Antimicrobial Susceptibility Testing of Helicobacter Pylori to Selected Agents by Agar Dilution Method in Shiraz-Iran

Kohanteb, J; Bazargani, Abdollah; Saberi-Firoozi, M; Mobasser, A

doi:10.1016/s0255-0857(21)02054-5

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…However successful eradication of H. pylori has been declining globally possibly due to increasing drug resistance rates, and therefore new regimens have been explored to increase successful treatment 7,8 . In Iran, bacterial resistance to clarithromycin, metronidazole, and amoxicillin is reported 28%–34%, 37%–78%, and 10%, respectively 9,10 . In such countries with higher rates of antibiotic resistance, quadruple therapy (QT) with PPI, Bismuth, amoxicillin, and clarithromycin for 14 days is considered as first‐line treatment regimen 11 .…”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 In Iran, bacterial resistance to clarithromycin, metronidazole, and amoxicillin is reported 28%–34%, 37%–78%, and 10%, respectively. 9 , 10 In such countries with higher rates of antibiotic resistance, quadruple therapy (QT) with PPI, Bismuth, amoxicillin, and clarithromycin for 14 days is considered as first‐line treatment regimen. 11 Another contributing factor to the failure of these regimens may be patients' compliance due to major antimicrobial side effects and prolonged treatment course.…”

Section: Introductionmentioning

confidence: 99%

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Sequential therapy versus quadruple therapy for Helicobacter pylori eradication: A prospective double‐blinded randomized controlled trial

Tabesh,

Yadmehr,

Feizi

et al. 2024

Health Science Reports

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Backgrounds and AimsThis controlled randomized clinical trial was designed to compare effectiveness, side effects, and severity of symptoms before and after therapy between quadruple (QT) and sequential regimens (SQ) for Helicobacter Pylori (H. pylori).MethodsPatients were randomly allocated into two groups. Group A received a 14‐day QT including pantoprazole 40 mg q12 h, bismuth subcitrate 240 mg q12 h, clarithromycin 500 mg q12 h, and amoxicillin 1000 mg q12 h and group B received ST including pantoprazole 40 mg q12 h and amoxicillin 1000 mg q12 h for the initial 5 days followed by pantoprazole 40 mg q12 h, clarithromycin 500 mg q12 h and tinidazole 500 mg q12 h for the next 5 days. Adverse drug reactions and patients' compliance were assessed after finishing the treatment course and also 4 weeks after. All patients were naive, therefore ST and QT were first‐line therapies. To evaluate severity of symptoms we used Short‐Form Leeds Dyspepsia Questionnaire (SF‐LDQ) before taking the first dose of regimens, at the end of therapy, and also 4 weeks after (follow‐up).ResultsThe mean age in Group A (n = 83) was 48.55 ± 12.56 and 47.24 ± 12.78 in Group B (n = 79). No statistically significant differences were observed between the two groups regarding age, gender, endoscopic findings, and also eradication rate. The analysis demonstrated a significant decrease in SF‐LDQ score between baseline and after therapy and baseline and follow‐up in both regimen groups. Both regimens were well tolerated by the majority of patients, and there were no significant differences between the two groups in terms of adverse drug reactionsConclusionThis study showed that ST can be used as an alternative first‐line therapy to QT in patients with H. pylori infection.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sequential therapy versus quadruple therapy for Helicobacter pylori eradication: A prospective double‐blinded randomized controlled trial

Tabesh,

Yadmehr,

Feizi

et al. 2024

Health Science Reports

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Helicobacter pylori: a systematic review of drug resistance in Iran

Jafari-Sales,

Jafari,

Khaneshpour

et al. 2022

Reviews and Research in Medical Microbiology

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AIM: Helicobacter pylori (H. pylori) is one of the most common causes of gastrointestinal diseases, including gastric infections in humans. It is estimated that the annual incidence of H. pylori infection in developing countries is 4–15%. Approximately 50% of people worldwide are infected with this bacterium. The purpose of this study is to review recent studies on antibiotic resistance of H. pylori in Iran. Methods: A complete search was performed using SID, PubMed, MEDLINE, Science Direct, Cochrane Library, EMBASE, Google Scholar, and Scopus databases to access various articles for these studies. In this study, articles published from 2005 to 2020 were selected. Previously published specialized articles and systematic meta-analysis were used as a supplementary source for identifying relevant articles. Finally, data from 34 articles were pooled and analyzed. Results: In this study, the resistance of H. pylori to metronidazole, ciprofloxacin, furazolidone, rifamycin, clarithromycin, amoxicillin, and tetracycline antibacterial agents was evaluated in about 34 studies over 15 years. The mean resistance to metronidazole is about 64.10%, rifamycin 27.78%, furazolidone 24.33%, ciprofloxacin 22.51%, clarithromycin 22.50%, amoxicillin 18.37, and tetracycline 14.89%. Conclusion: H. pylori drug resistance has increased throughout Iran against the studied antibiotics. The present study shows alarming results and a new program is needed to eradicate H. pylori infections.

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High Prevalence of Antibiotic Resistance in Iranian Helicobacter pylori Isolates: Importance of Functional and Mutational Analysis of Resistance Genes and Virulence Genotyping

Farzi

Yadegar

Sadeghi

et al. 2019

JCM

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The high prevalence of antibiotic resistance in Helicobacter pylori has become a great challenge in Iran. The genetic mutations that contribute to the resistance have yet to be precisely identified. This study aimed to investigate the prevalence of antibiotic resistance and virulence markers in Iranian H. pylori isolates and to analyze if there is any association between resistance and genotype. Antibiotic susceptibility patterns of 68 H. pylori isolates were investigated against metronidazole, clarithromycin, amoxicillin, rifampicin, ciprofloxacin, levofloxacin, and tetracycline by the agar dilution method. The frxA, rdxA, gyrA, gyrB, and 23S rRNA genes of the isolates were sequenced. The virulence genotypes were also determined using PCR. Metronidazole resistance was present in 82.4% of the isolates, followed by clarithromycin (33.8%), ciprofloxacin (33.8%), rifampicin (32.4%), amoxicillin (30.9%), levofloxacin (27.9%), and tetracycline (4.4%). Overall, 75% of the isolates were resistant to at least two antibiotics tested and considered as a multidrug resistance (MDR) phenotype. Most of the metronidazole-resistant isolates carried frameshift mutations in both frxA and rdxA genes, and premature termination occurred in positions Q5Stop and Q50Stop, respectively. Amino acid substitutions M191I, G208E, and V199A were predominantly found in gyrA gene of fluoroquinolone-resistant isolates. A2143G and C2195T mutations of 23S rRNA were found in four clarithromycin-resistant isolates. Interestingly, significant associations were found between resistance to metronidazole (MNZ) and cagA-, sabA-, and dupA-positive genotypes, with p = 0.0002, p = 0.0001, and p = 0.0001, respectively. Furthermore, a significant association was found between oipA “on” status and resistance to amoxicillin (AMX) (p = 0.02). The prevalence of H. pylori antibiotic resistance is high in our region, particularly that of metronidazole, clarithromycin, ciprofloxacin, and MDR. Simultaneous screening of virulence and resistance genotypes can help clinicians to choose the appropriate therapeutic regime against H. pylori infection.

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Antimicrobial Susceptibility Testing of Helicobacter Pylori to Selected Agents by Agar Dilution Method in Shiraz-Iran

Cited by 4 publications

References 17 publications

Sequential therapy versus quadruple therapy for Helicobacter pylori eradication: A prospective double‐blinded randomized controlled trial

Sequential therapy versus quadruple therapy for Helicobacter pylori eradication: A prospective double‐blinded randomized controlled trial

Helicobacter pylori: a systematic review of drug resistance in Iran

High Prevalence of Antibiotic Resistance in Iranian Helicobacter pylori Isolates: Importance of Functional and Mutational Analysis of Resistance Genes and Virulence Genotyping

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