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

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.

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Antibiotic resistance of Helicobacter pylori in Mongolia

The Journal of Infection in Developing Countries ◽

10.3855/jidc.8619 ◽

2017 ◽

Vol 11 (11) ◽

pp. 887-894 ◽

Cited By ~ 5

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.

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

Current Pharmaceutical Biotechnology ◽

10.2174/1389201021666200722162613 ◽

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．

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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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Diagnostic Performance of Gastric Imprint Smear for Determination ofHelicobacter pyloriInfection

Canadian Journal of Gastroenterology ◽

10.1155/2010/156310 ◽

2010 ◽

Vol 24 (10) ◽

pp. 603-606 ◽

Cited By ~ 1

Author(s):

J Al-Ali ◽

F Al-Asfar ◽

R Dhar ◽

PM Dhar ◽

K Kapila

Keyword(s):

Diagnostic Performance ◽

Rapid Test ◽

Reference Method ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Imprint Cytology ◽

Culture Methods ◽

Microbiological Methods ◽

Urease Test ◽

H Pylori

BACKGROUND: Despite the availability of several methods (invasive and noninvasive) for the diagnosis ofHelicobacter pyloriinfection, no test is considered to be the ‘gold standard’. Endoscopy-based tests are regarded as the reference method in most studies.OBJECTIVE: To evaluate the diagnostic performance of imprint cytology smears of antral biopsies compared with Gram-stained smears, the rapid urease test and culture methods, separately and in combination.METHODS: Antral biopsies were obtained from consecutive patients undergoing upper gastrointestinal endoscopy at a single centre. The biopsies were examined for the presence ofH pyloriby Gram-stained smear, the rapid urease test, culture methods and imprint cytology smear.RESULTS: A total of 273 biopsies were studied. All tests were positive in 36% of the patients. Of 252 biopsies tested, 73% were positive using the imprint cytology technique. Using Gram-stained smear, the rapid urease test and culture methods individually, the sensitivity and specificity of imprint cytology smears for the detection ofH pyloriwere found to be 92.7% and 50%; 92.7% and 49%; and 92.4% and 38.5%, respectively. Combining the three microbiological methods resulted in a sensitivity of 92.1%, a specificity of 51.0% and an efficiency of 71.7% for imprint cytology smears.CONCLUSIONS: Endoscopic examination provides useful clinical information. Imprint gastric cytology can be used as a rapid test to establish the diagnosis ofH pyloriinfection at the time endoscopy is performed, enabling the endoscopist to start treatment with immediate effect.

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

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.08.000761 ◽

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.

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GENDER, AGE, ENDOSCOPIC FINDINGS, UREASE AND HELICOBACTER PYLORI: ALL UNCORRELATED WITHIN A SAMPLE OF A HIGH GASTRIC CANCER PREVALENCE POPULATION IN AMAZON

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-50 ◽

2019 ◽

Vol 56 (3) ◽

pp. 264-269

Author(s):

Ariney Costa de MIRANDA ◽

Cássio CALDATO ◽

Mira Nabil SAID ◽

Caio de Souza LEVY ◽

Claudio Eduardo Corrêa TEIXEIRA ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cross Sectional Study ◽

Upper Gastrointestinal Endoscopy ◽

Histopathological Analysis ◽

Rapid Urease Test ◽

Cross Sectional ◽

Cancer Prevalence ◽

Urease Test ◽

H Pylori

ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.

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Helicobacter pylori eradication in renal transplant candidates

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2021-0097 ◽

2022 ◽

Author(s):

Mariana E. Maioli ◽

Raquel F. N. Frange ◽

Cintia M. C. Grion ◽

Vinicius D. A. Delfino

Keyword(s):

Chronic Kidney Disease ◽

Helicobacter Pylori ◽

Gastrointestinal Endoscopy ◽

Eradication Rate ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Urease Test ◽

Transplant Candidates ◽

H Pylori ◽

Upper Gastrointestinal

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.

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A REVIEW OF HELICOBACTER PYLORI INFECTION DISEASES, ANTIBIOTIC RESISTANCE AND DIAGNOSIS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i12.24745 ◽

2018 ◽

Vol 11 (12) ◽

pp. 566

Author(s):

Bolai Paul ◽

Senthil Adimoolam ◽

Mohd Javed Qureshi ◽

Nahlah Elkudssiah Ismail

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Developed Countries ◽

Epidemiologic Studies ◽

Diagnostic Methods ◽

Gastric Ulcers ◽

Rapid Urease Test ◽

Stool Antigen Test ◽

Urease Test ◽

H Pylori

Objective: The aim of the study was designed to assess the mechanisms of antibiotic resistance in Helicobacter pylori, affecting disease by this infection and diagnostic methods which are used to detect H. pylori.Methods: A wide literature search was performed using PubMed, Medline, Cinahl, Embase, Educational Resources Information Center, PsycINFO, Google Scholar, Scopus, and Web of Science, and review of appropriate epidemiologic studies conducted from 1995 to 2017 for studies fully published investigating a contribution between H. pylori infection, antibiotic resistance, and diagnosis of H. pylori infection.Results: H. pylori infection is extremely contributed to the main symptoms and death that is currently affecting 50–75% of the people in the world. It is more affected in developing countries compared to developed countries. These infections are regarded to be the most important reasons for gastric cancer, peptic ulcer, chronic gastritis, duodenal ulcer, mucosa-associated lymphoid tissue lymphomas, and gastric adenocarcinoma. About 90–100% of duodenal ulcers and 60–90% of gastric ulcers were associated with H. pylori infections. At present, antibiotic resistance is a growing problem for the eradication of H. pylori infection; it contains metronidazole, amoxicillin, clarithromycin, and levofloxacin resistance. Diagnosis of H. pylori infection is a crucial part for the better treatment of those diseases. Different types of testing method for H. pylori infection are used including invasive (endoscopic image, histology, rapid urease test, and culture) and non-invasive (urea breath test, stool antigen test, and serological).Conclusion: H. pylori antibiotic resistance is the major contributor to the failure of H. pylori treatment. Appropriate diagnostic method selected in detecting H. pylori antibiotic resistance may lead to reduced treatment failures and less antibiotic resistance.

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Prevalence of Helicobacter Pylori Infection in Patients with Portal Hypertension

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v6i2.22470 ◽

2018 ◽

Vol 6 (2) ◽

pp. 16-19

Author(s):

Shatdal Chaudhary ◽

Altaban Rahi ◽

Anita Shah ◽

Aakash Shahi ◽

Badri Kumar Gupta ◽

...

Keyword(s):

Helicobacter Pylori ◽

Portal Hypertension ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

World Population ◽

Gastric Erosion ◽

Inclusion Criteria ◽

Urease Test ◽

Study Population ◽

H Pylori

Introduction: Helicobacter pylori (H. pylori) is a microaerophile gram-negative bacillus which is found mainly on the surface of mucous membrane of the prepyloric part of the stomach. It is found to be infecting approximately 50% of world population. In patients with liver cirrhosis, the prevalence of H. pylori is variable. A high incidence of H. pylori colonization has been found in portal hypertension; especially in those with gastric erosion. This study was done to find out the prevalence of H. pylori infection in patients with portal hypertension at Universal College of Medical Sciences Teaching Hospital, Nepal. Materials and methods: It was a hospital based cross sectional observational study. All the consecutive patients aged more than 16 years, presented with portal hypertension who fulfilled the inclusion criteria were included in the study. The study period was from 1st September 2015 to 31st August 2016. The upper gastrointestinal endoscopy was done in all cases and mucosal biopsy was taken. H. pylori infection was diagnosed by using rapid urease test. Results: During the study period, 71 patients fulfilled the inclusion criteria and were included in the analysis. The majority of the patients 21 (29.6%) were between 51-60 years age group. There were more male (78.9%) then female (21.1%). The mean age of study population was 50.85 ± 12.47 years. Among the study population, rapid urease test was positive in 70.4% (n=50) patients. Conclusion: The prevalence of H. pylori infection was seen in 70.4% of the patients suffering with portal hypertension.

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