scholarly journals Analysis of the primary and post-treatment antibiotic resistance of Helico-bacter pylori in Nanjing area

2020 ◽  
Vol 21 ◽  
Author(s):  
Zong-Dan Jiang ◽  
Bang-Shun He ◽  
Zhen-Yu Zhang ◽  
Shu-Kui Wang ◽  
Dan Ran ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Post Treatment ◽  
Current Status ◽  
Antibiotics Resistance ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Rapid Urease Test ◽  
Urease Test ◽  
H Pylori ◽  
Resistance Rates

Background: Resistance of Helicobacter pylori（H. pylori） to antibiotics is increasing worldwide. In order to understand the current situation of antibiotic resistance in Nanjing and provide a reasonable basis for clinical selection of antibiotics to cure H. Pylori. Objective: To investigate the current status of H. Pylori antibiotics resistance in Nanjing area, and analyze the primary and post-treatment antibiotic resistance of H. pylori in this 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. 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. 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. 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．

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

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.

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

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．

scholarly journals Trends in Primary Antibiotic Resistance in H. pylori Strains Isolated in Italy between 2009 and 2019

Antibiotics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 26 ◽  
Author(s):  
Ilaria Maria Saracino ◽  
Giulia Fiorini ◽  
Angelo Zullo ◽  
Matteo Pavoni ◽  
Laura Saccomanno ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Reference Method ◽  
Susceptibility Test ◽  
Upper Gastrointestinal Endoscopy ◽  
Rapid Urease Test ◽  
Multiple Biopsies ◽  
Antibiotic Susceptibility Test ◽  
Urease Test ◽  
H Pylori ◽  
Resistance Rates

Background and aims: the increasing prevalence of strains resistant to antimicrobial agents is a critical issue for the management of Helicobacter pylori infection. This study aimed to evaluate, in Italian naïve patients, H. pylori antibiotic resistance trends and their potential predictive factors during the last decade. Methods: consecutive Italian naïve H. pylori positive patients, referred from General Practitioners to our Unit from January 2009 to January 2019 to perform an upper gastrointestinal endoscopy (UGIE), were considered. Each patient underwent 13C-urea breath test (13C-UBT) and UGIE with multiple biopsies to perform rapid urease test (RUT), culture/susceptibility test (vs. clarithromycin, metronidazole, levofloxacin), and histopathological examination. H. pylori status was assessed through CRM (composite reference method: at least two tests positive or only culture positive). Results: between 2009 and 2014, 1763 patients were diagnosed as H. pylori positive, 907 were naïve with antibiogram available. Between 2015 and 2019, 1415 patients were diagnosed as H. pylori positive, antibiotic susceptibility test was available in 739 naïve patients. H. pylori primary antibiotic resistance rates in the first and second five-year period were, respectively, clarithromycin 30.2% (95% CI 27.2–33.3), 37.8% (95% CI 34.2–41.4); metronidazole 33.3% (95% CI 30.2–36.5), 33.6% (95% CI 30.2–37.1); levofloxacin 25.6% (95% CI 22.8–28.5), 33.8% (95% CI 37.4–47.4), double resistance clarithromycin-metronidazole 18.9% (95% CI 16.4–21.6), 20.7% (95% CI 17.8–23.8). The increase of the resistance rates to clarithromycin and levofloxacin in naïve patients was statistically significant (p < 0.05). Although eradication rates for sequential therapy in the 10 years considered were 93.4% (95% CI 92–94.6) and 87.5% (95% CI 85.7–89) at per-protocol (PP) and intention-to-treat (ITT) analysis, respectively, they showed a significant decrease in the second five-year period. Conclusions: this data highlights an increase in primary H. pylori antibiotic resistance and strongly suggests the importance of drug susceptibility testing also in naïve patients.

scholarly journals Antimicrobial resistance of Helicobacter pylori in Smolensk

2018 ◽  
Vol 20 (1) ◽  
pp. 42-48
Author(s):  
Natalya N. Dekhnich ◽  
Nataly V. Ivanchik ◽  
Roman S. Kozlov ◽  
A.V. Alimov ◽  
A.S. Steshits ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Triple Therapy ◽  
Empirical Therapy ◽  
Adult Patients ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Rapid Urease Test ◽  
Quadruple Therapy ◽  
Urease Test ◽  
H Pylori

Objective. To study the antimicrobial resistance of H. pylori to clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline in adult patients in the Smolensk region. Materials and Methods. Overall, 573 adult patients were included in 2015-2017 and 210 – in 20092010 with positive rapid urease test at the time of gastroscopy for dyspeptic complaints. Antimicrobial susceptibility testing of H. pylori isolates to clarithromycin, amoxicillin, metronidazole, levofloxacin and tetracycline was performed by the agar dilution method. Results. 143 and 133 strains of H. pylori isolated in 2015-2017 and in 2009-2010 were tested. The rates of resistance of H. pylori strains in 2015-2017 were 6.3% for clarithromycin, 1.4% – for amoxicillin, 23.8% – for metronidazole, 24.5% – for levofloxacin, 0.7% – for tetracycline. In 2009-2010 the corresponding numbers were: 5.3% – for clarithromycin, 4.5% – for amoxicillin, 3.8% – for metronidazole, 8.3% – for levofloxacin, 0% – for tetracycline. When assessing the dynamics of antimicrobial resistance of H. pylori in the Smolensk region over the past 9 years, there has been no noticeable increase in the resistance to clarithromycin, amoxicillin and tetracycline (p>0.05), with a significant increase in H. pylori resistance to metronidazole and levofloxacin (p<0,01). The resistance of H. pylori to metronidazole did not exceed the critical value of 40%. Conclusions. The prevalence of H. pylori resistance to clarithromycin and metronidazole in the Smolensk region was low throughout the study period, therefore standard triple therapy is recommended as a first line empirical therapy for H. pylori infection in adults. Preference in choosing a second-line empirical therapy between quadruple therapy with bismuth and triple therapy with levofloxacin should be stated in favor of quadruple therapy with bismuth because of the high rates of H. pylori resistance to levofloxacin.

scholarly journals Antibiotic resistance of Helicobacter pylori in Mongolia

2017 ◽  
Vol 11 (11) ◽  
pp. 887-894 ◽  
Author(s):  
Mandkhai Bolor-Erdene ◽  
Bira Namdag ◽  
Yoshio Yamaoka ◽  
Sarantuya Jav
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Antibiotic Sensitivity ◽  
Upper Gastrointestinal Endoscopy ◽  
Rapid Urease Test ◽  
Treatment Regimens ◽  
Urease Test ◽  
H Pylori ◽  
Strip Testing ◽  
Resistance Rates

Introduction.The resistance of Helicobacter pylori to recently available antibiotic treatment regimens has been recognized as a growing problem. Therefore, the aim of this study was to determine the prevalence of antibiotic resistance among H. pylori strains isolated from Mongolians. Methodology. All gastric biopsy specimens were obtained during upper gastrointestinal endoscopy from patients referred for the exploration of dyspepsia. The urease positive samples by rapid urease test were cultured according to standard microbiological procedures and H. pylori were grown under microaerophilic conditions on selective Pylori agar. H. pylori antibiotic sensitivity was examined using E-test. In addition, the mutations of the corresponding gene were studied by GenoType HelicoDR DNA strip testing. Results. Three hundred twenty patients, 216 female and 104 male in the ages range of 18 to 83 years were included in this study. Rapid urease test yielded positive results for 65.9% (211/320). Among them, we have successfully obtained 72% H. pylori isolates. The antibiotic resistance rates were 35.5% for clarithromycin, 68.4% metronidazole, 23.0% amoxicillin, 25.0% tetracycline, 28.2% erythromycin and 14.5% nitrofuranton. Resistance for 2 drugs was 34.5% and that of 3 drugs was observed in 14.5% of isolates. The most prevalent mutation was A2147G followed by A2146G and D91Y. The prevalence of H. pylori infection increased among Mongolian population and the prevalence of resistance of H. pylori is very high to metronidazole, and moderate to clarithromycin. Conclusion. The data on antimicrobial susceptibilities provided by the present study is may assist the clinicians on the effectiveness of treatment regimens.

scholarly journals The Antibacterial Activity of Mass Galla Chinesis et Camelliae Fermentata on Helicobacter pylori Infection

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Jing Yu ◽  
Hui Ye ◽  
Jiang Li ◽  
Ning Li ◽  
Zong-ming Shi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Rapid Urease Test ◽  
Dosage Group ◽  
Urease Test ◽  
H Pylori ◽  
Time Kill

Mass Galla chinesis et camelliae Fermentata (Chinese gall leaven, CGL) was investigated for activities against Helicobacter pylori (H. pylori) both in vitro and in vivo. The agar dilution method and time-kill curves, as in vitro assays and an in vivo study using a Kunming mice model, were performed. CGL demonstrated a strong anti-Helicobacter pylori activity in vitro with the minimal inhibitory concentrations (MICs) against multiple H. pylori strains of 0.5~8 mg/ml and the decreasing trend time-kill curves when increasing CGL concentrations. H. pylori eradication rates in vivo were evaluated based on rapid urease test (RUT) and histopathologic criteria. Results revealed that the eradication rates in the CGL groups were 40% (4/10) in the high dosage group, 33% (4/11) in the medium dosage group, and 18% (2/11) in the low dosage group, with the difference between the high dosage and H. pylori control groups being significant (P=0.035). The H. pylori colonization scores could be reduced partly by CGL. These in vivo results demonstrated that CGL in a rationally high dosage might be the most effective.

scholarly journals Antibacterial resistance in Helicobacter pylori strains isolated from Bulgarian children and adult patients over 9 years

2006 ◽  
Vol 55 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Lyudmila Boyanova ◽  
Rossen Nikolov ◽  
Elena Lazarova ◽  
Galina Gergova ◽  
Nikolai Katsarov ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Treatment Resistance ◽  
Post Treatment ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Antibacterial Resistance ◽  
Primary Resistance ◽  
Metronidazole Resistance ◽  
H Pylori ◽  
Resistance Rates

The aim of this study was to evaluate the primary, combined and post-treatment antibacterial resistance rates in 1205 Helicobacter pylori strains from non-treated (786 adults, 282 children) and treated (109 adults, 28 children) patients in Bulgaria. Susceptibility was tested by the limited agar dilution method. Overall primary resistance rates to metronidazole, clarithromycin, amoxicillin, tetracycline and both metronidazole and clarithromycin were respectively 15·0, 12·5, 1·5, 3·4 and 4·7 % in children and 25·6, 12·6, 0·8, 5·2 and 4·9 % in adults. Primary metronidazole resistance in adults was more common than in children, but the differences for other agents tested were not significant. Primary resistance rates were in the range of those reported worldwide. There was no significant increase in primary resistance rates from 1996/1999 to 2003/2004; however, clarithromycin resistance rates exhibited a slight tendency to increase. Post-treatment resistance to amoxicillin was detected in 1·6 % of 63 strains. Post-treatment resistance to metronidazole was common (81·6 %) and that to clarithromycin was considerable (36 %). Alarming emergence of strains with triple resistance to amoxicillin, metronidazole and clarithromycin was found in two non-treated and three treated patients. The results motivate a larger and continuing surveillance of H. pylori resistance in Bulgaria and worldwide.

scholarly journals Antibiotic resistance of Helicobacter pylori in the European part of the Russian Federation: first results

2020 ◽  
Vol 92 (8) ◽  
pp. 24-28
Author(s):  
I. V. Maev ◽  
D. N. Andreev ◽  
V. M. Govorun ◽  
E. N. Ilina ◽  
Yu. A. Kucheryavyy ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Russian Federation ◽  
European Part ◽  
Diffusion Method ◽  
Rapid Urease Test ◽  
Urease Test ◽  
First Results ◽  
The Russian Federation ◽  
H Pylori

Aim. Determine the primary antibiotic resistance of Helicobacter pylori (H. pylori) strains isolated from patients living in the European part of the Russian Federation. Materials and methods. As part of a clinical laboratory study, from 2015 to 2018, 27 gastrobiopsy samples obtained from H. pylori-infected patients were analyzed. H. pylori infection was verified using a rapid urease test or a 13C-urea breath test. The values of the minimum inhibitory concentration (MIC) of antibiotics were determined by the diffusion method using E-test strips (BioMerieux, France) according to the recommendations of the manufacturer. The sensitivity of the isolates was determined for 6 antibacterial drugs (amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, rifampicin). Results. According to the data obtained, resistance to amoxicillin was 0%, clarithromycin 11.1%, metronidazole 59.3%, levofloxacin 3.7%, tetracycline 0%, and rifampicin 14.8%. Dual resistance to clarithromycin and metronidazole was recorded in two isolates (7.4%). Conclusion. Thus, the first results of the evaluation of H. pylori antibiotic resistance in the European part of the Russian Federation indicate a low resistance of the microorganism to clarithromycin and quite high to metronidazole.

scholarly journals Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

2016 ◽  
Vol 10 (03) ◽  
pp. 245-253 ◽  
Author(s):  
Hafeza Aftab ◽  
Muhammad Miftahussurur ◽  
Phawinee Subsomwong ◽  
Faruque Ahmed ◽  
AK Azad Khan ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Antibiotic Susceptibility ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Peptic Ulcers ◽  
H Pylori ◽  
Resistance Rates

Introduction: The most recent study to report Helicobacter pylori antibiotic resistance rates in Bangladesh was published 15 years ago and did not include levofloxacin. We therefore aimed to determine the current antibiotic susceptibility of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline and levofloxacin in Bangladesh. Methodology: This study included 133 consecutive patients who underwent endoscopy examination at Dhaka Medical College in November 2014. The serial two-fold agar dilution method was used to determine the minimum inhibitory concentrations of the five antibiotics. Results: Among 56 cultured strains, H. pylori showed high rates of resistance to clarithromycin and metronidazole (39.3% and 94.6%, respectively). Moreover, levofloxacin showed an emerging antimicrobial resistance pattern (66.1%), which was higher in patients with gastritis than that in those with peptic ulcers (p = 0.02). The resistance rate of levofloxacin was significantly higher in patients living in Dhaka city compared to those living in the village (p = 0.049). However, amoxicillin and tetracycline resistance rates were very low. Resistance to both metronidazole and levofloxacin was most commonly observed. Conclusions: The rates of resistance to clarithromycin, metronidazole, and levofloxacin were high in Bangladesh, which suggests that triple therapy based on these drugs may not be useful as first-line therapies in Bangladesh. Alternative strategies such as furazolidone-based triple therapy, bismuth-based quadruple therapies, or sequential therapy may be more effective for patients in in Bangladesh.

scholarly journals High Prevalence of Antibiotic Resistance in Iranian Helicobacter pylori Isolates: Importance of Functional and Mutational Analysis of Resistance Genes and Virulence Genotyping

2019 ◽  
Vol 8 (11) ◽  
pp. 2004 ◽  
Author(s):  
Nastaran Farzi ◽  
Abbas Yadegar ◽  
Amir Sadeghi ◽  
Hamid Asadzadeh Aghdaei ◽  
Sinéad Marian Smith ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Rrna Genes ◽  
23S Rrna ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Gyra Gene ◽  
Therapeutic Regime ◽  
High Prevalence ◽  
H Pylori

The high prevalence of antibiotic resistance in Helicobacter pylori has become a great challenge in Iran. The genetic mutations that contribute to the resistance have yet to be precisely identified. This study aimed to investigate the prevalence of antibiotic resistance and virulence markers in Iranian H. pylori isolates and to analyze if there is any association between resistance and genotype. Antibiotic susceptibility patterns of 68 H. pylori isolates were investigated against metronidazole, clarithromycin, amoxicillin, rifampicin, ciprofloxacin, levofloxacin, and tetracycline by the agar dilution method. The frxA, rdxA, gyrA, gyrB, and 23S rRNA genes of the isolates were sequenced. The virulence genotypes were also determined using PCR. Metronidazole resistance was present in 82.4% of the isolates, followed by clarithromycin (33.8%), ciprofloxacin (33.8%), rifampicin (32.4%), amoxicillin (30.9%), levofloxacin (27.9%), and tetracycline (4.4%). Overall, 75% of the isolates were resistant to at least two antibiotics tested and considered as a multidrug resistance (MDR) phenotype. Most of the metronidazole-resistant isolates carried frameshift mutations in both frxA and rdxA genes, and premature termination occurred in positions Q5Stop and Q50Stop, respectively. Amino acid substitutions M191I, G208E, and V199A were predominantly found in gyrA gene of fluoroquinolone-resistant isolates. A2143G and C2195T mutations of 23S rRNA were found in four clarithromycin-resistant isolates. Interestingly, significant associations were found between resistance to metronidazole (MNZ) and cagA-, sabA-, and dupA-positive genotypes, with p = 0.0002, p = 0.0001, and p = 0.0001, respectively. Furthermore, a significant association was found between oipA “on” status and resistance to amoxicillin (AMX) (p = 0.02). The prevalence of H. pylori antibiotic resistance is high in our region, particularly that of metronidazole, clarithromycin, ciprofloxacin, and MDR. Simultaneous screening of virulence and resistance genotypes can help clinicians to choose the appropriate therapeutic regime against H. pylori infection.

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