BACKGROUND AND AIMS: H. pylori eradication with standard therapies is decreasing worldwide, mainly because of increased primary antibiotic resistance rates. We aimed to assess primary resistance in H. pylori isolates towards the most used antibiotics in clinical practice. METHODS: The study enrolled consecutive, dyspeptic, adult patients, never treated for H. pylori, who had underwent upper endoscopy. Gastric biopsies were taken for standard histology, and two further antral biopsies were used for H. pylori culture. Minimal inhibitory concentrations (MIC) >/= 1, >/= 8 and >/= 1 mg/L were used as break point for clarithromycin, metronidazole, and levofloxacin resistance, respectively. RESULTS: Bacterial culture was successful in 145 (94%) out of 154 infected patients. Resistance towards at least one antibiotic was detected in 111 (76.6%) isolated, and multiple antibiotic resistance in 35.2% of cases. Primary resistance towards clarithromycin, metronidazole, and levofloxacin was detected in 51 (35.2%), 86 (59.3%), and in 32 isolated (22.1%), respectively. Levofloxacin resistance was significantly associated with the male sex (OR: 11.3, 95% CI = 1.2-103; P = 0.03), whilst females were at a higher risk of being infected with bacterial strains harbouring a double clarithromycin and metronidazole resistance (OR: 4.9, 95% CI = 1.2-19.8, P = 0.02). CONCLUSION: Our data indicate a very high primary resistance rate towards the most used antibiotics in H. pylori isolates. The efficacy of standard eradication therapies is expected to further decrease in the next years.
BACKGROUND AND AIMS: H. pylori eradication with standard therapies is decreasing worldwide, mainly because of increased primary antibiotic resistance rates. We aimed to assess primary resistance in H. pylori isolates towards the most used antibiotics in clinical practice. METHODS: The study enrolled consecutive, dyspeptic, adult patients, never treated for H. pylori, who had underwent upper endoscopy. Gastric biopsies were taken for standard histology, and two further antral biopsies were used for H. pylori culture. Minimal inhibitory concentrations (MIC) >/= 1, >/= 8 and >/= 1 mg/L were used as break point for clarithromycin, metronidazole, and levofloxacin resistance, respectively. RESULTS: Bacterial culture was successful in 145 (94%) out of 154 infectedpatients. Resistance towards at least one antibiotic was detected in 111 (76.6%) isolated, and multiple antibiotic resistance in 35.2% of cases. Primary resistance towards clarithromycin, metronidazole, and levofloxacin was detected in 51 (35.2%), 86 (59.3%), and in 32 isolated (22.1%), respectively. Levofloxacin resistance was significantly associated with the male sex (OR: 11.3, 95% CI = 1.2-103; P = 0.03), whilst females were at a higher risk of being infected with bacterial strains harbouring a double clarithromycin and metronidazole resistance (OR: 4.9, 95% CI = 1.2-19.8, P = 0.02). CONCLUSION: Our data indicate a very high primary resistance rate towards the most used antibiotics in H. pylori isolates. The efficacy of standard eradication therapies is expected to further decrease in the next years.
Authors: Marco Manfredi; Pierpacifico Gismondi; Valentina Maffini; Barbara Bizzarri; Fabiola Fornaroli; Carmen Madia; Antonino Salerno; A Marta Cangelosi; Gian Luigi de'Angelis Journal: Gastroenterol Res Pract Date: 2015-05-06 Impact factor: 2.260
Authors: I Thung; H Aramin; V Vavinskaya; S Gupta; J Y Park; S E Crowe; M A Valasek Journal: Aliment Pharmacol Ther Date: 2015-12-23 Impact factor: 8.171
Authors: Beom Jin Kim; Hyun-Soo Kim; Hyun Joo Song; Il-Kwun Chung; Gwang Ha Kim; Byung-Wook Kim; Ki-Nam Shim; Seong Woo Jeon; Yun Jin Jung; Chang-Hun Yang; Ji Hyun Kim; Tae Ho Kim; Sang Gyun Kim; Woon Geon Shin; Sun Moon Kim; Sok Won Han; Jun Haeng Lee; Kyung Ho Kim; Sue K Park; Byung-Joo Park; Joongyub Lee; Jae G Kim Journal: J Korean Med Sci Date: 2016-05-16 Impact factor: 2.153
Authors: Saman Alhooei; Hafez Tirgar Fakheri; Vahid Hosseini; Iradj Maleki; Tarang Taghvaei; Seyed Mohammad Valizadeh; Zohreh Bari Journal: Middle East J Dig Dis Date: 2016-07