Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Aftab, Hafeza; Miftahussurur, Muhammad; Subsomwong, Phawinee; Ahmed, Faruque; Khan, Adnan; Yamaoka, Yoshio

doi:10.3855/jidc.7713

Cited by 38 publications

(50 citation statements)

References 52 publications

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“…The point mutations correlated with clarithromycin resistance among H. pylori Asian isolates are different from those Western isolates. While, the A2143G mutation is responsible for 90% of the resistance cases in Western countries, but this rate for Asian countries is account for 23% (42). This finding is similar to our results (90% A2142G vs 10% A2143G mutation).…”

Section: Discussionsupporting

confidence: 91%

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

Khashei

Dara

Bazargani

et al. 2016

APMIS

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This study aimed to investigate the clarithromycin resistance and its associated molecular mechanisms among Helicobacter pylori isolates from dyspeptic patients in Shiraz, Iran. From January to May 2014, 100 H. pylori strains were isolated from patients with gastroduodenal disorders. The resistance to clarithromycin was quantitatively evaluated, using Epsilometer (E-test) method. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed on all the isolates to detect A2143G and A2142G mutations in 23S rRNA gene. The H. pylori isolation rate was found to be 31.4%. E-test showed that 20% of isolates were resistant to clarithromycin (MIC ≥ 1 mg/L). MIC of clarithromycin ranged between 0.016 and 24 mg/L. Findings of PCR-RFLP showed that the A2142G was the most (90%) frequently point mutation, followed by the A2143G (10%). No statistically significant difference was found between H. pylori clarithromycin resistance point mutations and patients' gender or age. To the best of our knowledge, this is the first report of high frequency of A2142G point mutation in Iran and probably in other regions of the world. Considering the increasing trend of H. pylori resistance to clarithromycin due to these mutations, it is crucial to investigate the new therapeutic approaches against H. pylori infection.

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Section: Discussionsupporting

confidence: 91%

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

Khashei

Dara

Bazargani

et al. 2016

APMIS

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“…Publication year 2004-2010 11 (23.9) (Arifeen et al, 2009;Brooks et al, 2005;Haque and Salam, 2010;Khan et al, 2004;Mahbubur et al, 2007;Monjur et al, 2010;Nahar et al, 2004;Rahman et al, 2005;Saha et al, 2009;Shahriar et al, 2010;Shill et al, 2010Shill et al, ) 2011Shill et al, -2014 14 (30.4) (Afroz et al, 2014;Ahmed et al, 2011Ahmed et al, , 2014Akram et al, 2014;Akter et al, 2014;Begum et al, 2013;Chiou et al, 2014;Dutta et al, 2013;Haque et al, 2011;Hossain et al, 2014;Islam et al, 2014;Khan et al, 2013;Rahman et al, 2014;Ud-Din et al, 2013-2018 21 (45.7) (Aftab et al, 2016;Ahmed et al, 2017Ahmed et al, , 2018Ahsan et al, 2016;Akter et al, 2016Akter et al, , 2017Begum et al, 2016;Chakraborty et al, 2016;Chowdhury and Parial, 2015;Haque et al, 2015;Hasan et al, 2016;Islam and Shamsuzzaman, 2015;Jobayer et al, 2017;Khanam et al, 2015;Nazme et al, 2017;…”

Section: Characteristicsmentioning

confidence: 99%

“…Community-acquired 5 (10.9) (Akter et al, 2014;Arifeen et al, 2009;Brooks et al, 2005;Mahbubur et al, 2007; (Aftab et al, 2016;Chiou et al, 2014;Hasan et al, 2016;Islam and Shamsuzzaman, 2015;Nahar et al, 2004;Rahman et al, 2014;Suchi et al, 2017) E-test 5 (10.9) (Arifeen et al, 2009;Begum et al, 2016;Khan et al, 2013;Mahbubur et al, 2007;Saha et al, 2009) Did not mention 5 (10.9) (Ahmed et al, 2018;Akram et al, 2014;Islam et al, 2014;Nazme et al, 2017;Shill et al, (Akter et al, 2016;Chowdhury and Parial, 2015;Haque et al, 2015;Khan et al, 2013;Nazme et al, 2017;Rahman et al, 2014;Saha et al, 2015;Shill et al, 2010;Suchi et al, 2017;Yasmeen et al, 2015) Bloodstream infection 7 (15.2) (Afroz et al, 2014;Ahmed et al, 2017Ahmed et al, , 2018Ahsan et al, 2016;Brooks et al, 2005;Khanam et al, 2015;Monjur et al, 2010) Gastroenteritis 8 (17.4) (Ahmed et al, 2011(Ahmed et al, , 2014Akter et al, 2017;Begum et al, 2016;Khan et al, 2004;…”

Section: Source Of Infectionmentioning

confidence: 99%

Antibiotic resistance in Bangladesh: A systematic review

Ahmed

Rabbi

Sultana

2019

International Journal of Infectious Diseases

176

125

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Background: Antibiotic resistance (ABR) is a worldwide problem and Bangladesh is a major contributor to this owing to its poor healthcare standards, along with the misuse and overuse of antibiotics. This systematic review was conducted to summarize the present scenario of ABR in Bangladesh, to identify gaps in surveillance, and to provide recommendations based on the findings. Methods: Google Scholar, PubMed, and Bangladesh Journals Online were searched using relevant keywords to identify articles related to ABR in Bangladesh published between 2004 and 2018. Inclusion or exclusion was based on a predefined set of criteria. The resistance of a bacterium to a given drug was presented as the median resistance (MR) and interquartile range (IQR). Results: Forty-six articles were included in this systematic review. Antimicrobial susceptibility testing was performed by disk diffusion method in 82.6% of studies, while the Clinical and Laboratory Standards Institute (CLSI) guidelines were followed in 78.3%. Data regarding the susceptibility testing method, guidelines for interpretation, and source of infection (hospital/community) were absent in 10.9%, 19.6%, and 73.9% of the studies, respectively. A high prevalence of resistance was detected in most tested pathogens, and many of the common first-line drugs were mostly ineffective. Resistance to carbapenems was low in most cases. The presence of extended-spectrum beta-lactamase (ESBL)-producing organisms was indicated by the high resistance to beta-lactams. Methicillin-resistant Staphylococcus aureus (MRSA) was identified in four studies. Three studies reported vancomycin susceptibility of enterococci, and the median susceptibility was 100%. Streptococcus pneumoniae exhibited high susceptibility to penicillin (MR 4%). Resistance data were available from only six out of the 64 districts of Bangladesh. Conclusions: A high prevalence of resistance to most antibiotics was detected, along with major gaps in surveillance and information gaps in the methodological data of the studies (susceptibility testing method, guidelines for susceptibility interpretation, source of infection). Based on the findings, we recommend appropriate initiatives to monitor and control the use of antibiotics, as well as nationwide surveillance following standardized methodologies.

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“…Generally, South Asian countries are the high CAM and MNZ resistance prevalence region [5]. Moreover, India and Bangladesh strains demonstrated emerging levofloxacin (LVX) resistance [22, 23], the second-line regimen drug and as a rescue treatment for H. pylori eradication . In recent years, antibiotic resistance is expanding overall [24, 25], it is critical to look at current drug resistance rates in Nepal.…”

Section: Introductionmentioning

confidence: 99%

Emerging Helicobacter pylori levofloxacin resistance and novel genetic mutation in Nepal

et al. 2016

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BackgroundThe prevalence of Helicobacter pylori antibiotic susceptibility in the Nepalese strains is untracked. We determined the antibiotic susceptibility for H. pylori and analyzed the presence of genetic mutations associated with antibiotic resistance in Nepalese strains.ResultsThis study included 146 consecutive patients who underwent gastroduodenal endoscopy in Kathmandu, Nepal. Among 42 isolated H. pylori, there was no resistance to amoxicillin and tetracycline. In contrast, similar with typical South Asian patterns; metronidazole resistance rate in Nepalese strains were extremely high (88.1 %, 37/42). Clarithromycin resistance rate in Nepalese strains were modestly high (21.4 %, 9/42). Most of metronidazole resistant strains had highly distributed rdxA and frxA mutations, but were relative coincidence without a synergistic effect to increase the minimum inhibitory concentration (MIC). Among strains with the high MIC, 63.6 % (7/11) were associated with frameshift mutation at position 18 of frxA with or without rdxA involvement. However, based on next generation sequencing data we found that one strain with the highest MIC value had a novel mutation in the form of amino acid substituted at Ala-212, Gln-382, Ile-485 of dppA and Leu-145, Thr-168, Glu-117, Val-121, Arg-221 in dapF aside from missense mutations in full-length rdxA. Mutations at Asn-87 and/or Asp-91 of the gyrA were predominantly in levofloxacin-resistant strains. The gyrB mutation had steady relationship with the gyrA 87–91 mutations. Although three (44.4 %) and two (22.2 %) of clarithromycin resistant strains had point mutation on A2143G and A2146G, we confirmed the involvement of rpl22 and infB in high MIC strains without an 23SrRNA mutation.ConclusionsThe rates of resistance to clarithromycin, metronidazole and levofloxacin were high in Nepalese strains, indicating that these antibiotics-based triple therapies are not useful as first-line treatment in Nepal. Bismuth or non-bismuth-based quadruple regimens, furazolidone-based triple therapy or rifabutin-based triple therapy may become alternative strategy in Nepal.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0873-6) contains supplementary material, which is available to authorized users.

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Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Cited by 38 publications

References 52 publications

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

Antibiotic resistance in Bangladesh: A systematic review

Emerging Helicobacter pylori levofloxacin resistance and novel genetic mutation in Nepal

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