Helicobacter pylori culture and antimicrobial resistance in Iran

Fallahi, Gholamhossein; Maleknejad, Shohreh

doi:10.1007/s12098-007-0003-4

Cited by 41 publications

(28 citation statements)

References 17 publications

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“…Resistance to amoxicillin (2003) was observed in 8.33% of the isolates, reflecting the importance of its administration in our country (3). Subsequent to this report, several investigations were done in Tehran, which considered amoxicillin resistance.…”

Section: Discussionmentioning

confidence: 74%

“…For instance, in several studies performed in Tehran, capital of Iran, resistance rate to clarithromycin was as follows: in two studies, Fallahi et al and Falsafi et al reported the rate of resistance to clarithromycin as 4.16% and 21%, respectively (3,28 (34). In Isfahan, Khashei et al conducted a study that reported 6.25% of resistance (23).…”

Section: Discussionmentioning

confidence: 99%

“…Helicobacter pylori (H. pylori), a class I carcinogen, is a Gram-negative, flagellate bacillus, microaerophilic, spiral bacterium that colonizes the stomachs of approximately half the world's population (1)(2)(3)(4). H. pylori is one of the most common infectious diseases in the world.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Mirzaei

Poursina

Faghri

et al. 2013

Jundishapur J Microbiol

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Background:Helicobacter pylori (H. pylori) is one of the most common infectious diseases in the world. It colonizes about 50-60% of the world's population. The estimated prevalence of H. pylori infection is approximately 65% in Iran. Objectives: The aim of the present study was to investigate the antimicrobial resistance of H. pylori to metronidazole, clarithromycin and amoxicillin. Materials and Methods: A total of 110 biopsy specimens were collected from patients with clinical symptoms of gastrointestinal disorders who were referred to the endoscopy unit at Al-Zahra Hospital, Isfahan, Iran. We investigated the frequency of H. pylori resistance to metronidazole, clarithromycin and amoxicillin among 48 positive isolates of H. pylori from the referred patients. After the culture of biopsy specimens and identification of H. pylori strains, susceptibility tests were done using the E test (epsilometer test) Results: The overall rates of resistance to metronidazole, clarithromycin and amoxicillin were 56.3%, 14.6% and 4.2% respectively. In our study, there was a significant correlation between resistance to metronidazole and gender (P < 0.05) but there was no significant correlation between resistance to amoxicillin and clarithromycin and gender (P ˃ 0.05). Conclusions: Information on antibiotic susceptibility profile plays an important role in empiric antibiotic treatment and management of refractive cases. With regards to this study, using metronidazole in the Isfahan region, can lead to eradication failure in clinical therapies due to having the highest rate of resistance but amoxicillin and clarithromycin are prescribed for first and second lines of treatment against H. pylori. Actually, susceptibility testing of H. pylori isolates in different geographical areas is advised because it aids the selection of optimal therapy regimens.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Mirzaei

Poursina

Faghri

et al. 2013

Jundishapur J Microbiol

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“…In several studies conducted in Iran, different resistance rates to clarithromycin were reported; 4.16, 16 and 2.4%. [162425] Albeit in developed countries approximately 10% of the H. pylori strains were clarithromycin-resistant, but in developing countries this resistance rate was higher. [26–28] Because of current usage of clarithromycin for treatment of H. pylori in Iran, this resistance may be related to cross resistance between other macrolide antibiotics such as erythromycin and clarithromycin.…”

Section: Discussionmentioning

confidence: 99%

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

Shokrzadeh

Jafari

Dabiri

et al. 2011

Saudi J Gastroenterol

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Background/Aim:Helicobacter pylori is an important pathogen for gastroduodenal diseases. Infection with H. pylori can be limited by regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. The aim of this study has been to determine the resistance patterns of H. pylori strains isolated from gastric biopsies of patients with dyspepsia by agar dilution method, in Tehran, IranPatients and Methods:H. pylori isolates from patients with gastrointestinal diseases were evaluated for susceptibility testing by agar dilution method. Susceptibility testing was performed to commonly used antibiotics including clarithromycin, tetracycline, amoxicillin, metronidazole and ciprofloxacin.Results:Among 92 patients with dyspepsia, H. pylori strains were isolated from 42 patients. Seventeen (40.5%) of the isolates were resistant to metronidazole (MICs ≥ 8 μg/l), whereas one isolate (2.4%) was resistant to amoxicillin (MICs ≤ 0. 5 μg/ml) and ciprofloxacin (MICs ≤ 1μg/ml). The resistance rates to other antibiotics in H. pylori isolates are recorded as follows: clarithromycin 6 (14.3 %), tetracycline 2 (4.8%). In 5 of 42 resistant cases, combined resistance was found.Conclusions:These data suggest that metronidazole should be used among Iranian patients in first-line therapy with caution, and ciprofloxacin in association with amoxicillin and a proton pump inhibitor is more recommended.

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“…Since resistance to amoxicillin, tetracycline, and furazolidone have been reported from Iran [17;18;52–55], one cannot assume that all infections are susceptible. Future studies should include collection and storage of biopsies for culture and susceptibility testing so that the results can be interpreted in relation to the susceptibility patterns.…”

Section: Recommendations For Future Studiesmentioning

confidence: 99%

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

et al. 2017

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Background Treatment success of H. pylori eradication therapy has declined worldwide largely because of increased antimicrobial resistance. New therapeutic approaches are needed, especially for countries like Iran, where resistance to commonly used drugs is already widespread and traditional H. pylori therapies produce poor cure rates. Aim to review the results of quadruple therapy trials containing bismuth and furazolidone in Iran. Methods We searched PubMed, Google scholar as well as the references of all published papers for studies done in Iran, utilizing furazolidone in the treatment of H. pylori infections. The target population was 4 drug studies that utilized a combination of bismuth, furazolidone, amoxicillin, or tetracycline plus a proton pump inhibitor. Results Eighteen studies with 22 arms including 1713 subjects were found. The weighted mean cure rate for 14-day studies (6 studies) using 200 mg b.i.d. furazolidone was 80% intention-to-treat (ITT) and 87% per protocol (PP). Studies using 100 mg b.i.d (3 studies) were less effective (weighted mean ITT cure rate = 67%). One small 14 day study with furazolidone 100 mg q.i.d. achieved cure rates of 94.5% ITT and PP. Conclusions Although furazolidone-bismuth quadruple therapy proved relatively effective in Iran, furazolidone-containing regimens remain to be optimized. Based on these data and results from China, it appears likely that 14 day therapy containing furazolidone 100 mg t.i.d. or q.i.d. is likely to provide the highest cure rates with lowest side effects; this remains to be experimentally tested. Detailed suggestions for further development of furazolidone-containing regimens are provided.

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Helicobacter pylori culture and antimicrobial resistance in Iran

Abstract: H. pylori antimicrobial resistance could be a major contributor to failure of H pylori eradication. Continuous prospective surveillance of H. Pylori is essential. Moreover, culture and antimicrobial susceptibility test is recommended for resistant cases after the first failure to therapy.

Cited by 41 publications

References 17 publications

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

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

Furazolidone, an Underutilized Drug for H. pylori Eradication: Lessons from Iran

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