Antibiotic susceptibility profile of Helicobacter pylori isolated from the dyspepsia patients in Tehran, Iran

Shokrzadeh, Leila; Jafari, Fatemeh; Dabiri, Hossein; Baghaei, Kaveh; Zojaji, Homayoun; Alizadeh, Amir Hooshang Mohammad; Aslani, Mohammad Mehdi; Zali, Mohammad Reza

doi:10.4103/1319-3767.82581

Cited by 29 publications

(13 citation statements)

References 26 publications

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“…Even though the rates of ciprofloxacin resistance among patients with gastritis and duodenal ulcers were 24.1% and 20%, respectively, there was no meaningful correlation between resistance rates and clinical parameters (17). Additionally, just like the present study, Llanes et al in Cuba and Shokrzadeh et al in Iran found no correlation between ciprofloxacin resistance and patients' gender (30,31). Lower rates of ciprofloxacin resistance among 60 -75-year-old patients might be due to the lower rate of ciprofloxacin consumption among these people compared to younger patients.…”

Section: Discussioncontrasting

confidence: 65%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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Background:The extent of antibiotic resistance among Helicobacter pylori strains influences current clinical therapeutic regimens in each region. Objectives: This cross-sectional study aimed to determine the resistance property and minimum inhibitory concentration (MIC50-90) of Helicobacter pylori strains toward metronidazole, clarithromycin, and ciprofloxacin in patients with distinct gastric histopathological changes in Tehran, Iran. Methods: This study was conducted on 170 patients suffering from gastric complications in three hospitals in Tehran from October 2014 until March 2015. Two separate biopsy samples were collected from each patient and used for pathological and microbiological examinations. Antimicrobial susceptibility tests were performed by agar dilution method according to the CLSI guidelines.The MIC values and susceptibility to varying concentrations of metronidazole (4 to 64 µg/mL), ciprofloxacin (0.5 to 16 µg/mL), and clarithromycin (0.25 to 16 µg/mL) were determined based on EUCAST recommendations. Results:Our results indicated the infection with H. pylori in a frequency of 32% (55/170) among the study patients (female, 51% and male, 49%). Endoscopic findings indicated that 42% of the patients suffered from peptic ulcers, 33% from duodenal ulcers, and 25% with a non-ulcer disease. Pathological findings indicated 58% of the patients had chronic gastritis, 33% had active chronic gastritis, and 9% suffered from intestinal metaplasia. In terms of antibiotic susceptibility, nearly 76.3%, 49%, and 45.5% of the strains were resistant to metronidazole, clarithromycin, and ciprofloxacin, respectively. The MIC values at which the growth of 50% and 90% of the strains was inhibited (MIC50-90) were 32 -64 µg/mL for metronidazole, 0.5 -16 µg/mL for clarithromycin, and 2 -16 µg/mL for ciprofloxacin. Conclusions: The overall resistance levels were relatively high among the study patients. Accordingly, the administration of other anti-Helicobacter drugs, as well as more appropriate therapeutic regimens based on laboratory results, is recommended in patients with a history of treatment failure. Patient Consent:All patients announced their agreement with this study by signing informed consent forms.

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Section: Discussioncontrasting

confidence: 65%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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“…Different resistance rates of H. pylori to clarithromycin have been reported in different regions of Iran. In studies by Safavi et al (40) and Shokrzadeh et al (37) the resistance rate was reported to be 22.4% and 14%, respectively (37,40), whereas Abdollahi et al reported a rate of 31.7% (31). For the first time, Versalovich and colleagues reported that point mutations in the 23s rRNA variable region are related to the resistance of H. pylori to clarithromycin.…”

Section: Discussionmentioning

confidence: 98%

“…For example, the resistance rate has been reported to be 77.8% and 68.8% in China and Gambia, respectively (12,35). Low rates of metronidazole resistance, 23.9% and 40.5%, have been reported from Taiwan and Iran, respectively (36,37).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Metronidazole and Clarithromycin Resistance Among Helicobacter pylori Isolates of Ahvaz (Southwest of Iran) During 2015 - 2016 by Phenotypic and Molecular Methods

Amin

Shayesteh

Serajian

et al. 2019

Jundishapur J Microbiol

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Background: Helicobacter pylori, a Gram-negative bacteria, is the most important cause of gastric ulcer, gastric malignancies, and chronic gastritis. Clarithromycin is recognized as the most important antibiotic for the treatment. Clarithromycin resistance is related to point mutations in the 23srRNA, and the most important mutation is A2143G, A2142G. The most common cause of resistance to metronidazole is rdxA gene mutational inactivation. Objectives: This study aimed to evaluate clarithromycin and metronidazole resistance in H. pylori by phenotypic and genotypic methods. Methods: In total, 338 gastric biopsy samples were collected. The samples were cultivated on Colombia agar, consisting of various antibiotics and were incubated at 37°C under microaerophilic conditions. The biochemical tests and PCR assay were applied to identify the strains as H. pylori. The E-test was applied in the antibiogram test based on CLSI standard. The PCR-RFLP assay was performed to identify point mutations and followed by sequencing. The PCR method was done to identify deletion of a 200-bp fragment from the rdxA gene. Results: In total, 131 (38.7%) H. pylori strains were isolated that among them, 70 (53.4%) and 83 (63.4%) showed resistance to clarithromycin and metronidazole, respectively. Prevalence of A2143G, A2142G, A2142C mutations were 71.4%, 7.1% and 4.3%, respectively. Seven (8.4%) strains, included 200-bp deletion. Conclusions: The high prevalence of resistance to clarithromycin and metronidazole in H. pylori is a major concern revealed by this study which should be taken into account by physicians in selecting drug regimens. The results confirmed the necessity of phenotypic and genotypic methods of antibiotic susceptibility.

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“…In most studies, resistance to Clarithromycin has been reported to be above 10% in Iran [41][42][43][44] and above 20% in Turkey [16,17,45] (Table 1). Furthermore, Clarithromycin is not routinely administered in Iran due to its high cost.…”

Section: Standard Triple Therapymentioning

confidence: 99%

“…In Iran, the resistance rate has been increasing, from 33% in 1997 to 76.8% in 2012 [13,14,[41][42][43][44]58] . The rate has also been rising from 38% to 78.5% over the past 20 years in Saudi Arabia [59][60][61][62] .…”

Section: Therapymentioning

confidence: 99%

Helicobacter pylorieradication in West Asia: A review

Fakheri

Bari

Aarabi

et al. 2014

WJG

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The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. However, no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region. Therefore, we conducted a review to select the best options and provide recommendations for H. pylori treatment in this geographic region. A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June 2013. According to the results, among different therapeutic regimens used as the first-line protocols, 10-d Bismuth-Furazolidone/Metronidazole quadruple therapy, 14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor + Bismuth + Tetracycline (500 mg QID) + Metronidazole (500 mg TDS) seemed to be appropriate options. Among second-line therapeutic regimens, Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole, triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth + Azithromycin and Ofloxacin seemed to be effective options. Third-line therapies were not evaluated in West Asia; most guidelines, however, recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H. pylori . Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same. Core tip: The efficacy of first-and second-line Helicobacter pylori (H. pylori ) eradication regimens varies considerably in West Asian countries, mainly due to the variable prevalence of resistant organisms. The present study evaluates and compares the efficacy of different regimens among different countries of this region. Although we limited our investigation to H. pylori eradication regimens in West Asia, the clinical significance of the results goes beyond the countries situated in this geographic region. In fact, the results are transferrable to any region as long as the patterns of resistance are the same.

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Antibiotic susceptibility profile of Helicobacter pylori isolated from the dyspepsia patients in Tehran, Iran

Cited by 29 publications

References 26 publications

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Assessment of Metronidazole and Clarithromycin Resistance Among Helicobacter pylori Isolates of Ahvaz (Southwest of Iran) During 2015 - 2016 by Phenotypic and Molecular Methods

Helicobacter pylorieradication in West Asia: A review

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