Primary clarithromycin resistance to<i>Helicobacter pylori</i>: Is this the main reason for triple therapy failure?

Giorgio, Floriana; Principi, Mariabeatrice; Francesco, Vincenzo De; Zullo, Angelo; Losurdo, Giuseppe; Leo, Alfredo Di; Ierardi, Enzo

doi:10.4291/wjgp.v4.i3.43

Cited by 40 publications

(48 citation statements)

References 25 publications

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“…Community perception of health service delivery often does not recognise the same boundaries of the health system, and tensions may exist with medico-legal requirements and bio-medical best practice. For example, potential for misperception has been highlighted in introducing MC for HIV prevention in some communities in South Africa due to conflicting messages of abstinence and sexual responsibility evident in the health program compared to the sexual privilege and masculine virility messages that accompany traditional circumcision and initiation ceremonies within the community [75-77]. In our study, there was clear evidence that communities in PNG endorsed forms of penile cutting that have not been confirmed to provide protection against HIV acquisition.…”

Section: Discussionmentioning

confidence: 62%

“…Most often, communities who engaged in traditional cutting in Africa were largely opposed to the medically performed procedure due to issues related to stigma, cost and cultural significance [5,75,94,95]. Although maintaining cultural significance plays an important part in PNG, many respondents from traditionally circumcising communities were supportive of a HW completing the procedure as part of traditional ceremony in the village.…”

Section: Discussionmentioning

confidence: 99%

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Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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BackgroundThe success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described.MethodsA multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software.ResultsA number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success.ConclusionsDifficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico-legal requirements, compared to existing socio-cultural interests. Community participatory approaches offer important opportunities to explore and design culturally safe, specific and accessible programs.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

et al. 2013

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“…Of interest, H. pylori resistance to clarithromycin has been found to be more frequently observed in female than in male patients. A possible explanation for this finding may be a wider use of antibiotics for curing infections, with a greater prevalence in females, with, for example, urinary tract infections (Giorgio et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Resistance to clarithromycin and genotypes in Helicobacter pylori strains isolated in Sicily

Fasciana

Calà

Bonura

et al. 2015

Journal of Medical Microbiology

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The resistance of Helicobacter pylori strains to clarithromycin is increasing in several developed countries and their association with a genetic pattern circulation has been variously explained as related to different geographical areas. In this study we have reported: the prevalence of the resistance of H. pylori, isolated in Sicily, to clarithromycin; the principal point of mutation associated with this resistance; and the more frequent association between resistance to clarithromycin and cagA, the EPIYA motif, and the vacA and oipA genes. Resistance to clarithromycin was detected in 25 % of cases, the main genetic mutation involved being A2143G. The cagA gene was present in 48 % of cases and the distribution of the EPIYA motif was: ABC in 35 cases; ABCC in 8 cases; ABCCC in 2 cases; ABC-ABCC in 2 cases; and ABC-ABCC-ABCCC in 1 case. Regarding the vacA allele, an s1i1m1 combination was detected in 35 % of cases, s1i1m2 in 12 %, s1i2m2 in 12 %, s2i2m2 in 40 %, and a double s1m1-m2 mosaic in 1 % of cases. The status of the oipA gene was 'off' in 45 % of cases and 'on' in 55 %. Resistance to clarithromycin was found to be high in Sicily, but no correlation was found among resistance to clarithromycin, the vacA gene and oipA status; a higher correlation was observed between resistant strains and cagA-negative strains.

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“…Antibiotic resistance is considered to be one of the main reasons for eradication failure. [27][28][29] Thus, it is considered as a major tailored determinant by most tailored trials. Importantly, our result challenges the necessity of performing traditional susceptibility tests within a tailored therapy.…”

Section: Summary Of Evidencementioning

confidence: 99%

“…Here, our result is consistent with the current opinion that 7-day standard triple therapy is obsolete mainly due to clarithromycin resistance. 29,33,34 Since pretreatment susceptibility tests would help overcome antibiotic resistance, tailored therapy is superior to standard triple therapy in eradication rate. However, the advantage of tailored therapy is undermined when the duration of triple therapy is prolonged to 10 days.…”

Section: Summary Of Evidencementioning

confidence: 99%

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

Chen¹,

Dang²,

Zhou³

et al. 2016

Gastroenterology

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Primary clarithromycin resistance toHelicobacter pylori: Is this the main reason for triple therapy failure?

Abstract: Conventional triple therapies for Helicobacter pylori (H.

Cited by 40 publications

References 25 publications

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Listening to diverse community voices: the tensions of responding to community expectations in developing a male circumcision program for HIV prevention in Papua New Guinea

Resistance to clarithromycin and genotypes in Helicobacter pylori strains isolated in Sicily

318 Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis

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