Dynamics of antimicrobial resistance of Helicobacter pylori isolates in the Smolensk region of Russian Federation

Abstract

Background Efficacy of Helicobacter pylori eradication therapy depends on the chance of having a resistant H. pylori strain, which is ultimately related to the local antimicrobial resistance epidemiology. Aim To assess H. pylori resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline in adult patients in the Smolensk region of Russian Federation over a 9‐year period. Materials and methods Biopsy samples were taken from the gastric antrum and body of 573 and 210 patients with dyspepsia symptoms and positive rapid urease test during esophagogastroduodenoscopy in 2015‐2017 and 2009‐2010, respectively. Antimicrobial susceptibility testing was performed for clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline by the agar dilution method. Results A total of 143 strains of H. pylori isolated during 2015‐2017 and 133 strains isolated during 2009‐2010 were tested. Culture success rates were 30% vs 64% for the two periods. Over the 2015‐2017, the prevalence of resistance to clarithromycin was 6.3%, to amoxicillin 1.4%, to metronidazole 23.8%, to levofloxacin 24.5%, and to tetracycline 0.7%. Over the 2009‐2010, the corresponding resistance rates were 5.3%, 4.5%, 3.8%, 8.3%, and 0%, respectively. There were no significant increases in resistance to clarithromycin, amoxicillin, and tetracycline (P > 0.05) over the 9 years period. Significant increase in resistance to levofloxacin (8.3% in 2009‐2010% vs 24.5% in 2015‐2017, P < 0.01) and metronidazole (3.8% in 2009‐2010% vs 23.8% in 2015‐2017, P < 0.01) was observed. Conclusions H. pylori resistance to clarithromycin remained low in the Smolensk region of Russian Federation between 2009 and 2017. Resistance to levofloxacin and metronidazole increased between 2009 and 2017.

Resistance of helicobacter pylori to antibacterial medications as a risk factor of infection development

“…Antimicrobial resistance of H. pylori isolates was estimated in the region via serial cultivations. Resistance amounted to 5.3 % in 2009-2010 and it grew insignificantly in a period from 2015 to 2017, to 6.3 % [44]. Similar results were obtained in cities located in Volga region.…”

“…Studies performed in Russia over a 10-year period allowed revealing a considerable growth in resistance to Metronidazole, from 3.8 % in 2009-2010 to 23.8 % in 2015-2017 [44]. There are also data on absence of any significant H. pylori resistance to Metronidazole and on rare resistance to bothmedications, Clarithromycin and Metronidazole [41].…”

Resistance of helicobacter pylori to antibacterial medications as a risk factor of infection development

“…Если в течение 2009-2010 гг. данный показатель был 5,3 %, то в период с 2015 по 2017 г. увеличился незначительно -до 6,3 % [44]. Аналогичные результаты были получены в городах Поволжья: в 2012 г. уровень первичной резистентности H. pylori к кларитромицину в Нижегородской области по данным ПЦР-анализа составил 7,3 %, а в 2016 г. вырос до 15,1 % [45].…”

“…до 23,8 % в 2015-2017 гг. [44]. Имеются данные об отсутствии значимой устойчивости патогена к метронидазолу и о редком обнаружении устойчивости к двум лекарствам: кларитромицину и метронидазолу [41].…”

“…до 24,5 %, зарегистрированных в течение 2015-2017 гг. [44]. При наличии приведенного значения данного показателя устойчивости левофлоксацин не может быть рекомендован как замена кларитромицину.…”