<i>Helicobacter pylori:</i> Antibiotic resistance and treatment options

Katelaris, Peter

doi:10.1111/j.1440-1746.2009.05911.x

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…Antimicrobial resistance varies by geographical region and is highly influenced by patterns of antimicrobial use within a population [4,5,14]. The key determinants of the outcome of eradication therapy for H. pylori infection are compliance and the presence of pretreatment antibiotic resistance of the isolate [15]. In this study we reported the susceptibility of H. pylori strains from Mongolia, a country with a high prevalence of infection, to the most commonly used antibiotics.…”

Section: Discussionmentioning

confidence: 93%

Antibiotic resistance of Helicobacter pylori in Mongolia

Bolor-Erdene

Namdag

Yamaoka

et al. 2017

J Infect Dev Ctries

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Introduction.The resistance of Helicobacter pylori to recently available antibiotic treatment regimens has been recognized as a growing problem. Therefore, the aim of this study was to determine the prevalence of antibiotic resistance among H. pylori strains isolated from Mongolians. Methodology. All gastric biopsy specimens were obtained during upper gastrointestinal endoscopy from patients referred for the exploration of dyspepsia. The urease positive samples by rapid urease test were cultured according to standard microbiological procedures and H. pylori were grown under microaerophilic conditions on selective Pylori agar. H. pylori antibiotic sensitivity was examined using E-test. In addition, the mutations of the corresponding gene were studied by GenoType HelicoDR DNA strip testing. Results. Three hundred twenty patients, 216 female and 104 male in the ages range of 18 to 83 years were included in this study. Rapid urease test yielded positive results for 65.9% (211/320). Among them, we have successfully obtained 72% H. pylori isolates. The antibiotic resistance rates were 35.5% for clarithromycin, 68.4% metronidazole, 23.0% amoxicillin, 25.0% tetracycline, 28.2% erythromycin and 14.5% nitrofuranton. Resistance for 2 drugs was 34.5% and that of 3 drugs was observed in 14.5% of isolates. The most prevalent mutation was A2147G followed by A2146G and D91Y. The prevalence of H. pylori infection increased among Mongolian population and the prevalence of resistance of H. pylori is very high to metronidazole, and moderate to clarithromycin. Conclusion. The data on antimicrobial susceptibilities provided by the present study is may assist the clinicians on the effectiveness of treatment regimens.

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Section: Discussionmentioning

confidence: 93%

Antibiotic resistance of Helicobacter pylori in Mongolia

Bolor-Erdene

Namdag

Yamaoka

et al. 2017

J Infect Dev Ctries

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“…The severity of clinical manifestations is associated with bacterial load (Kusters et al, 2006). Meanwhile, the growing H. pylori drug resistance in Asia countries severely influences the efficacy of eradication treatment, which required drug resistance analysis before treatment (Katelaris, 2009; Cammarota et al, 2012; Alfizah et al, 2014; Smith et al, 2014). Therefore, it is important to analyze the virulence, bacterial load and resistance profiles during the identification of H. pylori .…”

Section: Discussionmentioning

confidence: 99%

Validation of a High-Throughput Multiplex Genetic Detection System for Helicobacter pylori Identification, Quantification, Virulence, and Resistance Analysis

Zhang

Zhao

Kong³

et al. 2016

Front. Microbiol.

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Helicobacter pylori (H. pylori) infection is closely related to various gastroduodenal diseases. Virulence factors and bacterial load of H. pylori are associated with clinical outcomes, and drug-resistance severely impacts the clinical efficacy of eradication treatment. Existing detection methods are low-throughput, time-consuming and labor intensive. Therefore, a rapid and high-throughput method is needed for clinical diagnosis, treatment, and monitoring for H. pylori. High-throughput Multiplex Genetic Detection System (HMGS) assay was established to simultaneously detect and analyze a set of genes for H. pylori identification, quantification, virulence, and drug resistance by optimizing the singlet-PCR and multiple primers assay. Twenty-one pairs of chimeric primers consisted of conserved and specific gene sequences of H. pylori tagged with universal sequence at the 5′ end were designed. Singlet-PCR assay and multiple primers assay were developed to optimize the HMGS. The specificity of HMGS assay was evaluated using standard H. pylori strains and bacterial controls. Six clinical isolates with known genetic background of target genes were detected to assess the accuracy of HMGS assay. Artificial mixed pathogen DNA templates were used to evaluate the ability to distinguish mixed infections using HMGS assay. Furthermore, gastric biopsy specimens with corresponding isolated strains were used to assess the capability of HMGS assay in detecting biopsy specimens directly. HMGS assay was specific for H. pylori identification. HMGS assay for H. pylori target genes detection were completely consistent with the corresponding genetic background. Mixed infection with different drug-resistant isolates of H. pylori could be distinguished by HMGS assay. HMGS assay could efficiently diagnose H. pylori infection in gastric biopsy specimens directly. HMGS assay is a rapid and high throughput method for the simultaneous identification and quantification of H. pylori, analysis of virulence and drug resistance in both isolated strains and biopsy specimens. It could also be used to distinguish the mixed infection with different resistant genotype strains. Furthermore, HMGS could detect H. pylori infection in gastric biopsy specimens directly.

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“…Recently, the resistance rate for MNZ has increased, and this is a main factor leading to the reduction in the efficacy of standard triple therapy in most countries 20 . Although in vitro resistance to MNZ may not accurately reflect in vivo resistance, regimens including MNZ are not a preferable choice in populations with >40% MNZ resistance 17, 35 . Therefore, MNZ will not be useful as a first-line regimen instead of CLR in Vietnam.…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Primary Antibiotic Resistance of Helicobacter pylori in Vietnam

Binh

Shiota

Nguyen

et al. 2013

Journal of Clinical Gastroenterology

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Goals To determine the susceptibility of Helicobacter pylori strains isolated from a Vietnamese population to 5 antibiotics. Background The incidence of antibiotic resistance in H. pylori infection is increasing worldwide and has become a leading cause for failure of treatment. Antibiotic susceptibility testing is very important to provide optimal regimens in a clinical setting. Study We isolated 103 H. pylori strains from the gastric mucosa of H. pylori-infected patients from 2 areas in Vietnam (Ho Chi Minh and Hanoi) in 2008. Epsilometer test was used to determine the minimum inhibitory concentrations of amoxicillin (AMX), clarithromycin (CLR), metronidazole (MNZ), levofloxacin (LVFX), and tetracycline (TC). Results Among the 103 strains, the resistance rates were 0% (AMX), 33% (CLR), 69.9% (MNZ), 18.4% (LVFX), and 5.8% (TC). The resistant strains showed a high-level of resistance (≥256 μg/mL) to CLR, 23.5% (8/34), and MNZ, 29.1% (21/72). The resistance rate for CLR was significantly higher in Ho Chi Minh than in Hanoi (49% vs. 18.5%, P = 0.001). Resistance to both CLR and MNZ was most commonly observed (24.3%). Two strains (1.9%) were resistant to 4 of the 5 antibiotics. No significant association was observed between antibiotic resistance rates and age, gender, or clinical outcomes of the patients. Conclusions High incidence of resistance to CLR and MNZ suggests that standard triple therapies may not be useful as first-line treatment in Vietnam. Alternative strategies such as bismuth-based quadruple therapies or sequential therapy may be more effective in Vietnam.

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Helicobacter pylori: Antibiotic resistance and treatment options

Cited by 17 publications

References 14 publications

Antibiotic resistance of Helicobacter pylori in Mongolia

Antibiotic resistance of Helicobacter pylori in Mongolia

Validation of a High-Throughput Multiplex Genetic Detection System for Helicobacter pylori Identification, Quantification, Virulence, and Resistance Analysis

The Incidence of Primary Antibiotic Resistance of Helicobacter pylori in Vietnam

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