V J Warburton-Timms1, C A McNulty. 1. Public Health Laboratory, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK.
Abstract
BACKGROUND: Resistance of Helicobacter pylori to the more frequently used antibiotics (metronidazole and clarithromycin) reduces eradication rates even with triple treatment. Determining the antibiogram profile of H pylori can take up to 14 days and delays appropriate treatment. AIMS: To determine the role of screening agar plates for more rapid in vitro susceptibility of H pylori to metronidazole, amoxicillin, and clarithromycin. METHODS: Routine gastric biopsy specimens from 507 dyspeptic patients were inoculated on to 10% lysed blood agar plates containing metronidazole (8 microg/ml), clarithromycin (2 microg/ml), or amoxicillin (0.5 microg/ml). The minimum inhibitory concentration (MIC) of the 90 isolates was determined using the E test. RESULTS: Metronidazole resistance was detected in 28 of 90 isolates by E test and nine of 98 by screening agar. The screening agar detected none of the four clarithromycin resistant isolates detected by the E test. CONCLUSIONS: The screening agar method is not sufficiently sensitive to be used alone.
BACKGROUND: Resistance of Helicobacter pylori to the more frequently used antibiotics (metronidazole and clarithromycin) reduces eradication rates even with triple treatment. Determining the antibiogram profile of H pylori can take up to 14 days and delays appropriate treatment. AIMS: To determine the role of screening agar plates for more rapid in vitro susceptibility of H pylori to metronidazole, amoxicillin, and clarithromycin. METHODS: Routine gastric biopsy specimens from 507 dyspeptic patients were inoculated on to 10% lysed blood agar plates containing metronidazole (8 microg/ml), clarithromycin (2 microg/ml), or amoxicillin (0.5 microg/ml). The minimum inhibitory concentration (MIC) of the 90 isolates was determined using the E test. RESULTS:Metronidazole resistance was detected in 28 of 90 isolates by E test and nine of 98 by screening agar. The screening agar detected none of the four clarithromycin resistant isolates detected by the E test. CONCLUSIONS: The screening agar method is not sufficiently sensitive to be used alone.
Authors: L M Best; D J M Haldane; M Keelan; D E Taylor; A B R Thomson; V Loo; C A Fallone; P Lyn; F M Smaill; R Hunt; C Gaudreau; J Kennedy; M Alfa; R Pelletier; S J O Veldhuyzen Van Zanten Journal: Antimicrob Agents Chemother Date: 2003-10 Impact factor: 5.191