Characteristics of Helicobacter pylori antibiotic resistance: data from four different populations

Abstract Aims To describe the characteristics of Helicobacter pylori (H. pylori) antibiotic resistance in clinical isolates from four populations. Methods In total, 1463 H. pylori strains were examined for antibiotic resistance. Among these strains, 804 were isolated from treatment-naïve adults, 133 from previously treated adults, 100 from treatment-naïve children and 426 from a population who participated in a health survey (age ≥ 40 years). The minimum inhibitory concentration was determined by the E-test method. Results In the treatment-naïve adult group, the resistance rates for metronidazole, clarithromycin, levofloxacin, amoxicillin, rifampicin and tetracycline were 78.4, 19.0, 23.3, 1.2, 1.7 and 2.3%, respectively. Compared with this group, the previously treated adult group had significantly higher resistance rates for metronidazole (99.2%), clarithromycin (58.3%) and levofloxacin (52.3%). In addition, the treatment-naïve children had a lower metronidazole resistance rate (46.0%) than the treatment-naïve adults. The resistance rate for clarithromycin was low in treatment-naïve patients with ages ranging from 10 to 24 years. For the strains isolated from the general population group, the resistance rates for metronidazole, clarithromycin, levofloxacin, amoxicillin, rifampicin and tetracycline were 78.6, 10.1, 25.1, 0.5, 2.1 and 0.9%, respectively. Compared with the treatment-naïve adult group, the general population group showed significant differences in clarithromycin resistance. Conclusion The resistance rates for metronidazole, clarithromycin and levofloxacin were high, especially in previously treated adults. Compared to those in treatment-naïve younger patients, the resistance rates for clarithromycin were significantly lower in treatment-naïve patients with ages ranging from 10 to 24 years and in the general population.

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Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China

Frontiers in Microbiology ◽

10.3389/fmicb.2020.621791 ◽

2021 ◽

Vol 11 ◽

Author(s):

Juan Li ◽

Jianjun Deng ◽

Zhiling Wang ◽

Hong Li ◽

Chaomin Wan

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Pediatric Patients ◽

Southwest China ◽

Pediatric Population ◽

Primary Resistance ◽

Secondary Resistance ◽

Treatment Naïve ◽

H Pylori ◽

Resistance Rates

The number of antibiotics that are appropriate for Helicobacter pylori eradication in children is limited. Profiling regional or population-specific antibiotic resistance is essential in guiding the H. pylori eradication treatment in children. The aim of this study was to evaluate the antibiotic resistance in H. pylori strains isolated from children and adolescents in Southwest China. Gastric biopsies from 157 pediatric patients with or without previous H. pylori eradication treatment were collected for H. pylori culture. Susceptibility to amoxicillin (AML), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET), furazolidone (FZD), and rifampicin (RIF) was determined by E-test or a disk diffusion assay. A total of 87 patients from three ethnic groups (Han/Tibetan/Yi) were H. pylori culture positive (55.4%). The overall resistance rates were 55.2% for CLR, 71.3% for MTZ, 60.9% for RIF, and 18.4% for LEV. No isolate was found to be resistant to AML, TET, and FZD. Among the 53 treatment-naïve pediatric patients, primary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 45.3, 73.6, 15.1, and 60.4%, respectively. Among the 34 treatment-experienced patients, secondary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 70.6, 67.6, 23.5, and 61.8%, respectively. Isolates exhibiting simultaneous resistance to clarithromycin and metronidazole were 28.3 and 52.9% among the treatment-naïve and treatment-experienced patients, respectively. In conclusion, among pediatric patients in Southwest China, resistance rates were high for clarithromycin, metronidazole, levofloxacin, and rifampicin, whereas nil resistance was found to amoxicillin, tetracycline, and furazolidone. Our data suggest that the standard clarithromycin-based triple therapy should be abandoned as empiric therapy, whereas the bismuth quadruple therapy (bismuth/PPI/amoxicillin/tetracycline) would be suitable as first-line empiric treatment regimen for this pediatric population. Tetracycline and furazolidone may be considered for treating refractory H. pylori infections in adolescent patients.

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Primary antibiotic resistance of Helicobacter pylori among a Chinese Tibetan population

Future Microbiology ◽

10.2217/fmb-2020-0206 ◽

2020 ◽

Vol 15 (14) ◽

pp. 1353-1361

Author(s):

Xiaoqiong Tang ◽

Xiaohong Chen ◽

Yalin Shen ◽

Tiankuo Yang ◽

Renwei Hu ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Primary Resistance ◽

Tibetan Population ◽

Disk Diffusion Assay ◽

Treatment Naïve ◽

Gastric Biopsies ◽

H Pylori ◽

Resistance Rates ◽

Diffusion Assay

Aim: To evaluate the primary antibiotic resistance in Helicobacter pylori strains isolated from a Chinese Tibetan population. Methods & materials: Gastric biopsies from 400 H. pylori treatment-naive Tibetan patients were collected for H. pylori isolation. Susceptibility to amoxicillin (AML)/clarithromycin (CLR)/levofloxacin (LEV)/metronidazole (MTZ)/tetracycline (TET)/rifampicin (RIF)/furazolidone (FZD) was determined by E-test or a disk diffusion assay. Results: Biopsies from 117 patients were H. pylori culture positive (29.3%). The primary resistance rates to MTZ, CLR, LEV, RIF, AML, TET and FZD were 90.6, 44.4, 28.2, 69.2, 7.7, 0.8 and 0.8%, respectively. Interestingly, 42.7% of the strains had simultaneous resistance to CLR and MTZ. Conclusion: Among Tibetan strains, primary resistance rates were high for CLR/MTZ/LEV, whereas primary resistance rates to AML/TET/FZD were low. The high resistance to RIF is a concerning finding.

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Therapeutic Potential of Sitafloxacin as a New Drug Candidate for Helicobacter Eradication in Korea: An In Vitro Culture-Based Study

Antibiotics ◽

10.3390/antibiotics10101242 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1242

Author(s):

Youn I Choi ◽

Sung Min Lee ◽

Jun-Won Chung ◽

Kyoung Oh Kim ◽

Kwang An Kwon ◽

...

Keyword(s):

Antibiotic Resistance ◽

Therapeutic Potential ◽

Medical Center ◽

Therapeutic Option ◽

Drug Candidate ◽

Treatment Naïve ◽

H Pylori ◽

Resistance Rates ◽

Medical Burden

Background: Increased prevalence of antibiotic resistance to Helicobacter pylori (H. pylori) infection worldwide has driven the search for a new therapeutic candidate. Recently, sitafloxacin, a novel 4-quinolone agent, has emerged as a new therapeutic option for H. pylori eradication, in Japan. However, data on its efficacy for H. pylori eradication in Korea are limited. Therefore, we aimed to investigate the therapeutic potential of sitafloxacin as a first-line treatment for patients with Helicobacter infection through gastric tissue culture-based studies. Materials and Methods: We prospectively enrolled treatment-naïve patients with H. pylori infection who visited the Gil Medical Center between March 2015 and March 2018. After obtaining written informed consent from patients, a total of 121 H. pylori strains were collected. We tested the susceptibility of these strains to sitafloxacin, and other antibiotics for Helicobacter eradication, including clarithromycin (CLR), metronidazole (MTZ), amoxicillin (AMX), tetracycline (TET), levofloxacin (LEV), and ciprofloxacin (CIP) using the agar dilution technique. The minimum inhibitory concentration (MIC) of these antibiotics against H. pylori strains were determined. Results: None of the H. pylori strains obtained were resistant to sitafloxacin (MIC > 1, n = 0), while other conventional eradication drugs including CLR, MTZ, AMX, and TET showed 24.8% (n = 30), 30.6% (n = 37), 5.0% (n = 6), and 0.8% (n = 1) resistance, respectively. Compared to the resistance rates of other quinolones (LEV [36.4%, n = 44] and CIP [37.2%, n = 45]), sitafloxacin showed the best antibiotic performance against Helicobacter strains (0%, n = 0). Furthermore, sitafloxacin also inhibited the growth of 14 H. pylori strains (12.4%), which were resistant to both of clarithromycin, and metronidazole, and 27 strains (22.3%) with multidrug resistance. Conclusions: Sitafloxacin might be a new promising candidate for Helicobacter eradication where antibiotic resistance for Helicobacter is an emerging medical burden, such as in Korea.

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Analysis of the primary and post-treatment antibiotic resistance of Helicobacter pylori in Nanjing area

10.21203/rs.2.22065/v1 ◽

2020 ◽

Author(s):

jiang zongdan ◽

Bang-Shun He ◽

Zhen-Yu Zhang ◽

Shu-Kui Wang ◽

Dan Ran ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Resistance Rate ◽

Post Treatment ◽

Current Status ◽

Antibiotics Resistance ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

Resistance Rates

Abstract Background To investigate the current status and trend of Helicobacter pylori(H. pylori)antibiotics resistance over 5 years in Nanjing area.Then we evaluated the primary and post-treatment antibiotic resistance of H. pylori in Nanjing area. Methods During the period from July 2017 to December 2019, 1533 gastric mucosal specimens from patients with positive H. pylori confirmed by breath test or rapid urease test were collected for isolation and identify H. pylori. The agar dilution method was used for antibiotic resistance test. The antibiotic resistance of H. pylori were compared with that in the period from May 2014 to May 2015. Results The result showed that the resistance rates of H. pylori to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 2.74%, 47.03%, 33.59%, 0.91%, 0.52% and 80.76%, respectively in the period of July 2017 to December 2019. Compared with the period of May 2014 to May 2015, the resistance rate of metronidazole was the most obvious, from 60.5% to 80.76% in the period of July 2017 to December 2019, followed by clarithromycin from 29.5% to 47.03%, and levofloxacin from 14.7% to 33.59%. The resistance rates of H. pylori (primary Vs post-treatment) to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 1.83% Vs 6.08%, 38.62% Vs 77.81%, 27.41% Vs 56.23%, 0.58% Vs 2.13%, 0.33% Vs 1.22%, 78.57% Vs 88.75%, respectively during the period of July 2017 to December 2019. Conclusions Antibiotic resistance of H. pylori remained a problem for the effective eradication of this pathogen and its associated diseases in Nanjing area. For post-treatment eradication patients, clinicians should took into account regional antibiotic resistance rate, personal antibiotic exposure history, economic benefit ratio, adverse antibiotic reactions, antibiotic availability and other aspects.

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Analysis of the primary and post-treatment antibiotic resistance of Helicobacter pylori in Nanjing area

10.21203/rs.2.20406/v1 ◽

2020 ◽

Author(s):

jiang zongdan ◽

Bang-Shun He ◽

Zhen-Yu Zhang ◽

Shu-Kui Wang ◽

Dan Ran ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Resistance Rate ◽

Post Treatment ◽

Current Status ◽

Antibiotics Resistance ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

Resistance Rates

Abstract Background: To investigate the current status and trend of Helicobacter pylori（H. pylori）antibiotics resistance over 5 years in Nanjing area．Then we evaluated the primary and post-treatment antibiotic resistance of H. pylori in Nanjing area. Methods: During the period from July 2017 to December 2019, 1533 gastric mucosal specimens from patients with positive H. pylori confirmed by breath test or rapid urease test were collected for isolation and identify H. pylori. The agar dilution method was used for antibiotic resistance test. The antibiotic resistance of H. pylori were compared with that in the period from May 2014 to May 2015. Results: The result showed that the resistance rates of H. pylori to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 2.74%, 47.03%, 33.59%, 0.91%, 0.52% and 80.76%, respectively in the period of July 2017 to December 2019. Compared with the period of May 2014 to May 2015, the resistance rate of metronidazole was the most obvious, from 60.5% to 80.76% in the period of July 2017 to December 2019, followed by clarithromycin from 29.5% to 47.03%, and levofloxacin from 14.7% to 33.59%. The resistance rates of H. pylori (primary Vs post-treatment) to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 1.83% Vs 6.08%, 38.62% Vs 77.81%, 27.41% Vs 56.23%, 0.58% Vs 2.13%, 0.33% Vs 1.22%, 78.57% Vs 88.75%, respectively during the period of July 2017 to December 2019. Conclusions: Antibiotic resistance of H. pylori remained a problem for the effective eradication of this pathogen and its associated diseases in Nanjing area. For post-treatment eradication patients, clinicians should took into account regional antibiotic resistance rate, personal antibiotic exposure history, economic benefit ratio, adverse antibiotic reactions, antibiotic availability and other aspects．

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Methicillin-resistant Staphylococcus aureus of the clonal lineage ST5-SCCmecII-t2460 was associated with high mortality in a Wuhan hospital

Brazilian Journal of Microbiology ◽

10.1007/s42770-021-00557-5 ◽

2021 ◽

Author(s):

Xuehan Li ◽

Jing Zhang ◽

Yifan Zhang ◽

Junying Zhou ◽

Xinwei Li ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Resistance ◽

White Blood Cells ◽

Resistance Rate ◽

Molecular Characteristics ◽

Invasive Procedures ◽

Methicillin Resistant ◽

Small Colony Variant ◽

Recent Emergence ◽

Resistance Rates

AbstractMethicillin-resistant Staphylococcus aureus (MRSA) is an important human pathogen that can cause serious infectious diseases. An emerging MRSA strain, ST5-SCCmecII spa-type-t2460 (SMRSA), has spread rapidly since its recent emergence in China, but little information is available about this lineage. In this study, 91 MRSA isolates were collected from patients treated in the Zhongnan Hospital, Wuhan University, from 2018 to 2019, and investigated for their molecular characteristics, antibiotic resistance profiles, and clinical characteristics. The predominant lineage, SMRSA, accounted for 37.4% (34/91) of the isolates, followed by ST239-SCCmecIII-t030 (19.8%, 18/91) and ST59-SCCmecIV-t437 (8.8%, 8/91). In contrast to the latter two non-SMRSA (nSMRSA) lineages, which are among the main MRSA found in Chinese settings, SMRSA exhibited small colony variant (SCV) phenotype and had extremely high resistance rates to erythromycin (100.0%), clindamycin (100.0%), levofloxacin (100.0%), tetracycline (97.1%), moxifloxacin (97.1%), and ciprofloxacin (100%), but was more susceptible to rifampicin (resistance rate 3%). The levels of white blood cells (WBC) and procalcitonin (PCT) and the 30-day mortality in patients infected with SMRSA were (12.54 ± 6.61) × 109/L, 0.66 ng/mL, and 52.9%, respectively, which were much higher than those in patients infected with nSMRSA. In addition, patients infected with SMRSA were more frequently admitted to the intensive care unit (ICU) and submitted to invasive procedures than those infected with nSMRSA. In conclusion, SMRSA showed SCV phenotype and exhibited multiple antibiotic-resistance profiles. In this study, SMRSA was associated with serious infections and poor prognosis. Compared with ST239, ST59, or other nSMRSA strains, patients infected with SMRSA strains have higher 30-day mortality, increased levels of inflammatory biomarkers, and more frequent ICU hospitalization and invasive procedures.

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Checklist Identification of Elementary Schoolboys for Clinical Referral or Evaluation of Eligibility for Special Education

Behavioral Disorders ◽

10.1177/019874299301800303 ◽

1993 ◽

Vol 18 (3) ◽

pp. 218-227 ◽

Cited By ~ 6

Author(s):

Richard E. Mattison ◽

James C. Lynch ◽

Helen Kales ◽

Alan D. Gamble

Keyword(s):

Mental Health ◽

Logistic Regression ◽

General Population ◽

Population Group ◽

Regression Analyses ◽

Practical Procedure ◽

Emotional Dysfunction ◽

Mental Health Referral ◽

General Population Group ◽

Clinical Referral

Achenbach and Edelbrock teacher and parent checklists were used to develop a practical procedure to assist educators in determining if a boy with behavioral/emotional dysfunction in elementary school requires mental health referral or SED evaluation. SED, psychiatric outpatient, and general population Caucasian boys ages 6 to 11 years were compared. Appropriately, scores for the SED and the outpatient groups were pathological and significantly greater than scores for the general population group on both checklists, while SED scores were significantly higher than outpatient scores on the teacher checklist. Logistic regression analyses showed the Total Problem scales of both checklists to be the most efficient and economical scales for classification. Finally, probability tables were constructed to distinguish SED and outpatient boys from general population boys, and SED boys from outpatient boys.

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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 ◽

10.3390/antibiotics10091058 ◽

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.

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Obstructive sleep apnoea is more prevalent in men with schizophrenia compared to general population controls: results of a matched cohort study

Australasian Psychiatry ◽

10.1177/1039856218772241 ◽

2018 ◽

Vol 26 (6) ◽

pp. 600-603 ◽

Cited By ~ 4

Author(s):

Hannah Myles ◽

Andrew Vincent ◽

Nicholas Myles ◽

Robert Adams ◽

Madhu Chandratilleke ◽

...

Keyword(s):

Relative Risk ◽

General Population ◽

Obstructive Sleep Apnoea ◽

Population Group ◽

Sleep Apnoea ◽

General Population Study ◽

Obstructive Sleep ◽

General Population Group ◽

Relative Prevalence ◽

Population Controls

Objectives: Obstructive sleep apnoea (OSA) may be more common in people with schizophrenia compared to the general population, but the relative prevalence is unknown. Here, we determine the relative prevalence of severe OSA in a cohort of men with schizophrenia compared to representative general population controls, and investigate the contribution of age and body mass index (BMI) to differences in prevalence. Methods: Rates of severe OSA (apnoea–hypopnoea index > 30) were compared between male patients with schizophrenia and controls from a representative general population study of OSA. Results: The prevalence of severe OSA was 25% in the schizophrenia group and 12.3% in the general population group. In subgroups matched by age, the relative risk of severe OSA was 2.9 ( p = 0.05) in the schizophrenia subjects, but when adjusted for age and BMI, the relative risk dropped to 1.7 and became non-significant ( p = 0.17). Conclusions: OSA is prevalent in men with schizophrenia. Obesity may be an important contributing factor to the increased rate of OSA.

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Prävalenz und Charakteristika von Muskelkrämpfen bei Patienten mit Varikosis

VASA ◽

10.1024/0301-1526.29.4.269 ◽

2000 ◽

Vol 29 (4) ◽

pp. 269-273 ◽

Cited By ~ 20

Author(s):

Masafumi Hirai

Keyword(s):

General Population ◽

Patient Group ◽

Venous Insufficiency ◽

Varicose Veins ◽

Population Group ◽

Venous Hypertension ◽

Muscle Cramps ◽

Significant Difference ◽

General Population Group ◽

Short Saphenous Vein

Background: It has been suggested that limb circulation may be disturbed in patients with muscle cramps due to leg venous hypertension. The aim of this study was to examine the incidence and characteristics of muscle cramps from venous insufficiency. Patients and methods: The incidence and characteristics of muscle cramps, which were investigated by a questionnaire, were compared between 288 patients with incompetence of the long or short saphenous vein and 550 age-matched individuals from the general population. Results: The patient group showed a significantly higher incidence of muscle cramps in the last year than the general population group, 67% and 53%, respectively (p < 0.001). The incidence of calf cramps was significantly higher in the patient group than in the general population group, 91% and 75%, respectively (p < 0.001). Although most subjects reported symptoms occurring only at night, the incidence was significantly higher in the patient group than in the general population group, 78% and 52%, respectively (p < 0.001). There was no significant difference in the duration or severity of muscle cramps between the groups. The patient group showed a significantly higher incidence of more than 12 episodes per year than the general population group (p < 0.001). Conclusions: Muscle cramps in patients with varicose veins occur more frequently and more often at night and in the calf in comparison with those from the general population.

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