Bilge Müge Gökçekuyu1, Özlem Yılmaz2, Müjde Soytürk3, Hülya Ellidokuz4, Hale Akpınar3, İlkay Şimşek3. 1. Division of Geriatrics, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey;Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey. 2. Deparment of Medical Microbiology, Dokuz Eylül University School of Medicine, İzmir, Turkey. 3. Division of Gastroenterology, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey. 4. Institute of Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Abstract
BACKGROUND: It is known that clarithromycin resistance has increased over the years (success rate 60%). The aim of the study was to investigate the importance of regional antimicrobial resistance rates for full accuracy of both diagnosis and treatment of Helicobacter pylori infection. METHODS: This study was carried out in the University Hospital Department of Gastroenterology. A total of 116 patients were evaluated with upper gastrointestinal endoscopy. Gastric antrum and corpus biopsy samples were taken for the rapid urease test (RUT), culture, and antimicrobial susceptibility testing for the presence of H. pylori. Antimicrobial susceptibilities of isolated H. pylori strains for clarithromycin and levofloxacin were determined by the epsilometer test (E-test). Minimal inhibitory concentration values for clarithromycin and levofloxacin were ≥1 and >1 μg/mL, respectively. RESULTS: H. pylori infection was considered clinically positive in 93 (80.2%) patients with either the RUT, culture, or histopathological examination. Seventy (60.3%) of the patients had RUT positivity. Sixty (85.7%) of these 70 patients had RUT positivity within the first 20 min. Among the 90 patients, who had a histopathological examination, HLO was positive in 76 (84.4%) patients. Fifty-two (44.8%) out of 116 patients were culture positive. Resistance rates for both clarithromycin and levofloxacin were high. In these 52 culture-positive patients, resistance rates determined for clarithromycin and levofloxacin were 26.9% and 25.5%, respectively. CONCLUSION: Clarithromycin or levofloxacin-based treatment regimen may not be an ideal alternative therapy for Turkish patients regardless of culture.
BACKGROUND: It is known that clarithromycin resistance has increased over the years (success rate 60%). The aim of the study was to investigate the importance of regional antimicrobial resistance rates for full accuracy of both diagnosis and treatment of Helicobacter pylori infection. METHODS: This study was carried out in the University Hospital Department of Gastroenterology. A total of 116 patients were evaluated with upper gastrointestinal endoscopy. Gastric antrum and corpus biopsy samples were taken for the rapid urease test (RUT), culture, and antimicrobial susceptibility testing for the presence of H. pylori. Antimicrobial susceptibilities of isolated H. pylori strains for clarithromycin and levofloxacin were determined by the epsilometer test (E-test). Minimal inhibitory concentration values for clarithromycin and levofloxacin were ≥1 and >1 μg/mL, respectively. RESULTS: H. pylori infection was considered clinically positive in 93 (80.2%) patients with either the RUT, culture, or histopathological examination. Seventy (60.3%) of the patients had RUT positivity. Sixty (85.7%) of these 70 patients had RUT positivity within the first 20 min. Among the 90 patients, who had a histopathological examination, HLO was positive in 76 (84.4%) patients. Fifty-two (44.8%) out of 116 patients were culture positive. Resistance rates for both clarithromycin and levofloxacin were high. In these 52 culture-positive patients, resistance rates determined for clarithromycin and levofloxacin were 26.9% and 25.5%, respectively. CONCLUSION: Clarithromycin or levofloxacin-based treatment regimen may not be an ideal alternative therapy for Turkish patients regardless of culture.
Authors: Adrian Gerald McNicholl; Julio Ducons; Jesús Barrio; Luis Bujanda; Montserrat Forné-Bardera; Reyes Aparcero; Julio Ponce; Robin Rivera; José María Dedeu-Cuso; Pilar Garcia-Iglesias; Miguel Montoro; Alicia Bejerano; Yolanda Ber-Nieto; Belen Madrigal; Eva Zapata; Carmen Loras-Alastruey; Manuel Castro; Andrea Nevarez; Isabel Mendez; Felipe Bory-Ros; Mireia Miquel-Planas; Isabel Vera; Olga P Nyssen; Javier P Gisbert Journal: Gastroenterol Hepatol Date: 2017-09-21 Impact factor: 2.102
Authors: Murat Erkut; Doğan Yusuf Uzun; Neşe Kaklıkkaya; Sami Fidan; Yaşar Yoğun; Arif Mansur Coşar; Esma Akyıldız; Murat Topbaş; Orhan Özgür; Mehmet Arslan Journal: Turk J Gastroenterol Date: 2020-03 Impact factor: 1.852