scholarly journals Antimicrobial Susceptibility and Mutations Involved in Clarithromycin Resistance in Helicobacter pylori Isolates from Patients in the Western Central Region of Colombia

2009 ◽  
Vol 53 (9) ◽  
pp. 4022-4024 ◽  
Author(s):  
Adalucy Álvarez ◽  
José Ignacio Moncayo ◽  
Jorge Javier Santacruz ◽  
Mario Santacoloma ◽  
Luisa Fernanda Corredor ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Point Mutation ◽  
Central Region ◽  
Antimicrobial Susceptibility ◽  
Empirical Treatment ◽  
Clarithromycin Resistance ◽  
H Pylori

ABSTRACT Resistance to metronidazole, clarithromycin, and amoxicillin (amoxicilline) was found in 82, 3.8, and 1.9% of 106 Helicobacter pylori isolates, respectively. No tetracycline-resistant isolates were found. In all of the clarithromycin-resistant isolates, only one point mutation was present, either A2143G or A2142G. Our results indicate that metronidazole should not be included in the empirical treatment of H. pylori infection in this region.

scholarly journals Helicobacter pylori Eradication According to Sequencing-Based 23S Ribosomal RNA Point Mutation Associated with Clarithromycin Resistance

2019 ◽  
Vol 9 (1) ◽  
pp. 54 ◽  
Author(s):  
Seung In Seo ◽  
Byoung Joo Do ◽  
Jin Gu Kang ◽  
Hyoung Su Kim ◽  
Myoung Kuk Jang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Point Mutation ◽  
Ribosomal Rna ◽  
Eradication Rate ◽  
Point Mutations ◽  
Clarithromycin Resistance ◽  
Clinically Significant ◽  
H Pylori ◽  
23S Ribosomal Rna ◽  
Significant Point

Background/Aims: Clarithromycin resistance in Helicobacter pylori is associated with point mutations in the 23S ribosomal RNA (rRNA) gene. We investigated the point mutations in the 23S rRNA genes of patients with clarithromycin-resistant H. pylori and compared the H. pylori eradication rates based on the point mutations. Methods: A total of 431 adult patients with H. pylori infection were recruited in Kangdong Sacred Heart Hospital in 2017 and 2018. Patients who did not have point mutations related to clarithromycin resistance and/or had clinically insignificant point mutations were treated with PAC (proton pump inhibitor, amoxicillin, clarithromycin) for seven days, while patients with clinically significant point mutations were treated with PAM (proton pump inhibitor, amoxicillin, metronidazole) for seven days. H. pylori eradication rates were compared. Results: Sequencing-based detection of point mutations identified four mutations that were considered clinically significant (A2142G, A2142C, A2143G, A2143C). The clarithromycin resistance rate was 21.3% in the overall group of patients. A2143G was the most clinically significant point mutation (84/431, 19.5%), while T2182C was the most clinically insignificant point mutation (283/431, 65.7%). The overall H. pylori eradication rate was 83.7%, and the seven-day PAM-treated clarithromycin-resistance group showed a significantly lower eradication rate than the seven-day PAC-treated nonresistance group (ITT; 55.4% (51/92) vs. 74.3% (252/339), p = 0.001, PP; 66.2% (51/77) vs. 88.4% (252/285), p = 0.0001). Conclusions: There were significantly lower eradication rates in the patients with clarithromycin-resistant H. pylori when treated with PAM for seven days. A future study comparing treatment regimens in clarithromycin-resistant H. pylori-infected patients may be necessary.

scholarly journals Clarithromycin Resistance and Eradication ofHelicobacter pylori in Children

2001 ◽  
Vol 45 (7) ◽  
pp. 2134-2135 ◽  
Author(s):  
N. Kalach ◽  
P. H. Benhamou ◽  
F. Campeotto ◽  
M. Bergeret ◽  
C. Dupont ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Antimicrobial Susceptibility ◽  
Bacterial Eradication ◽  
Clarithromycin Resistance ◽  
H Pylori

ABSTRACT Outcome of Helicobacter pylori infection was analyzed in 61 children treated with a triple therapy including clarithromycin. Bacterial eradication was obtained in all children with clarithromycin-susceptible strains but not in children with clarithromycin-resistant ones (P = 0.0001). H. pylori antimicrobial susceptibility is mandatory before choosing a treatment, and clarithromycin should be avoided in case of resistance.

scholarly journals Antimicrobial susceptibility and clarithromycin resistance patterns of Helicobacter pylori clinical isolates in Vietnam

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 671 ◽  
Author(s):  
Camelia Quek ◽  
Son T. Pham ◽  
Kieu T. Tran ◽  
Binh T. Pham ◽  
Loc V. Huynh ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
23S Rrna ◽  
Rrna Gene ◽  
Clarithromycin Resistance ◽  
Resistance Patterns ◽  
23S Rrna Gene ◽  
H Pylori

Helicobacter pylori is a gastric pathogen that causes several gastroduodenal disorders such as peptic ulcer disease and gastric cancer.  Eradication efforts of H. pylori are often hampered by antimicrobial resistance in many countries, including Vietnam.  Here, the study aimed to investigate the occurrence of antimicrobial resistance among H. pylori clinical isolates across 13 hospitals in Vietnam.  The study further evaluated the clarithromycin resistance patterns of H. pylori strains.  In order to address the study interests, antimicrobial susceptibility testing, epsilometer test and PCR-based sequencing were performed on a total of 193 strains isolated from patients, including 136 children (3–15 years of age) and 57 adults (19–69 years of age).  Antimicrobial susceptibility testing showed that the overall resistance to amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline was 10.4%, 85.5%, 24.4%, 37.8%, and 23.8% respectively.  The distribution of minimum inhibitory concentrations (MICs) of clarithromycin-resistant strains was 85.5% with MIC >0.5 μg/mL.  The majority of the clarithromycin resistant isolates (135 of 165 subjects) have MICs ranging from 2 μg/mL to 16 μg/mL.  Furthermore, sequencing detection of mutations in 23S rRNA gene revealed that strains resistant and susceptible to clarithromycin contained both A2143G and T2182C mutations.  Of all isolates, eight clarithromycin-resistant isolates (MIC >0.5 μg/mL) had no mutations in the 23S rRNA gene.  Collectively, these results demonstrated that a proportion of clarithromycin-resistant H. pylori strains, which are not related to the 23S rRNA gene mutations, could be potentially related to other mechanisms such as the presence of an efflux pump or polymorphisms in the CYP2C19 gene.  Therefore, the present study suggests that providing susceptibility testing prior to treatment or alternative screening strategies for antimicrobial resistance is important for future clinical practice.  Further studies on clinical guidelines and treatment efficacy are pivotal for successful eradication of H. pylori infection.

scholarly journals Different dose of new generation proton pump inhibitors for the treatment of Helicobacter pylori infection: A meta-analysis

2021 ◽  
Vol 35 ◽  
pp. 205873842110303
Author(s):  
Wenwen Gao ◽  
Xiang Zhang ◽  
Yanhui Yin ◽  
Shuwen Yu ◽  
Lu Wang
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eradication Rate ◽  
Standard Dose ◽  
Statistical Significance ◽  
High Dose ◽  
Clarithromycin Resistance ◽  
H Pylori ◽  
New Generation

The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens: 85.3% versus 84.2%, OR 1.09 (0.86–1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn’t reach statistical significance (OR 1.25, 95% CI: 0.99–1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75–1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84–1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58–2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45–2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.

Culture and Susceptibility of Levofloxacin Resistant H.pylori

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sameh Mohamed Fahiem Ghaly ◽  
Hany Ali Hussien Abd El-Rahman ◽  
Mohamed Osama Aly Aly ◽  
Ahmed Medhat Youssef Ibrahim Youssef
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Proper Time ◽  
Wide Spectrum ◽  
Signs And Symptoms ◽  
Line Treatment ◽  
Clarithromycin Resistance ◽  
Prior Use ◽  
H Pylori ◽  
Main Factor

Abstract Background Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Prevalence of H.pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim is to investigate H.pylori resistant patients toward Levofloxacin and detect the most effective antibiotic in eradication of H.pylori. Objective To investigate H.pylori resistant patients toward Levofloxacin including regimens and to detect the most effective antibiotic in H.pylori eradication. Patients and Methods The present study aimed to investigate the Susceptibility of Levofloxacin Resistant H.pylori in patients who had been diagnosed and received any regimen including Levofloxacin and still signs and symptoms of H.pylori infection not releaved and after proper time of stoppage of PPI and antibiotics H.pylori Ag in stool still positive at the period from January 2019 to February 2020. Results In the present study we found a wide spectrum of resistance to rates of H. pylori, from nearly negligible rates of Rifampicin (0%), Imipenem (0%), Cefotaxime (2%), Tetracycline (6%), Doxycycline(10%), and Amoxicillin(38%). To high rates resistance to Metronidazole (100%), Erythromycin (72%), Clarithromycin (68%), Azithromycin (60%), Ciprofloxacin (52%), and Levofloxacin (48%). Conclusion Helicobacter pylori is the most common chronic bacterial infection in humans. Antibiotic resistance is a major issue nowadays. Prior use of macrolide antibiotics or metronidazole appears to increase the risk of H. pylori resistance. Clarithromycin resistance appears to be an "absolute" condition that can not be overcome by increasing the macrolide dose. Levofloxacin resistance seems to be increasing. Culture and susceptibility should be done before starting second line treatment.

scholarly journals Antibiotic Resistance Prevalence and Trends in Patients Infected with Helicobacter pylori in the Period 2013–2020: Results of the European Registry on H. pylori Management (Hp-EuReg)

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1058
Author(s):  
Luis Bujanda ◽  
Olga P. Nyssen ◽  
Dino Vaira ◽  
Ilaria M. Saracino ◽  
Giulia Fiorini ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Resistance Rate ◽  
Antimicrobial Susceptibility Testing ◽  
Metronidazole Resistance ◽  
Infected Adult ◽  
H Pylori ◽  
European Registry

Background: Bacterial antibiotic resistance changes over time depending on multiple factors; therefore, it is essential to monitor the susceptibility trends to reduce the resistance impact on the effectiveness of various treatments. Objective: To conduct a time-trend analysis of Helicobacter pylori resistance to antibiotics in Europe. Methods: The international prospective European Registry on Helicobacter pylori Management (Hp-EuReg) collected data on all infected adult patients diagnosed with culture and antimicrobial susceptibility testing positive results that were registered at AEG-REDCap e-CRF until December 2020. Results: Overall, 41,562 patients were included in the Hp-EuReg. Culture and antimicrobial susceptibility testing were performed on gastric biopsies of 3974 (9.5%) patients, of whom 2852 (7%) were naive cases included for analysis. The number of positive cultures decreased by 35% from the period 2013–2016 to 2017–2020. Concerning naïve patients, no antibiotic resistance was found in 48% of the cases. The most frequent resistances were reported against metronidazole (30%), clarithromycin (25%), and levofloxacin (20%), whereas resistances to tetracycline and amoxicillin were below 1%. Dual and triple resistances were found in 13% and 6% of the cases, respectively. A decrease (p < 0.001) in the metronidazole resistance rate was observed between the 2013–2016 (33%) and 2017–2020 (24%) periods. Conclusion: Culture and antimicrobial susceptibility testing for Helicobacter pylori are scarcely performed (<10%) in Europe. In naïve patients, Helicobacter pylori resistance to clarithromycin remained above 15% throughout the period 2013–2020 and resistance to levofloxacin, as well as dual or triple resistances, were high. A progressive decrease in metronidazole resistance was observed.

scholarly journals Diagnostic Techniques and Antimicrobial Susceptibility Test of Helicobacter Pylori Infection in Gashua Town

2019 ◽  
Vol 15 (10) ◽  
pp. 126
Author(s):  
A.G. Dagona ◽  
I.G Dagona ◽  
K Muhammad ◽  
F.A. Garba ◽  
W.D Taura ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Likelihood Ratio ◽  
Antimicrobial Susceptibility ◽  
Accurate Diagnosis ◽  
Test Method ◽  
Susceptibility Test ◽  
Antimicrobial Susceptibility Test ◽  
Noninvasive Methods ◽  
Urease Test ◽  
H Pylori

<p class="0abstract">Helicobacter pylori eradication continues to be a challenge in a group of patients after the failure of several therapeutic regimen attempts. Treatment regimen is generally chosen on the basis of the prevalence of bacterial resistance detected against the tested antibiotics. 60 sixty  (60), adult out patients presented to Gastroenterology clinic of General Hospital Gashua undertook multiple gastric biopsy and specimens were carried for gram stain, culture, antimicrobial sensitivity testing, rapid urease test and histology. Antimicrobial susceptibility test were carryout using Epsilometer testing Kit (E-test) method and tested against Omeprazole, metronidazole Ranitidine, and Amoxicillin. About Sixty percent (30%) of the study population was positive for H. pylori infection (mean age of 34 years ± 15), 60% were males while 40% are women which are mostly married. Helicobacter pylori culture showed a sensitivity of 55% (95% CI (29.5– 62.1), specificity of 97% (95%CI (80.5–100%), positive likelihood ratio of 19.93 (95% CI (1.254– 317.04) and a negative likelihood ratio of 0.76 (95% CI (0.406–0.772). Eighteen (18) strains of Helicobacter pylori isolated 14 are sensitive to Amoxicillin, Ciprofloxacin, metronidazole; amoxicillin three (4) strains were resistant to ciprofloxacin and Amoxicillin and metronidazole when tested. It is imperative to have indebted knowledge on diagnostic method and antibiotic susceptibility patterns in the study area, since the accurate diagnosis of H. pylori is the idealistic view for both gastroenterologists and microbiologists, using synergistically invasive and noninvasive methods will be a future challenge in medical research topics. It is clear that recent advances in invasive and noninvasive methods for accurate diagnosis of the H. pylori can drastically change upcoming guidelines attributed with the management of this infection.</p>

scholarly journals Evaluation of clinical and socio-demographic risk factors for antibacterial resistance of Helicobacter pylori in Bulgaria

2009 ◽  
Vol 58 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Lyudmila Boyanova ◽  
Juliana Ilieva ◽  
Galina Gergova ◽  
Zoya Spassova ◽  
Rossen Nikolov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Resistance Rate ◽  
Symptom Duration ◽  
Antibacterial Resistance ◽  
Clarithromycin Resistance ◽  
Metronidazole Resistance ◽  
H Pylori ◽  
Demographic Risk ◽  
Demographic Risk Factors

The aim of this study was to assess the clinical and socio-demographic risk factors for primary Helicobacter pylori antibacterial resistance. In total, 266 consecutive H. pylori strains, from untreated symptomatic adult patients who answered a questionnaire, were evaluated. Strain susceptibility to amoxicillin, metronidazole, clarithromycin and tetracycline was tested by a breakpoint susceptibility test. Metronidazole resistance was found in fewer (17.0 %) peptic ulcer patients than in non-ulcer subjects (28.3 %, P=0.037), as well as in fewer patients born in villages (12.7 %) than in those born in towns (27.6 %, P=0.016). Clarithromycin resistance varied from 8.8 to 23.4 % (P=0.009) within the hospital centres. The highest clarithromycin resistance rate was found in hospital centre A (23.4 %) compared to other centres (12.9 %, P=0.041). The factors sex, age, symptom duration, non-steroidal anti-inflammatory drug use, diabetes, type of profession and educational level were not associated with H. pylori resistance. Logistic regression revealed that the risk factors for metronidazole resistance were non-ulcer disease [odds ratio (OR) 1.95, 95 % confidence interval (95 % CI) 1.04–3.65] and a birthplace of a town (OR 2.64, 95 % CI 1.18–5.93). The hospital centre may be a risk factor (OR 2.07, 95 % CI 1.02–4.21) for clarithromycin resistance but further studies are required to verify this suggestion. In conclusion, the knowledge of the risk factors for H. pylori resistance to antibacterials could facilitate the treatment choice for H. pylori eradication.

scholarly journals Rapid screening of clarithromycin resistance in Helicobacter pylori by pyrosequencing

2007 ◽  
Vol 56 (10) ◽  
pp. 1370-1376 ◽  
Author(s):  
Karen-Anja Moder ◽  
Franziska Layer ◽  
Wolfgang König ◽  
Brigitte König
Keyword(s):  
Helicobacter Pylori ◽  
Point Mutations ◽  
Rapid Screening ◽  
23S Rrna ◽  
Resistance Testing ◽  
Resistance Mutations ◽  
Additional Time ◽  
Clarithromycin Resistance ◽  
H Pylori ◽  
Domain V

Helicobacter pylori infections can be effectively treated with clarithromycin, a macrolide, in combination with other antibiotics, such as amoxicillin, tetracycline or metronidazole. The failure of H. pylori eradication is mainly associated with macrolide-resistant strains. Three point mutations (A2142G/C, A2143G, T2182C) in the peptidyltransferase region of domain V of the 23S rRNA have been described as being associated with clarithromycin resistance. Therefore, the determination of clarithromycin resistance by pyrosequencing was evaluated. H. pylori from 81 gastric biopsies was cultured and clarithromycin resistance was determined by Etest, as well as by pyrosequencing technology (PSQ 96 system; Biotage). The respective mutations were set in relation to the MIC measured in μg ml−1 by Etest. In this study, point mutations in positions 2142 and 2143 were associated with clarithromycin resistance. Mutations in position 2182 did not contribute to clarithromycin resistance. In addition, from 22 out of the 81 biopsies, clarithromycin resistance was determined directly without culturing H. pylori to save additional time. Identical results were obtained as compared to resistance testing with pure H. pylori strains. All results obtained by pyrosequencing were evaluated by Sanger sequencing. The data show that pyrosequencing to detect point mutation is a fast and reliable method for determining clarithromycin resistance in H. pylori, and provides the same results as the Etest.

Sign in / Sign up

Export Citation Format

Share Document