Recent trends in primary antimicrobial resistance of Helicobacter pylori in Finland

Abstract

The antimicrobial susceptibility of Helicobacter pylori is an important predictor of the success of eradication therapy. To evaluate recent changes in primary antimicrobial resistance of H. pylori isolated from Finnish patients, the clinical records of H. pylori-positive patients referred for endoscopy to Herttoniemi Hospital (Helsinki, Finland) during 2000-2008 were investigated retrospectively. Stored H. pylori strains from 505 patients without previous eradication therapy were tested for clarithromycin, metronidazole, levofloxacin, tetracycline and amoxicillin susceptibility by Etest. Data on local consumption of antimicrobials were collected and correlations between consumption and resistance were calculated. During the 9-year study period, metronidazole resistance was high (range 29-59%, overall 41%). After an initial increase in clarithromycin resistance (0% in 2000 to 16% in 2003), resistance to clarithromycin decreased to 4% in 2008. No significant correlation was detected between consumption of macrolides and resistance of clarithromycin. Resistance to levofloxacin varied between 0% and 12%. Primary metronidazole resistance in H. pylori is at a high level, however levofloxacin and clarithromycin resistances are still at a reasonable level. Thus, primary clarithromycin resistance in H. pylori in Finland has not become such a problem as in many other countries. Primary resistance to the antimicrobials studied varied considerably from year to year.

Primary antibiotic resistance of Helicobacter pylori strains among adults and children in a tertiary referral centre in Lithuania

“…Resistance rates of metronidazole in 34 both adult and children populations were relatively high -32.8% and 25%, respectively. Metronidazole resistance remains high across Europe with no major changes in 10 years or regional distribution (4,(13)(14)(15)(16)(17)(18)(19)(20)(22)(23)(24)(25)(26)(27). It is important to point out that within our study, the tendency of increasing prevalence of clarithromycin resistance has been observed with 8.2% in adults and 17.7% in children.…”

“…Resistance rates of metronidazole in both adult and children populations were relatively high – 32.8% and 25%, respectively. Metronidazole resistance remains high across Europe with no major changes in 10 years or regional distribution ().…”

Numerous risk factors for Helicobacter pylori antibiotic resistance revealed by extended anamnesis: a Bulgarian study

“…pylori resistance to metronidazole has been associated with previous use of nitroimidazoles for gynaecological diseases, e.g. trichomoniasis and bacterial vaginosis, leading to higher resistance rates in women than in men, and use for parasitic diseases in some developing countries, leading to elevated resistance rates in inhabitants of or immigrants from these countries (McMahon et al, 2003;Koivisto et al, 2004;Mégraud, 2004aZullo et al, 2007O'Connor et al, 2010;Kostamo et al, 2011). In addition, resistance has been associated with birthplace and place of residence (Boyanova & Mitov, 2010).…”

Green Synthesis of Silver Nanoparticles: Structural Features andIn VivoandIn VitroTherapeutic Effects againstHelicobacter pyloriInduced Gastritis

“…It is a small curved Gram-positive and microaerophilic bacterium which is fastidious to grow under ordinary growth medium [13]. Triple therapy has been recommended for the complete eradication of H. pylori [14]. Presently, the major concern around the world in medical science is that H. pylori has developed resistance against the standard antibiotics being used in the clinical practices [15].…”