Drug Resistance in Helicobacter Pylori

Vianna, Júlia Silveira; Ramis, Ivy Bastos; Ramos, Daniela Fernandes; Groll, Andréa von; Silva, Pedro Eduardo Almeida da

doi:10.1590/s0004-28032016000400002

Cited by 42 publications

(34 citation statements)

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“…In the present study, we found a high prevalence of primary resistance to CLA; thus, according to Maastricht's recommendations it should not be used for H. pylori eradication prior to in vitro susceptibility testing . Also, it is necessary to determine the prevalence of FLQ resistance and to restrict its use to treatment of infections caused by H. pylori . Regarding MTZ, the high rate of resistance to it found in the present study may limit its use for H. pylori eradication.…”

Section: Discussionmentioning

confidence: 57%

Molecular diagnosis of Helicobacter pylori antibiotic resistance in the Taif region, Saudi Arabia

Eed

Hawash

Khalifa

et al. 2019

Microbiology and Immunology

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Success in eradication of Helicobacter pylori is declining globally because H. pylori has developed resistance against most of the antibiotics proposed for eradication regimens, mainly through point mutations. The present study included 200 patients with dyspepsia attending Taif Hospital. Gastric biopsies were obtained during gastroscopy and subjected to rapid urease testing. Molecular methods were used to confirm diagnoses of H. pylori infection and to identify resistance gene variants of four antibiotics; namely, clarithromycin, metronidazole, fluoroquinolones and tetracycline (23S rRNA, gyrA, rdxA and 16S rRNA respectively). Of all investigated patients, Molecular diagnoses were made in 143 of all investigated patients; thus, the prevalence was .5%. The overall rate of resistance to clarithromycin among the H. pylori‐positive patients was high (39.9%) and the rate of resistance significantly greater (48.2%) among the secondary resistance group, secondary resistance being defined as resistance as a result of previous exposure to the relevant antibiotic. The rate of resistance to fluoroquinolones was considered moderate; the difference in rate of resistance between the primary and secondary resistance groups (8.4% and 9.5%, respectively) was not significant Also, there was a low prevalence of both primary and the secondary tetracycline resistance in the study cohort. In contrast, the prevalence of metronidazole resistance was considered high with no significant difference between the two resistance groups. H. pylori showed an increased prevalence of resistance to all four of the commonly used therapeutic agents. Thus, eradication therapy should be based on the regional results of susceptibility testing. Moreover, treatment tailored according to individually determined H. pylori susceptibility may be a reasonable future goal.

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Section: Discussionmentioning

confidence: 57%

Molecular diagnosis of Helicobacter pylori antibiotic resistance in the Taif region, Saudi Arabia

Eed

Hawash

Khalifa

et al. 2019

Microbiology and Immunology

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“…9,10 Nonetheless, H. pylori's resistance to levofloxacin is on the rise due to fluoroquinolone overuse, and rates have been estimated at 22%-33.9% in Europe, 4.9%-34.5% in Asia, and 31.9% in the United States accordingly to a recent study among male US Veterans. 4,11 Thus, in the subgroup of patients refractory to first-and second-line treatment, bismuthquadruple therapy (bismuth, metronidazole, tetracycline, and a PPI) is lately recommended, although available evidence supporting this approach is limited. 3,7 This combination has several advantages: First, tetracycline resistance is rare (<1%) or even absent in some regions 4 ; second, its effectiveness despite in vitro metronidazole resistance has been reported 12,13 ; and third, it has been shown that bismuth tends to aggregate within and on the surface of H. pylori exerting an antibacterial effect.…”

Section: Introductionmentioning

confidence: 99%

Limited effectiveness with a 10‐day bismuth‐containing quadruple therapy (Pylera^®) in third‐line recue treatment for Helicobacter pylori infection. A real‐life multicenter study

et al. 2017

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“…Vianna et al conducted an extensive review of the major studies carried out in different regions of the world on the resistance to each antibiotic routinely used in H. pylori eradication schemes. The authors showed different results observed in studies across the US, Europe and Asia, once again highlighting the importance of local and regional determination of antimicrobial resistance (12) . 2000 and 2014 show that the population's resistance to clarithomycin ranged from 7% to 27%, varying across different regions (3) .…”

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confidence: 80%

“…draws attention to some factors that may commit the efficacy of the threefold scheme, such as high resistance to antibiotics, specially to clarithomycin; incomplete treatment compliance; high gastric acidity, high bacterial load and different strains of H. pylori (8) . This months' edition of Archives of Gastroenterology journal publishes an excellent review paper on the resistance of H. pylori to antimicrobials, written by Vianna et al (12) . The authors carried a careful and comprehensive literature review on available methods to diagnose bacterial resistance, further highlighting the current susceptibility to each of the antibiotics used to treat this infection and the main factors associated with resistance in these cases.…”

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confidence: 99%