Jeong Hoon Lee1, Ji Yong Ahn1, Kee Don Choi1, Hwoon-Yong Jung1, Jung Mogg Kim2, Gwang Ho Baik3, Byung-Wook Kim4, Jun Chul Park5, Hye-Kyung Jung6, Soo Jeong Cho7, Cheol Min Shin8, Yoon Jin Choi8, Si Hyung Lee9, Ji Hyun Kim10, Wan Sik Lee11, Jae Kyu Sung12, Jun-Won Chung13, Dae Young Cheung14, Hyuk Lee15, Yang Won Min15, Jae J Kim15, Seung Young Kim16. 1. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 2. Department of Microbiology, Hanyang University College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. 4. Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea. 5. Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 6. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. 7. Center for Gastric Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. 8. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 9. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. 10. Department of Internal Medicine, Inje University College of Medicine, Busan, Korea. 11. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. 12. Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea. 13. Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea. 14. Department of Internal Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 15. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 16. Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Abstract
INTRODUCTION: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. MATERIALS AND METHODS: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at -80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. RESULTS: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. CONCLUSION: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.
INTRODUCTION: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. MATERIALS AND METHODS: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at -80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. RESULTS: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. CONCLUSION: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.
Authors: Chang Seok Bang; Hyun Lim; Hae Min Jeong; Woon Geon Shin; Jae Ho Choi; Jae Seung Soh; Ho Suk Kang; Young Joo Yang; Ji Taek Hong; Suk Pyo Shin; Ki Tae Suk; Jae Jun Lee; Gwang Ho Baik; Dong Joon Kim Journal: Gut Microbes Date: 2020-05-02
Authors: Young-Il Kim; Jong Yeul Lee; Chan Gyoo Kim; Boram Park; Jin Young Park; Il Ju Choi Journal: BMC Gastroenterol Date: 2021-03-02 Impact factor: 3.067
Authors: Beom Jin Kim; Hyuk Lee; Yong Chan Lee; Seong Woo Jeon; Gwang Ha Kim; Hyun-Soo Kim; Jae Kyu Sung; Dong Ho Lee; Heung Up Kim; Moo In Park; Il Ju Choi; Soon Man Yoon; Sang Wook Kim; Gwang Ho Baik; Ju Yup Lee; Jin Il Kim; Sang Gyun Kim; Jayoun Kim; Joongyup Lee; Jae Gyu Kim; Jae J Kim Journal: Gut Liver Date: 2019-09-15 Impact factor: 4.519