<p>Increase in antibiotic resistant <em>Helicobacter pylori</em> in a University Hospital in Japan</p>

Abstract

BackgroundEradication effectively prevents Helicobacter pylori-associated diseases; however, H. pylori antibiotic resistance has increased throughout Japan and worldwide. This study aimed to assess rates of resistance to antibiotics; amoxicillin, clarithromycin and metronidazole in a University Hospital in Japan.Materials and methodsH. pylori (208 strains) were isolated from patients at the Okayama University Hospital in Japan. The minimum inhibitory concentrations (MIC) were determined using the mean values of the E-test to determine the antimicrobial susceptibilities of the strains. Sequencing and gene analysis were performed to analyze resistance genes to clarithromycin and amoxicillin.ResultsRates of amoxicillin, clarithromycin, and metronidazole resistance were 13%, 48%, and 49%, respectively. Genetic analysis indicated that the A2143G point mutation in 23S rDNA is closely associated with the MIC of clarithromycin. The MIC in amoxicillin-resistant strains increased with an increase in the number of PBP1A amino acids mutations.ConclusionGenetic analysis for resistant strains is not clinically effective in cases of amoxicillin resistance. Numerous bacteria with already high antibiotic resistance rates have been isolated in large hospitals such as a University Hospital. For effective eradication therapy, MIC measurement should be considered via several methods.

A Next-Generation Sequencing-Based Approach to Identify Genetic Determinants of Antibiotic Resistance in Cambodian Helicobacter pylori Clinical Isolates

“…Some genetic determinants (e.g., N562Y, S414R, T593A, G595S, and A599T) have been reported using a classic approach, in which the limitation was demonstrated as discussed above. Because of the invalidity of these mutations in other studies, a recent paper by Chihiro K et al [53] concluded that AMX resistance determination should not be identified based on one amino acid substitution at a specific position. Our study found three AMX-resistant associated loci (P473L, E406K, and T593A/G/K mutations).…”

Review: Treatment of Helicobacter pylori Infection 2019

“…The individual studies detailing resistance are summarized in Table 1. [21][22][23][24][25][26][27][28][29][30][31][32]…”

E-test versus agar dilution for antibiotic susceptibility testing of Helicobacter pylori: a comparison study

“…However, antibiotic resistance caused in Helicobacter pylori eradication failure and the resistance rates widely vary around the world [2][3][4]. Recent hospital-based study in Japan reporting 48% of clarithromycin resistance [5] while our previous study in Indonesia reported a 9% resistant rate [6]. Because of such differences, the Maastricht Consensus Report on H. pylori infection has stated that antibiotic susceptibility tests with periodic monitoring should be performed in each region to determine the most suitable therapy for a given population [2].…”