Helicobacter pylori resistance to metronidazole and clarithromycin in Ireland.
AffiliationDeparment of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Dublin, Ireland., firstname.lastname@example.org
Anti-Bacterial Agents/*therapeutic use
*Drug Resistance, Bacterial
Helicobacter Infections/*drug therapy/epidemiology/pathology
Helicobacter pylori/*drug effects
MetadataShow full item record
CitationEur J Gastroenterol Hepatol. 2010 Sep;22(9):1123-7.
JournalEuropean journal of gastroenterology & hepatology
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.
- Incidence of secondary Helicobacter pylori resistance to antibiotics in treatment failures after 1-week proton pump inhibitor-based triple therapies: a prospective study.
- Authors: Pilotto A, Franceschi M, Rassu M, Leandro G, Bozzola L, Furlan F, Di Mario F
- Issue date: 2000 Nov
- Resistance to metronidazole, clarithromycin and levofloxacin of Helicobacter pylori before and after clarithromycin-based therapy in Taiwan.
- Authors: Chang WL, Sheu BS, Cheng HC, Yang YJ, Yang HB, Wu JJ
- Issue date: 2009 Jul
- The relationship between consumption of antimicrobial agents and the prevalence of primary Helicobacter pylori resistance.
- Authors: Perez Aldana L, Kato M, Nakagawa S, Kawarasaki M, Nagasako T, Mizushima T, Oda H, Kodaira J, Shimizu Y, Komatsu Y, Zheng R, Takeda H, Sugiyama T, Asaka M
- Issue date: 2002 Oct
- Failure of first-line eradication treatment significantly increases prevalence of antimicrobial-resistant Helicobacter pylori clinical isolates.
- Authors: Romano M, Iovene MR, Russo MI, Rocco A, Salerno R, Cozzolino D, Pilloni AP, Tufano MA, Vaira D, Nardone G
- Issue date: 2008 Oct
- The importance of the level of metronidazole resistance for the success of Helicobacter pylori eradication.
- Authors: Wheeldon TU, Granström M, Hoang TT, Phuncarg DC, Nilsson LE, Sörberg M
- Issue date: 2004 Jun 15