Searching the H. pylori; serology & PCR in children with adenoid hypertrophy and rhino sinusitis: a cross sectional study, Tehran, Iran

Background: The adenoid tissue may act as a reservoir for bacteria.Goal of study was to evaluate the role of H.pylori infection (PCR and serology) in children with adenoid hypertrophy and rhino sinusitis. Methods: a cross- sectional study had done upon 53 children (Mean age 8 ±1.9 years) with adenoid surgery in ENT and Pediatric Department of Rasul Akram Hospital (2008-2010). Of 53 cases with adenoid surgery, 40 cases had rhino sinusitis (in sinus CT scan). The resected adenoid tissues (n=40) centrifuged and homogenized and its DNAs extracted and searched for H. pylori- DNAs by qualitative PCR. Serum H. pylori antibodies (IgG &IgA ELISA) calculated quantitatively. Chi square values (p < 0.05) calculated for all categorical variables. The agreement between serologic test and PCR was assessed by the calculation of kappa statistic. Results: Positive PCR for H. pylori detected in 15%of cases; regardless of sex and age of cases. Positive IgA: 17.5% (7/40) and IgG: 20% (8/40) respectively. All cases with positive H .pylori- IgG were female; p=0.003 and meaningful differences in mean age of cases observed for positive IgA (p=0.001) and IgG (p=0.01). Poor agreement observed between positive PCR and serum IgG&IgA (Fisher’s Exact test=0.3; 0.5). Conclusion: Positive PCR in adenoid tissue (15%) was very close to positive serum IgA (15%) but without any agreement for each case. The H .pylori infection may have a relative role at least in 15% of children with ade-noid surgery. Chronic sinusitis and ear infection might be added to infected adenoid tissue as a reservoir for bacteria. The search by specific culture may elucidate better the role of H. pylori infections in both gastric and adenoid tissues. The decision for use of antibiotics to eradicate the H. pylori infection in recurrent or chronic adenotonsillar infections (with rhinosinusitis) before adenoid surgery needs Randomized Control Trial (RCT) studies. Drug of choice for eradication of H. pylori dependent to antibiotic sensitivity test in each country