{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:57:27Z","timestamp":1785538647935,"version":"3.56.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> infection acquisition occurs mainly in childhood and may be a critical factor in developing long\u2010term complications. In contrast to other developed countries, previous studies have reported a relatively high <jats:italic>H.\u00a0pylori<\/jats:italic> infection prevalence in Portugal, both in children and adults. However, there are no recent data concerning pediatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We performed a retrospective observational study concerning an 11\u2009years period (2009, 2014, 2019), that included patients under 18\u2009years old who underwent upper endoscopy at a pediatric tertiary center. Demographic, clinical\u2010pathological, and microbiological data were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and sixty one children were included. The average age was 11.7\u00a0\u00b1\u20094.4\u2009years. In total, <jats:italic>H.\u00a0pylori<\/jats:italic> infection was confirmed in 37.3% of cases (histology and\/or culture) and a decreasing infection trend was observed (<jats:italic>p<\/jats:italic>\u00a0=\u2009.027). The most common indication for endoscopy was abdominal pain, which was a good predictor of infection. Antral nodularity was present in 72.2% of the infected children (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001). In the oldest age groups, moderate\/severe chronic inflammation, <jats:italic>H.\u00a0pylori<\/jats:italic> density and lymphoid aggregates\/follicles were positive predictors for the presence of antral nodularity. For all ages, the presence of antral nodularity, neutrophilic activity in the antrum and corpus and lymphoid follicles\/aggregates in the antrum were positive predictors for the presence of <jats:italic>H.\u00a0pylori<\/jats:italic> infection. Among the 139 strains tested for antibiotic susceptibility, 48.9% were susceptible to all tested antibiotics. Resistance to clarithromycin, metronidazole, and both was detected in 23.0%, 12.9%, and 6.5% of the strains, respectively; furthermore, resistance to ciprofloxacin and to amoxicillin was observed in 5.0% and 1.4% of the strains, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study reports (for the first time in Portugal) a significant decreasing trend in the prevalence of pediatric <jats:italic>H.\u00a0pylori<\/jats:italic> infection, although it remains relatively high compared to the recently reported prevalence in other South European countries. We confirmed a previously recognized positive association of some endoscopic and histological features with <jats:italic>H.\u00a0pylori<\/jats:italic> infection, as well as a high prevalence rate of resistance to clarithromycin and to metronidazole.<\/jats:p><jats:p>The clinical relevance of these findings requires confirmation with further studies at a national level, taking into account the high incidence rate of gastric cancer in Portugal and the potential need for country\u2010specific intervention strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12963","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T11:09:46Z","timestamp":1678446586000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Time trend prevalence of <i>helicobacter pylori<\/i> infection and endoscopic findings in symptomatic children in Portugal: A retrospective study based on three time points in 2009, 2014, and 2019"],"prefix":"10.1111","volume":"28","author":[{"given":"Raquel","family":"Antunes","sequence":"first","affiliation":[{"name":"Pediatrics University Clinic, Medical School University of Lisbon  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6360-2576","authenticated-orcid":false,"given":"Monica","family":"Oleastro","sequence":"additional","affiliation":[{"name":"National Institute of Health Ricardo Jorge, Department of Infectious Diseases National Reference Laboratory for Gastrointestinal Infections  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-5035","authenticated-orcid":false,"given":"Jo\u00e3o Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Biomathematics Laboratory, Medical School University of Lisbon  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Isabel","family":"Lopes","sequence":"additional","affiliation":[{"name":"Pediatrics University Clinic, Medical School University of Lisbon  Lisbon Portugal"},{"name":"Pediatric Gastroenterology Unit, Department of Pediatrics Santa Maria University Hospital \u2013CHULN, Lisboa, Portugal, Lisbon Academic Medical Center  Lisbon 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