Nationwide antibiotic resistance mapping of <i>Helicobacter pylori</i> in Korea: A prospective multicenter study

Lee, Jeong Hoon; Ahn, Ji Yong; Choi, Kee Don; Jung, Hwoon‐Yong; Kim, Jung Mogg; Baik, Gwang Ho; Kim, Byung‐Wook; Park, Jun Chul; Jung, Hye‐Kyung; Cho, Soo‐Jeong; Shin, Cheol Min; Choi, Yoon Jin; Lee, Si Hyung; Kim, Ji Hyun; Lee, Wan Sik; Sung, Jae Kyu; Chung, Jun‐Won; Cheung, Dae Young; Lee, Hyuk; Ye, Min; Kim, Jae J.; Kim, Seung Young

doi:10.1111/hel.12592

Cited by 113 publications

(114 citation statements)

References 30 publications

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“…Another reason could be the differences in the 15 participating institutes. 44 In fact, we have also reported regional differences in which the MIC study was performed by the SNUBH team by the same technician (NRH) as the present study. 49 This study showed a considerable difference in the antibiotic resistance rate between urban areas and rural areas.…”

Section: Discussionsupporting

confidence: 49%

“…In contrast, our institute has continuously performed H pylori culture with fresh tissue from multiple biopsy samples with a consistent protocol for the past 16 years, and the culture success rate is approximately 80%. Another reason could be the differences in the 15 participating institutes . In fact, we have also reported regional differences in which the MIC study was performed by the SNUBH team by the same technician (NRH) as the present study .…”

Section: Discussionmentioning

confidence: 79%

“…Patient characteristics and prevalence of resistance in Helicobacter pylori isolates: secondary strain tance 29.5%, and levofloxacin resistance 37.0% 44. This result is somewhat low compared with existing Korean data45,46 and recent data from Japan12 and China.…”

mentioning

confidence: 67%

“…First, in this recent nationwide study, only two biopsy samples were obtained from the antrum and the body, while in the present study, 5 biopsy samples were taken from the antrum and the body, respectively, to enhance the culture success rate in our institution. Second, in this recent nationwide study, the tissue was frozen at −80°C at each institute and sent to the central laboratory for H pylori culture, while in the present study, the culture specimen was kept in a culture dish with adequate media and went to culture immediately. These two factors might have caused the culture success rate to be as low as 60%, and the resistance rate might have appeared considerably lower than expected.…”

Section: Discussionmentioning

confidence: 95%

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Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

et al. 2019

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Background Antimicrobial resistance of Helicobacter pylori (H pylori) affects the efficacy of eradication therapy. The aim of this study was to estimate the prevalence of primary and secondary resistance of H pylori isolates to antibiotics in Korea. Methods The present study was performed from 2003 to 2018. Primary resistance was evaluated in 591 patients without any history of eradication and secondary resistance in 149 patients from whom Helicobacter pylori was cultured after failure of eradication. A minimal inhibitory concentration test was performed for amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and rifabutin using the agar dilution method. Results An increase in the primary resistance rate was found in clarithromycin (P < .001), metronidazole (P < .001), and both levofloxacin (P < .001) during the study period. The primary resistance rates of amoxicillin and tetracycline were low and stable during the study period. The secondary resistance rate significantly increased in metronidazole and levofloxacin (P = .022 and .039, respectively). Conclusions The primary and secondary resistance rates of clarithromycin, metronidazole, and levofloxacin for Helicobacter pylori in Korea were high and increased over time. However, the primary and secondary resistance rates of amoxicillin and tetracycline were low and stable over time. These results will help in selecting effective eradication regimens of H pylori in Korea in the future.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 67%

Section: Discussionmentioning

confidence: 95%

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Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

et al. 2019

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“…Furthermore, H. pylori resistance against tetracycline has been low and stable in Korea for the past 16 years . A recent multicenter study showed that the antibiotic resistance rate in H. pylori is lowest in Seoul . In that study, the rate of tetracycline resistance was 0%.…”

Section: Introductionmentioning

confidence: 84%

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

et al. 2020

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Background/Aims Conventional second‐line, bismuth‐containing quadruple therapy is administered four times a day. We aimed to evaluate the efficacy and safety of twice a day administration compared to the four times a day therapy. Methods Medical records of consecutive patients with positive 13C‐urea breath tests (UBTs) after first‐line eradication were reviewed. From December 2018 to June 2019, 100 consecutive 13C‐UBT‐positive patients received tetracycline 1 g, metronidazole 750 mg, bismuth subcitrate 300 mg, and pantoprazole 20 mg twice a day for one week. The same number of consecutive13C‐UBT‐positive patients before December 2018 was included as controls. The control group received tetracycline 500 mg and bismuth subcitrate 300 mg four times a day, metronidazole 500 mg three times a day, and pantoprazole 20 mg twice a day for one week. Eradication was confirmed based on a 13C‐UBT performed in the 5th week after taking quadruple therapy. Results Ninety‐eight patients from the twice a day group and 99 patients from the four times a day group were analyzed. The eradication rate did not differ between the twice a day group (92/98, 93.9%) and the four times a day group (92/99, 92.9%). Adverse drug effects were found in 36 patients from the twice a day group and 50 patients from the four times a day group (P = .051). Abdominal pain, discomfort, and distention were more common with four times a day intake (13.1%) than with twice a day intake (4.1%; P = .024). Conclusions We determined for the first time that twice a day intake of bismuth‐containing quadruple therapy using 2 g/d of tetracycline, 1.5 g/d of metronidazole, and 600 mg/d of bismuth subcitrate for one week is effective and safe as the conventional four times a day therapy. Twice a day intake decreased abdominal pain, discomfort, and distention.

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Diagnostic usefulness of deep learning methods for Helicobacter pylori infection using esophagogastroduodenoscopy images

Kang,

Lee,

Kim

2023

JGH Open

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Background and AimsWe aimed to assess the diagnostic potential of deep convolutional neural networks (DCNNs) for detecting Helicobacter pylori infection in patients who underwent esophagogastroduodenoscopy and Campylobacter‐like organism tests.MethodsWe categorized a total of 13,071 images of various gastric sub‐areas and employed five pretrained DCNN architectures: ResNet‐101, Xception, Inception‐v3, InceptionResnet‐v2, and DenseNet‐201. Additionally, we created an ensemble model by combining the output probabilities of the best models. We used images of different sub‐areas of the stomach for training and evaluated the performance of our models. The diagnostic metrics assessed included area under the curve (AUC), specificity, accuracy, positive predictive value, and negative predictive value.ResultsWhen training included images from all sub‐areas of the stomach, our ensemble model demonstrated the highest AUC (0.867), with specificity at 78.44%, accuracy at 80.28%, positive predictive value at 82.66%, and negative predictive value at 77.37%. Significant differences were observed in AUC between the ensemble model and the individual DCNN models. When training utilized images from each sub‐area separately, the AUC values for the antrum, cardia and fundus, lower body greater curvature and lesser curvature, and upper body greater curvature and lesser curvature regions were 0.842, 0.826, 0.718, and 0.858, respectively, when the ensemble model was used.ConclusionsOur study demonstrates that the DCNN model, designed for automated image analysis, holds promise for the evaluation and diagnosis of Helicobacter pylori infection.

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Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study

Cited by 113 publications

References 30 publications

Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

Diagnostic usefulness of deep learning methods for Helicobacter pylori infection using esophagogastroduodenoscopy images

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