Helicobacter pylori resistance to metronidazole and clarithromycin in Ireland.

Hdl Handle:
http://hdl.handle.net/10147/207855
Title:
Helicobacter pylori resistance to metronidazole and clarithromycin in Ireland.
Authors:
O'connor, Anthony; Taneike, Ikue; Nami, Abdurrazag; Fitzgerald, Niamh; Murphy, Philip; Ryan, Barbara; O'connor, Humphrey; Qasim, Asghar; Breslin, Niall; O'morain, Colm
Affiliation:
Deparment of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Dublin, Ireland., jpanthonyoconnor@hotmail.com
Citation:
Eur J Gastroenterol Hepatol. 2010 Sep;22(9):1123-7.
Journal:
European journal of gastroenterology & hepatology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207855
DOI:
10.1097/MEG.0b013e328338e43d
PubMed ID:
20354442
Abstract:
INTRODUCTION: Helicobacter pylori eradication rates have fallen considerably in recent years. Antibiotic resistance is thought to be rising. OBJECTIVES: To examine the levels of resistance to metronidazole (MTZ) and clarithromycin (CLA) in H. pylori, isolates were taken in a reference centre in Ireland from 2007 to 2008 and were compared to a similar cohort from a study in 1997. METHOD: Antimicrobial susceptibilities were tested by E-test. Frequencies of spontaneous metronidazole and clarithromycin resistance were measured on an agar plate containing the antibiotics at concentrations of 2x and 4x minimum inhibition concentration values. Clinical data were obtained from charts, laboratory and endoscopy reports. RESULTS: Two hundred and twenty-two patients were analyzed, 98 were females. Colonies amenable to culture were grown in 219 patients. Thirty-seven had prior attempts at eradication therapy (all with amoxicillin-CLA-proton pump inhibitor. A total of 31.5% of the patients had strains resistant to MTZ and 13.2% of the patients were noted to have strains resistant to CLA. About 8.6% of the patients had strains resistant to both the agents. CLA resistance was 9.3% in those who had no prior eradication therapy compared with 32.4% of those who had. CLA resistance increased from 3.9%, among treatment-naive patients in 1997, to 9.3% in our study. MTZ resistance was 29.1% in the treatment-naive population. In 1997, MTZ resistance in the treatment-naive cohort was 27.1%. MTZ resistance was more likely to occur in females (35.4 vs. 28.5%) than in males. CONCLUSION: This study shows that resistance to CLA among Irish patients infected with H. pylori has increased since 1997. The future of treatment may well lie in the widespread use of sensitivity testing before the treatment. This would promote an accurate treatment.
Language:
eng
MeSH:
Adult; Anti-Bacterial Agents/*therapeutic use; Biopsy; Clarithromycin/*therapeutic use; *Drug Resistance, Bacterial; Female; Gastritis/drug therapy/epidemiology/pathology; Helicobacter Infections/*drug therapy/epidemiology/pathology; Helicobacter pylori/*drug effects; Humans; Ireland/epidemiology; Male; Metronidazole/*therapeutic use; Middle Aged; Prevalence
ISSN:
1473-5687 (Electronic); 0954-691X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'connor, Anthonyen_GB
dc.contributor.authorTaneike, Ikueen_GB
dc.contributor.authorNami, Abdurrazagen_GB
dc.contributor.authorFitzgerald, Niamhen_GB
dc.contributor.authorMurphy, Philipen_GB
dc.contributor.authorRyan, Barbaraen_GB
dc.contributor.authorO'connor, Humphreyen_GB
dc.contributor.authorQasim, Asgharen_GB
dc.contributor.authorBreslin, Niallen_GB
dc.contributor.authorO'morain, Colmen_GB
dc.date.accessioned2012-02-01T10:48:10Z-
dc.date.available2012-02-01T10:48:10Z-
dc.date.issued2012-02-01T10:48:10Z-
dc.identifier.citationEur J Gastroenterol Hepatol. 2010 Sep;22(9):1123-7.en_GB
dc.identifier.issn1473-5687 (Electronic)en_GB
dc.identifier.issn0954-691X (Linking)en_GB
dc.identifier.pmid20354442en_GB
dc.identifier.doi10.1097/MEG.0b013e328338e43den_GB
dc.identifier.urihttp://hdl.handle.net/10147/207855-
dc.description.abstractINTRODUCTION: Helicobacter pylori eradication rates have fallen considerably in recent years. Antibiotic resistance is thought to be rising. OBJECTIVES: To examine the levels of resistance to metronidazole (MTZ) and clarithromycin (CLA) in H. pylori, isolates were taken in a reference centre in Ireland from 2007 to 2008 and were compared to a similar cohort from a study in 1997. METHOD: Antimicrobial susceptibilities were tested by E-test. Frequencies of spontaneous metronidazole and clarithromycin resistance were measured on an agar plate containing the antibiotics at concentrations of 2x and 4x minimum inhibition concentration values. Clinical data were obtained from charts, laboratory and endoscopy reports. RESULTS: Two hundred and twenty-two patients were analyzed, 98 were females. Colonies amenable to culture were grown in 219 patients. Thirty-seven had prior attempts at eradication therapy (all with amoxicillin-CLA-proton pump inhibitor. A total of 31.5% of the patients had strains resistant to MTZ and 13.2% of the patients were noted to have strains resistant to CLA. About 8.6% of the patients had strains resistant to both the agents. CLA resistance was 9.3% in those who had no prior eradication therapy compared with 32.4% of those who had. CLA resistance increased from 3.9%, among treatment-naive patients in 1997, to 9.3% in our study. MTZ resistance was 29.1% in the treatment-naive population. In 1997, MTZ resistance in the treatment-naive cohort was 27.1%. MTZ resistance was more likely to occur in females (35.4 vs. 28.5%) than in males. CONCLUSION: This study shows that resistance to CLA among Irish patients infected with H. pylori has increased since 1997. The future of treatment may well lie in the widespread use of sensitivity testing before the treatment. This would promote an accurate treatment.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnti-Bacterial Agents/*therapeutic useen_GB
dc.subject.meshBiopsyen_GB
dc.subject.meshClarithromycin/*therapeutic useen_GB
dc.subject.mesh*Drug Resistance, Bacterialen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGastritis/drug therapy/epidemiology/pathologyen_GB
dc.subject.meshHelicobacter Infections/*drug therapy/epidemiology/pathologyen_GB
dc.subject.meshHelicobacter pylori/*drug effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMetronidazole/*therapeutic useen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPrevalenceen_GB
dc.titleHelicobacter pylori resistance to metronidazole and clarithromycin in Ireland.en_GB
dc.contributor.departmentDeparment of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Dublin, Ireland., jpanthonyoconnor@hotmail.comen_GB
dc.identifier.journalEuropean journal of gastroenterology & hepatologyen_GB
dc.description.provinceLeinster-

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