14 years with clinical diagnosis of peptic ulcer underwent upper gastrointestinal endoscopy. Biopsy specimens from stomach and duodenum were cultured. In isolated colonies, tests of catalase, urease, and oxidase as well as gram staining were performed. After confirming the colonies as H. pylori, the antibiogram was obtained using disk diffusion method. Results: Culture for H. pylori was positive in 12.3% of the specimens, urease test in 21.3%, serological test in 18.9% and stool antigen test was positive in 21.9%. We could show high specificity but moderate sensitivity of both histological and H. pylori stool antigen tests to detect H. pylori. The overall susceptibility to metronidazole was 42.9%, amoxicillin 95.2%, clarithromycin 85.7%, furazolidone 61.9%, azithromycin 81.0%, and tetracycline 76.2% with the highest resistance to metronidazole and the lowest to clarithromycin. Conclusions: In our region, there is high resistance of H. pylori to some antibiotics including metronidazole and furazolidone among affected children. To reduce the prevalence of this antibiotic resistance, more controlled use of antibiotics should be considered in children.

Spectrum-effect relationships between high performance liquid chromatography fingerprints and bioactivities of charred areca nut

Purpose: To investigate the spectrum-effect relationships between high performance liquid chromatography (HPLC) fingerprints and duodenum contractility of charred areca nut (CAN) on rats. Methods: An HPLC method was used to establish the fingerprint of charred areca nut (CAN). The promoting effect on contractility of intestinal smooth was carried out to evaluate the duodenum contractility of CAN in vitro. In addition, the spectrum-effect relationships between HPLC fingerprints and bioactivities of CAN were investigated using multiple linear regression analysis (backward method). Results: Fourteen common peaks were detected and peak 3 (5-Hydroxymethyl-2-furfural, 5-HMF) was selected as the reference peak to calculate the relative retention time of 13 other common peaks. In addition, the equation of spectrum-effect relationships {Y = 3.818 - 1.126X1 + 0.817X2 - 0.045X4 - 0.504X5 + 0.728X6 - 0.056X8 + 1.122X9 - 0.247X13 - 0.978X14 (p < 0.05, R2 = 1)} was established in the present study by the multiple linear regression analysis (backward method). According to the equation, the absolute value of the coefficient before X1, X2, X4, X5, X6, X8, X9, X13, X14 was the coefficient between the component and the parameter. Conclusion: The model presented in this study successfully unraveled the spectrum-effect relationship of CAN, which provides a promising strategy for screening effective constituents of areca nut.