Značajke infekcije Helicobacter pylori u djece

master's thesis

• Title (english): The characteristics of Helicobacter pylori infection in children
• Author: Ema Kovačević
• Mentor: Irena Senečić-Čala (mentor)
• Committee member: Duška Tješić-Drinković (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Irena Senečić-Čala (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Helicobacter pylori gram-negativna je bakterija s prepoznatim karcinogenim potencijalom, a nalazi se u želucu 4 milijarde ljudi u svijetu. Veći dio H. pylori infekcija stječe se u djetinjstvu, a glavni čimbenik rizika zaraze u ranoj dobi loš je socioekonomski status. Infekcija može proći nezapaženo uzrokujući kronični gastritis bez značajnih simptoma, ali može biti uzrokom i vrlo ozbiljnih i po život opasnih stanja poput peptičkog ulkusa i zloćudnih bolesti želuca. U usporedbi s odraslima, djeca i adolescenti mnogo rjeđe razvijaju simptome ili komplikacije. Najčešće tegobe su nespecifični bolovi u trbuhu, gubitak apetita, mučnina i povraćanje. H. pylori je u djece povezana i s anemijom zbog manjka željeza, a mnoge druge bolesti i poremećaji također se pokušavaju povezati s ovom infekcijom. Pristup u dijagnostici i liječenju znatno se razlikuje u odraslih i djece. Smatra se da će tretiranje infekcije poboljšati stanje one djece koja boluju od nekog oblika ulkusne bolesti, dok kod ostale djece neće doći do značajne promjene po eradikaciji. Testirati treba onu djecu za koju očekujemo da će se eradikacija provesti. Dijagnoza se uvijek postavlja invazivnim testovima, a optimalnu terapiju čini trojna terapija u trajanju od 14 dana. Po završetku terapije, kod sve je djece potrebno provjeriti uspjeh eradikacije neinvazivnim testovima te svakako nastaviti liječenje alternativnim antibioticima u slučaju neuspjeha. Izbor antibiotika ovisi o osjetljivosti soja ili poznatoj lokalnoj rezistenciji. Zbog sve više rezistencije na antibiotike i problema reinfekcije, nada se polaže u oralno cjepivo koje bi preveniralo infekciju ili njene posljedice. Zaštitno djelovanje H. pylori na imunosni sustav djece nije još dovoljno istraženo, ali postoje dokazi o manjem broju alergijskih bolesti, a isto tako i o blažim oblicima upalnih bolesti crijeva u inficirane djece.

Abstract (english)

Helicobacter pylori is a gram-negative bacterium which infects 4 billion people worldwide and is a recognized carcinogen. Infection, predominately, occurs in childhood, low socioeconomic status being the main risk factor. Infection can pass unrecognized, causing asymptomatic chronic gastritis, but can also be the cause for life threatening conditions such as peptic ulcers and abdominal cancer. In comparison with adults, children and adolescents rarely develop any symptoms or complications. Complaints mostly include nonspecific abdominal pain, loss of appetite, nausea and vomiting. H. pylori is also connected to iron-deficiency anemia in children. Many other conditions and diseases are being linked to H. pylori, so far with insufficient evidence. Diagnostics and treatment of children strongly differ to that of adults. It is believed that only children with peptic ulcer disease would benefit from treatment while others wouldn’t significantly profit from eradication. Testing is indicated for children who are expected to undergo eradication. Diagnosis is always established on the basis of invasive tests. Optimal treatment includes a 14-day course of triple therapy. Children treated for H. pylori should be assessed for treatment success with a reliable noninvasive test. In case of eradication failure, treatment with alternative antibiotics should follow. Antibiotics should be chosen based on antimicrobial susceptibility. In light of ever so high antimicrobial resistance and reinfection, great hopes are put into oral vaccine, which would prevent infection or its complications. The protective role of H. pylori is still not sufficiently researched, although there is proof of fewer allergies, as well as milder forms of inflammatory bowel disease in infected children.

• Keywords: H. pylori; infekcija; djeca
• Keywords (english): H. pylori; infection; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:896185
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-25 10:06:07