In vitro Susceptibility Testing of Helicobacter pylori to Metronidazole, Amoxicillin, Tetracycline and Ciprofloxacin in Iran

Background Antimicrobial resistance of Helicobacter pylori can result in eradication failure. Metadata on the antimicrobial resistance of H pylori in Iran could help to formulate H pylori eradication strategies in Iran. Methods A systematic review was performed after searching in MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Library. A meta‐analysis was performed, and a comparison of the rates between children and adults; time periods (1999‐2010, 2011‐2016, 2017‐2019); and the methods used was carried out. Results A total of 66 studies investigating 5936 H pylori isolates were analyzed. The weighted pooled resistance (WPR) rates were as follows: clarithromycin 21% (95% CI 16‐26), metronidazole 62% (95% 57‐67), clarithromycin in combination with metronidazole 16% (95% CI 10‐23), ciprofloxacin 24% (95% CI 15‐33), levofloxacin 18% (95% CI 9‐30), erythromycin 29% (95% CI 12‐50), furazolidone 13% (95% CI 4‐27), tetracycline 8% (95% CI 5‐13), and amoxicillin 15% (95% CI 9‐22). During the three time periods, there was an increased resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline (P ˂ .05). Furazolidone and a clarithromycin/metronidazole combination had the higher resistance rates in children (P ˂ .05). Conclusion An increasing rate of resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline in Iranian H pylori isolates was identified. In children, the resistance to furazolidone and a combination of clarithromycin and metronidazole is higher compared to adults. As a stable, high resistance to metronidazole was found in children and adults in all Iranian provinces, we suggest that metronidazole should not be included in the Iranian H pylori eradication scheme.

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The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

Sholeh

Maleki

Krutova

et al. 2020

Helicobacter

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Estado actual de la resistencia de Helicobacter pylori a tetraciclina: revisión sistemática de la literatura

Ramírez-Bulla¹,

Mercado-Reyes²,

Trespalacios-Rangel³

et al. 2012

Univ. Sci.

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ResumenObjetivo. Determinar la prevalencia de resistencia de Helicobacter pylori a tetraciclina y las posibles mutaciones que generan esta resistencia mundialmente. Materiales y método. Se realizó una búsqueda sistemática de literatura en las bases de datos: Medline, Science Direct (Elsevier), Ovid, Pubmed, Lilacs y MEDICLATINA, con el uso de palabras clave relevantes. La extracción de los datos fue independiente y se realizaron listas de verificación para evaluar la calidad metodológica de los estudios. El análisis de la información fue realizado en el programa RevMan 5®. Resultados. Se evidenció resistencia a tetraciclina por Helicobacter pylori con prevalencias de 1% para Norte América, 8% para Centro y Sur América; 5% para Asia y 2% para Europa . La alta resistencia se debe a la triple mutación AGA(926-928)-->TTC, en el gen 16S rDNA. Conclusiones. La resistencia antibiótica es una de las causas que más se asocia a falla terapéutica en la erradicación de Helicobacter pylori, así como la poca adherencia al tratamiento y el uso indiscriminado de antibióticos. Se evidenció que la tasa de resistencia a tetraciclina aumenta después de un primer tratamiento con este antibiótico, sin embargo la prevalencia de la resistencia global a tetraciclina es baja sin aún alcanzar límites que impidan su utilización en los esquemas de tratamiento. Palabras clave:Helicobacter pylori, tetraciclina, resistencia, mutación, tratamiento, epidemiología, 16S rRNA. AbstractCurrent status of Helicobacter pylori resistance to tetracycline: a systematic review of the literature. Objective. To determine the prevalence of Helicobacter pylori resistance to and the possible mutations that generate this worldwide resistance. Materials and methods. A systematic search for literature was performed in the databases Medline, Science Direct (Elsevier), Ovid, PubMed, Lilacs and MedicLatina using relevant key words. Data extraction was independent and checklists were prepared to assess the methodological quality of the studies. Analysis of information was done with RevMan 5®. Results. We found Helicobacter pylori resistance prevalence rates of 1% for North America, 8% for Central and South America, 5% for Asia, and 2% for Europe. The mutation associated to this resistance is in the 16S rDNA gene at nucleotide position 967TTC to AGA965 responsible of high resistance to tetracycline. Conclusions. Antibiotic resistance is one of the causes most associated to treatment failure in the eradication of Helicobacter pylori, as well as poor adherence to treatment and indiscriminate use of antibiotics. We also evidenced that the rate of tetracycline resistance is higher when it is used in a second treatment scheme. The distribution of resistance is variable in different areas and it is important to know these resistances to avoid treatment failures.

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Consequences of Chronic Bacterial Infections on Development of Cancer

Ibrahim¹,

Makkiya²

2011

Research J. of Microbiology

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In vitro Susceptibility Testing of Helicobacter pylori to Metronidazole, Amoxicillin, Tetracycline and Ciprofloxacin in Iran

Cited by 3 publications

References 25 publications

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

Estado actual de la resistencia de Helicobacter pylori a tetraciclina: revisión sistemática de la literatura

Consequences of Chronic Bacterial Infections on Development of Cancer

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