Peng Chao, Hu Yi, Ge Zhong-Ming, Zou Quan-Ming, Lyu Nong-Hua
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nachang, Jiangxi 330000, China.
Division of Comparative Medicine, The Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Chronic Dis Transl Med. 2020 Jan 8;5(4):243-251. doi: 10.1016/j.cdtm.2019.12.003. eCollection 2019 Dec.
() infection is associated with various gastric and extra-gastric diseases. Importantly, this infection is the strongest known risk factor for gastric cancer (GC). eradication can effectively prevent infection-associated diseases in -positive patients, including children and elderly subjects. However, a limited selection of antibiotics, a higher reinfection rate, and certain spontaneous clearance rates, to some extent, restrict the choice of treatments in pediatrics. In addition, it is imperative to perform an accurate diagnosis of infection in children by determining the presence of the infection and the underlying cause of symptoms. In elderly patients, poor tolerance to drugs and higher sensitivity to adverse effects are major concerns during therapy. Recent studies have demonstrated that eradication could significantly lower the GC risk in the elderly population. The benefit and risk of eradication in elderly patients should be comprehensively considered and balanced. If available, susceptibility-based tailored therapies may be preferable in eradicating . In addition, to increase the eradication rate and reduce adverse effects, new therapeutic strategies (e.g., probiotic supplementation, berberine supplementation, dual therapy) for infection are being extensively investigated. The impact of eradication with antibiotics on the microbiota in children has been explored, but further high-quality studies are crucial to delineate the extent of eradication affecting the microbial community in children. In this review, we summarize the current understanding of diagnosis and treatment in children and the elderly population and aim to provide insights into the efficient management and treatment implementation in these populations.
（）感染与多种胃部及胃外疾病相关。重要的是，这种感染是已知的最强的胃癌（GC）风险因素。根除（该感染）可有效预防阳性患者（包括儿童和老年受试者）中与感染相关的疾病。然而，抗生素选择有限、再感染率较高以及一定的自发清除率在一定程度上限制了儿科中（该感染）治疗方法的选择。此外，通过确定感染的存在和症状的潜在原因来准确诊断儿童感染至关重要。在老年患者中，药物耐受性差和对不良反应的高敏感性是治疗期间的主要关注点。最近的研究表明，根除（该感染）可显著降低老年人群患GC的风险。应全面考虑和权衡老年患者根除（该感染）的益处和风险。如果可行，基于药敏的个体化治疗在根除（该感染）方面可能更可取。此外，为了提高根除率并减少不良反应，正在广泛研究针对（该感染）的新治疗策略（例如补充益生菌、补充黄连素、双联疗法）。已经探讨了用抗生素根除（该感染）对儿童微生物群的影响，但进一步的高质量研究对于阐明根除（该感染）对儿童微生物群落的影响程度至关重要。在本综述中，我们总结了目前对儿童和老年人群中（该感染）诊断和治疗的认识，旨在为这些人群的有效管理和治疗实施提供见解。
