scholarly journals Surveillance of primary antibiotic resistance of Helicobacter pylori at centres in England and Wales over a six-year period (2000-2005)

2007 ◽  
Vol 12 (7) ◽  
pp. 3-4 ◽  
Author(s):  
S A Chisholm ◽  
E L Teare ◽  
K Davies ◽  
R J Owen
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Eradication Therapy ◽  
England And Wales ◽  
North Wales ◽  
Key Factor ◽  
Male Patients ◽  
South East England ◽  
H Pylori ◽  
Resistance Rates

Antibiotic resistance is a key factor in the failure of Helicobacter pylori eradication therapy, yet few sentinel schemes exist to monitor trends in resistance at local, national or international levels. This study aimed, over a six-year period, to monitor resistance levels of H. pylori in England and Wales to the four antibiotics used in its treatment. A total of 1,310 isolates from Gwynedd in north Wales and from mid-Essex in south-east England were collected from 2000 to 2005 and tested for susceptibilities to metronidazole, clarithromycin, amoxicillin and tetracycline. Overall, metronidazole and clarithromycin resistance rates were 28.6% and 8.3% in Gwynedd and significantly higher (36.3%, p=0.0031, and 12.7%, p=0.0112) in mid-Essex. Rates of resistance to metronidazole and clarithromycin increased in both areas over this six-year period. Resistance rates were higher in female compared with male patients (38.1% vs 26.6% for metronidazole, p

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

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.

Primary antibiotic resistance of Helicobacter pylori among a Chinese Tibetan population

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.

scholarly journals ANTIBIOTIC RESISTANCE SURVEILLANCE OF HELICOBACTER PYLORI AT THE BIOBÍO REGION (CHILE) IN A DECADE

2019 ◽  
Vol 56 (4) ◽  
pp. 361-366
Author(s):  
Cristian PARRA-SEPÚLVEDA ◽  
José S MERINO ◽  
Katia SÁEZ-CARRILLO ◽  
Carlos GONZÁLEZ ◽  
Apolinaria GARCÍA-CANCINO
Keyword(s):  
Health Care ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Blood Cells ◽  
Eradication Therapy ◽  
Clarithromycin Resistance ◽  
Resistant Strains ◽  
H Pylori ◽  
Horse Red Blood Cells ◽  
Co2 Atmosphere

ABSTRACT BACKGROUND: Helicobacter pylori infection in Chile remains as a public and private health-care system’s challenge, with a prevalence of the infection over 70%. Nowadays, antibiotic treatment of the infection is mandatory to prevent the arising of severe associated diseases but failures in the eradication therapy mainly due to clarithromycin resistance has been observed worldwide and first line eradication therapy seems to be not effective anymore in several geographical areas. Thus, health-care systems are committed to maintain an epidemiological surveillance upon the evolution of the antibiotic resistance of this priority 2 pathogen. OBJECTIVE: This work reports a 10 years surveillance of the primary antibiotic resistance of H. pylori clinical isolates at the Biobío region-Chile, and the evolution of resistance toward amoxicillin, clarithromycin, levofloxacin, metronidazole, and tetracycline among the species. METHODS: H. pylori strains were investigated during the periods 2005-2007 (1435 patients analysed) and 2015-2017 (220 patients analysed) by inoculating a saline homogenate biopsy onto the surface of Columbia agar (Oxoid, Basingstoke, UK) - supplemented with 7% horse red blood cells plus DENT inhibitor (Oxoid, Basingstoke, UK) - following by incubation at 37ºC under 10% CO2 atmosphere for five days. Antibiotic resistance pattern of the isolates was assessed using the disk diffusion test in Müeller-Hinton agar supplemented with 7% horse red blood cells followed by incubation for further three days under 10% CO2 atmosphere. Statistical analysis was done using the SPSS v22 software and P values <0.05 were considered statistically significant. RESULTS: A total of 41% of 1435 patients were detected to be infected with H. pylori by bacteriological culture in 2005-2007 period, meanwhile 32.7% from 220 patients were also infected in 2015-2017 period. The clinical isolates of H. pylori are mostly susceptible to amoxicillin and tetracycline (both over 98% of strains), but less susceptible to levofloxacin in both periods analysed (over 79% of the strains). On the other hand, metronidazole continuous showing the highest score of resistant isolates (over 40% of resistant strains), although an 18% fewer resistant strains were observed in 2015-2017 period. Clarithromycin, the key antibiotic in eradication therapies, has an increased frequency of resistant strain isolated in the decade (22.5% in 2005-2007 and 29.2% in 2015-2017). Multidrug resistant strains (two, three and four antibiotics) were also detected in both periods with the highest scores for simultaneous resistance to clarithromycin-metronidazole (18%) and clarithromycin-metronidazole-levofloxacin (12.5%) resistant strains. According to gender, the isolates resistant to amoxicillin, clarithromycin and metronidazole were more frequent in female, with a specific increment in amoxicillin and clarithromycin resistance. CONCLUSION: The frequency of clarithromycin resistance (29.2%) detected in 2015-2017 suggests that conventional triple therapy is no longer effective in this region.

scholarly journals Treatment of Helicobacter pylori infections in the light of the increase of antibiotic resistance

2018 ◽  
Vol 72 ◽  
pp. 143-158
Author(s):  
Eliza Mnich ◽  
Jakub Ibran ◽  
Magdalena Chmiela
Keyword(s):  
Fatty Acids ◽  
Ascorbic Acid ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Eradication Therapy ◽  
The World ◽  
Potential Alternative ◽  
Resistant Strains ◽  
Treatment Mechanisms ◽  
H Pylori

The aim of this study was to present the risks associated with the occurrence of Helicobacter pylori (H. pylori) infection in humans and the problems related to eradication procedures with the use of antibiotic treatment. The content provides an overview of the available methods of infection diagnosis and recommended therapeutic schemes as well as potential alternative schedules of treatment. Mechanisms of H. pylori resistance to commonly used antibiotics including the mutations in the genome leading to resistance and the incidence of resistant strains in the world has been described. Finally, we introduced substances with some potential in eradication therapy, including probiotics, plant formulations as well as polyunsaturated fatty acids and ascorbic acid.

scholarly journals Microarray-Based Detection and Clinical Evaluation for Helicobacter pylori Resistance to Clarithromycin or Levofloxacin and the Genotype of CYP2C19 in 1083 Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Yi Song ◽  
Fengna Dou ◽  
Zhe Zhou ◽  
Ningmin Yang ◽  
Jing Zhong ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Limit Of Detection ◽  
Eradication Therapy ◽  
Gastric Biopsy ◽  
Individual Therapy ◽  
23S Rrna ◽  
Antibiotic Administration ◽  
Cyp2c19 Polymorphism ◽  
H Pylori

Background. Helicobacter pylori (H. pylori) is one of the most frequent and persistent bacterial infections that affect nearly half of the world’s population. Antibiotic resistance is a constantly evolving process and local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy. The aim of this study was to establish a microarray-based detection to identify H. pylori infection, clarithromycin and levofloxacin susceptibility, and CYP2C19 genetic polymorphism and guide to potential choice of proton pump inhibitor (PPI), antibiotic administration for tailored H. pylori eradication therapy. Methods. By analyzing the sequence of human genomic CYP2C19⁎2 and CYP2C19⁎3 and mutations within the 23S rRNA and gyrA gene regions conferring clarithromycin and levofloxacin resistance, respectively, we developed a microarray for individual therapy detection of H. pylori infection. Plasmids were established as positive or limit of detection (LOD) reference materials. The specificity and sensitivity of the microarray had been performed. And a total of 1083 gastric biopsy samples were tested and the Kappa value had been calculated between the array and Sanger sequencing. We also analyzed the resistance to clarithromycin and levofloxacin in China, as well as the CYP2C19 polymorphisms. Results. The LOD of detecting H. pylori was 103 CFU/mL and human genome DNA was 2 ng/μL. The detection results of 1083 gastric biopsy samples showed that 691 (63.80%) were H. pylori positive, of which 266 (38.49%) were resistant to clarithromycin, 192 (27.79%) were resistant to levofloxacin, and 61 (8.83%) were resistant to both of them. For the type of CYP2C19 polymorphism, 412 (38.04%) were homozygous fast type (HomEM), 574 (53%) were heterozygous EM (HetEM), and 97 (8.96%) were poor metabolizer (PM). Conclusions. The proposed microarray-based detection has high specificity, sensitivity, and reproducibility for detecting the resistance of clarithromycin or levofloxacin as well as CYP2C19 polymorphism, which may help to improve the clinical eradication rate of H. pylori.

scholarly journals Trend of changes in antibiotic resistance in Helicobacter pylori from 2013 to 2019: a multicentre report from Taiwan

2020 ◽  
Vol 13 ◽  
pp. 175628482097699
Author(s):  
Chih-Ming Liang ◽  
Wei-Chen Tai ◽  
Pin-I Hsu ◽  
Deng-Chyang Wu ◽  
Chao-Hung Kuo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Linear Trend ◽  
Eradication Therapy ◽  
Resistance Rate ◽  
Test Method ◽  
Success Rates ◽  
Primary Resistance ◽  
Secondary Resistance ◽  
H Pylori

Background: Antibiotic resistance plays a crucial role in the treatment failure of Helicobacter pylori (H. pylori) infection. This study aimed to determine the trend of changes in the primary, secondary and tertiary antibiotic resistance of H. pylori in Taiwan over the last 7 years. Methods: We retrospectively analysed H. pylori-infected isolates from patients with primary resistance ( n = 1369), secondary resistance ( n = 196) and tertiary resistance ( n = 184) from January 2013 to December 2019. The H. pylori strains were tested for susceptibility to amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline using the Epsilometer test method. Results: A progressively higher primary resistance rate was observed for clarithromycin (11.8–20.4%, p = 0.039 in χ2 test for linear trend), levofloxacin (17.3–38.8%, p < 0.001) and metronidazole (25.6–42.3%, p < 0.001) among naïve patients who received first-line eradication therapy. The dual primary resistance to clarithromycin and metronidazole also progressively increased in a linear trend (2.4–10.4%, p = 0.009). For secondary resistance, an increase was observed for levofloxacin (30.5–64.7%, p = 0.006) and metronidazole (40.5–77.4%, p < 0.001). For tertiary resistance, the observed increase was even more significant for levofloxacin (65.9–100.0%, p = 0.106) and metronidazole (44.4–88.2%, p < 0.001). The resistance to amoxicillin and tetracycline remained very low in Taiwan regardless of primary, secondary and tertiary resistance. Conclusion: Primary, secondary and tertiary antibiotic resistance to clarithromycin, levofloxacin and metronidazole for H. pylori has been increasing in Taiwan since 2013. Treatment should be targeted for eradication success rates of more than 90%. Third-line treatment should be based on antibiotic susceptibility.

scholarly journals Current understanding and management of Helicobacter pylori infection: an updated appraisal

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 721 ◽  
Author(s):  
Shamshul Ansari ◽  
Yoshio Yamaoka
Keyword(s):  
Helicobacter Pylori ◽  
Management Strategy ◽  
Asymptomatic Patient ◽  
Eradication Therapy ◽  
Critical Issue ◽  
Effective Management ◽  
Timely Diagnosis ◽  
Metronidazole Resistance ◽  
H Pylori ◽  
Resistance Rates

In addition to its role in gastric conditions, Helicobacter pylori has been found to contribute to the development of several non-gastric issues in recent years. Eradication therapy is the only effective management strategy to minimize the H. pylori-related gastric cancer and extra-gastric complications. For an effective “test and treat” strategy, diagnosis and therapy are both important. Because the infection is usually asymptomatic, patient selection is a critical issue for timely diagnosis and many clinical and demographic factors should be considered. Clarithromycin and metronidazole resistance rates also need to be considered while eradication therapy is offered. In this report, we discuss the issues which must be taken into account for the correct and timely diagnosis and for the antibiotic therapy-based management of H. pylori infection.

scholarly journals Helicobacter pylori Eradication Therapy - Recent Trend in Research

2020 ◽  
Vol 20 (3) ◽  
pp. 210-217
Author(s):  
Heung Up Kim
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Gastric Mucosa ◽  
Drug Exposure ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Resistance Rate ◽  
H Pylori ◽  
Selection Of

It is well known that <i>Helicobacter pylori (H. pylori)</i> can cause peptic ulcer, mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, intestinal metaplasia, and ultimately, gastric cancer. Various studies have proven that <i>H. pylori</i>, which attaches to the gastric mucosa, is the cause of gastric cancer and can be eradicated using appropriate antibiotics. Since 2013, Japan has been carrying out national-led eradication treatment of <i>H. pylori</i> for the whole population. However, as drug exposure increases, the resistance rate to some antibiotics increases, and the pattern of antibiotic resistance varies from region to region. Therefore, the development of individualized antimicrobial therapies has become important since antibiotic resistance to <i>H. pylori</i> eradication is a problem worldwide. To help overcome this, remedies such as selection of antibiotics through susceptibility testing, selection of empirical treatment combinations appropriate for the region, dual therapy with high doses of amoxicillin, and the use of rifabutin or sitafloxacin with low antibiotic resistance have been studied. Potassium-competitive acid blocker has been reported to be more potent in inhibiting acid secretion than proton pump inhibitor, and its role in <i>H. pylori</i> eradication is expected. Drug formulations and regimens that are easy to take are being developed to increase compliance. New treatments such as spraying antibiotics directly to the gastric mucosa are being developed and studied.

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 Resistotype of Helicobacter pylori isolates: the impact on eradication outcome

2014 ◽  
Vol 63 (5) ◽  
pp. 703-709 ◽  
Author(s):  
Hanafiah Alfizah ◽  
Ahmad Norazah ◽  
Razlan Hamizah ◽  
Mohamed Ramelah
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Eradication Therapy ◽  
Fluoroquinolone Resistance ◽  
23S Rrna ◽  
Nonsense Mutations ◽  
Metronidazole Resistance ◽  
Resistant Strains ◽  
H Pylori ◽  
The Impact

Antibiotic resistance is increasing worldwide, and it has been regarded as the main factor reducing the efficacy of Helicobacter pylori therapy. The aim of this study was to determine the phenotype and genotype of antibiotic-resistant strains of H. pylori in the Malaysian population and to evaluate the impact of antibiotic resistance to eradication outcome. One hundred and sixty-one H. pylori isolates were analysed in this study. Metronidazole, clarithromycin, fluoroquinolone, amoxicillin and tetracycline susceptibilities were determined by Etest. PCR followed by DNA sequencing was carried out to determine mutations. The medical records of the patients infected with resistant strains were reviewed to determine the eradication outcome. Metronidazole resistance was encountered in 36.6 % of H. pylori isolates, whereas clarithromycin and fluoroquinolone resistance was observed in 1.2  and 1.9 % of isolates, respectively. All strains tested were susceptible to amoxicillin and tetracycline. Frameshift and nonsense mutations in rdxA and frxA genes resulting in stop codons contributed to metronidazole resistance, which leads to reduced eradication efficacy. A2142G and A2143G mutations of 23S rRNA were identified as causing failure of the eradication therapy. Mutation at either codon 87 or 91 of the gyrA gene was identified in fluoroquinolone-resistant strains. However, the effect of resistance could not be assessed. This study showed that frameshift and nonsense mutations in rdxA or frxA genes and point mutations in the 23S rRNA affected the efficacy of H. pylori eradication therapy.

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