Pretreatment Antimicrobial Susceptibility-Guided Vs. Clarithromycin-Based Triple Therapy for Helicobacter pylori Eradication in a Region With High Rates of Multiple Drug Resistance

2014 ◽  
Vol 109 (10) ◽  
pp. 1595-1602 ◽  
Author(s):  
Chung-Su Park ◽  
Su-Mi Lee ◽  
Chang-Hwan Park ◽  
Han-Ra Koh ◽  
Chung-Hwan Jun ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Antimicrobial Susceptibility ◽  
Multiple Drug Resistance ◽  
Multiple Drug ◽  
Helicobacter Pylori Eradication

scholarly journals Klebsiella Pneumoniae in Septicemic Neonates with Special Reference to Extended Spectrum β-lactamase, AmpC, Metallo β-lactamase Production and Multiple Drug Resistance in Tertiary Care Hospital

2015 ◽  
Vol 7 (01) ◽  
pp. 032-037 ◽  
Author(s):  
Shivali V Gajul ◽  
Shivajirao T Mohite ◽  
Smita S Mangalgi ◽  
Sanjay M Wavare ◽  
Satish V Kakade
Keyword(s):  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Multiple Drug Resistance ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Neonatal Septicemia ◽  
Extended Spectrum ◽  
Disk Method

ABSTRACT Background: β-lactamases viz., extended spectrum β-lactamase (ESBL), AmpC, and metallo β-lactamase (MBL) production in Klebsiella pneumoniae has led to a serious concern about septicemic neonates in Neonatal Intensive Care Units due to high resistance against commonly used antimicrobials Purpose:To study the prevalence of ESBL, AmpC, and MBL production in K. pneumoniae isolates in neonatal septicemia, to check antimicrobial susceptibility to various drugs including tigecycline; and to assess burden of multiple drug resistance (MDR). Materials and Methods: Total 24 clinical isolates of K. pneumoniae isolated from 318 blood samples of suspected cases of neonatal septicemia were studied. Isolates were screened for ESBL, AmpC, and MBL production by Clinical and Laboratory Standards Institute (CLSI) disk method, AmpC cefoxitin screen, and imipenem, meropenem, ceftazidime disk screen respectively; and confirmation was done by CLSI phenotypic disk confirmatory test, AmpC sterile disk method, and imipenem ethylenediamine tetracetic acid double disk synergy test respectively. Antimicrobial susceptibility was determined by Kirby-Bauer's disk diffusion method. Efficacy of tigecycline was evaluated using United States Food and Drug Administration guidelines. Results: Of the 24 K. pneumoniae isolates, co-production of AmpC + MBL was found in more number of isolates (67%) (P < 0.0001) compared to single enzyme production (ESBL and MBL 8% both, AmpC 12.5%). Rate of resistance for penicillins and cephalosporins was highest. Susceptibility was more for imipenem, co-trimoxazole, and meropenem. Nonsusceptibility to tigecycline was low (21%). A total of 23 (96%) isolates were MDR. Conclusions: Routine detection of ESBL, AmpC, and MBL is required in laboratories. Carbapenems should be kept as a last resort drugs. Trend of tigecycline susceptibility has been noted in the study. Continued monitoring of susceptibility pattern is necessary to detect true burden of resistance for proper management.

scholarly journals Plasmid Analysis and Curing of Multidrug Resistant of Helicobacter pylori Isolated from Ulcer Patients in Ondo State, Nigeria

2019 ◽  
pp. 1-8
Author(s):  
A. K. Onifade ◽  
M. A. Bakare
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Multiple Drug Resistance ◽  
Multidrug Resistant ◽  
Plasmid Profile ◽  
Multiple Drug ◽  
In Vitro Susceptibility ◽  
Ondo State ◽  
H Pylori

Plasmid profile of multidrug resistant Helicobacter pylori isolated from ulcer patients in Ondo State, Nigeria was investigated. It was observed that the H. pylori isolated from ulcer patients in the course of the research were resistance to certain antibiotics. Consequently on the emergence of multiple drug resistance exhibited by the H. pylori, a total of 9 different antibiotics were tested against the H. pylori isolated from various locations to determine their in-vitro susceptibility pattern. The findings of the in-vitro antibiotics susceptibility testing are quite astonishing due to a high incidence of multiple drug resistance. Majority of the H. pylori showed high level of resistance against some specific number of antibiotics.  The multidrug resistance observed in this study seems to be plasmid mediated. Moreover frequent use of over-the-counter antibiotics and abuse of non steroidal anti inflammatory drugs (NSAIDs) administration and abuse of drugs of sub – standard chemical quality has been identified as a major problem. The results from this investigative study have shown that resistance in H. pylori was plasmid based.

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