scholarly journals Analysis of Helicobacter pylori’s Antibiotic Resistance Rate and Research on Its Eradication Treatment Plan

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Li Jiao ◽  
Junmin Wang ◽  
Huan Ma
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Treatment Plan ◽  
Drug Susceptibility ◽  
Resistance Rate ◽  
Clinical Isolates ◽  
Treatment Plans ◽  
H Pylori ◽  
The Right

How to choose the right plan is the key to treatment, and this must take into account the local eradication of Helicobacter pylori and the drug resistance of Helicobacter pylori. In order to better eradicate Helicobacter pylori, in the current clinical treatment process, most of the combined treatments of triple drugs are used, but the therapeutic effect is still not ideal. In addition, many studies have focused on changing the types and dosages of drugs, but they have not yet achieved good results. This paper combines experimental research to analyze the drug resistance rate of Helicobacter pylori and obtains gastric mucosal specimens of patients through gastroscopy to cultivate clinical isolates of H. pylori.. Furthermore, this study used the Kirby-Bauer drug susceptibility disc technique to determine the sensitivity of H. pylori clinical isolates to a range of regularly used clinical antibiotics, as well as a set of instances of H. pylori antibiotic resistance. Finally, this research integrates experimental analyses and various successful eradication treatment plans to provide a unique eradication treatment strategy.

scholarly journals Antibiotic Resistance Prevalence and Trends in Patients Infected with Helicobacter pylori in the Period 2013–2020: Results of the European Registry on H. pylori Management (Hp-EuReg)

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1058
Author(s):  
Luis Bujanda ◽  
Olga P. Nyssen ◽  
Dino Vaira ◽  
Ilaria M. Saracino ◽  
Giulia Fiorini ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Resistance Rate ◽  
Antimicrobial Susceptibility Testing ◽  
Metronidazole Resistance ◽  
Infected Adult ◽  
H Pylori ◽  
European Registry

Background: Bacterial antibiotic resistance changes over time depending on multiple factors; therefore, it is essential to monitor the susceptibility trends to reduce the resistance impact on the effectiveness of various treatments. Objective: To conduct a time-trend analysis of Helicobacter pylori resistance to antibiotics in Europe. Methods: The international prospective European Registry on Helicobacter pylori Management (Hp-EuReg) collected data on all infected adult patients diagnosed with culture and antimicrobial susceptibility testing positive results that were registered at AEG-REDCap e-CRF until December 2020. Results: Overall, 41,562 patients were included in the Hp-EuReg. Culture and antimicrobial susceptibility testing were performed on gastric biopsies of 3974 (9.5%) patients, of whom 2852 (7%) were naive cases included for analysis. The number of positive cultures decreased by 35% from the period 2013–2016 to 2017–2020. Concerning naïve patients, no antibiotic resistance was found in 48% of the cases. The most frequent resistances were reported against metronidazole (30%), clarithromycin (25%), and levofloxacin (20%), whereas resistances to tetracycline and amoxicillin were below 1%. Dual and triple resistances were found in 13% and 6% of the cases, respectively. A decrease (p < 0.001) in the metronidazole resistance rate was observed between the 2013–2016 (33%) and 2017–2020 (24%) periods. Conclusion: Culture and antimicrobial susceptibility testing for Helicobacter pylori are scarcely performed (<10%) in Europe. In naïve patients, Helicobacter pylori resistance to clarithromycin remained above 15% throughout the period 2013–2020 and resistance to levofloxacin, as well as dual or triple resistances, were high. A progressive decrease in metronidazole resistance was observed.

scholarly journals Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

Toxins ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 473 ◽  
Author(s):  
Kartika Afrida Fauzia ◽  
Muhammad Miftahussurur ◽  
Ari Fahrial Syam ◽  
Langgeng Agung Waskito ◽  
Dalla Doohan ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Crystal Violet ◽  
Antibiotic Susceptibility ◽  
Biofilm Formation ◽  
Clinical Isolates ◽  
Resistance Phenotype ◽  
Resistance To Antibiotics ◽  
Inhibition Concentration ◽  
H Pylori

We evaluated biofilm formation of clinical Helicobacter pylori isolates from Indonesia and its relation to antibiotic resistance. We determined the minimum inhibition concentration (MIC) of amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline by the Etest to measure the planktonic susceptibility of 101 H. pylori strains. Biofilms were quantified by the crystal violet method. The minimum biofilm eradication concentration (MBEC) was obtained by measuring the survival of bacteria in a biofilm after exposure to antibiotics. The majority of the strains formed a biofilm (93.1% (94/101)), including weak (75.5%) and strong (24.5%) biofilm-formers. Planktonic resistant and sensitive strains produced relatively equal amounts of biofilms. The resistance proportion, shown by the MBEC measurement, was higher in the strong biofilm group for all antibiotics compared to the weak biofilm group, especially for clarithromycin (p = 0.002). Several cases showed sensitivity by the MIC measurement, but resistance according to the MBEC measurements (amoxicillin, 47.6%; tetracycline, 57.1%; clarithromycin, 19.0%; levofloxacin, 38.1%; and metronidazole 38.1%). Thus, biofilm formation may increase the survival of H. pylori and its resistance to antibiotics. Biofilm-related antibiotic resistance should be evaluated with antibiotic susceptibility.

scholarly journals Antibiotic Resistance of Helicobacter Pylori and Influencing Factors in Yangzhou, China: a Cross-sectional Study

2021 ◽  
Author(s):  
Yun Zhang ◽  
Xinyi Feng ◽  
Lijun Bian ◽  
Yan Zhang ◽  
Qian Li ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Resistance Rate ◽  
Resistance Pattern ◽  
Cross Sectional ◽  
Chip Technology ◽  
Resistance Patterns ◽  
H Pylori

Abstract Background: The Helicobacter pylori (H. pylori) antibiotic resistance pattern differs geographically, knowledge of local antimicrobial resistance pattern is key to successful eradication. The current study was performed to investigate the resistance of H. pylori to 5 commonly used antibiotics in Yangzhou.Methods: A total of 461 H. pylori strains were collected from April 2018 to September 2019 in Yangzhou and tested for their susceptibility to clarithromycin, levofloxacin, metronidazole, amoxicillin, tetracycline using gene chip technology.Results: The resistance rates of H. pylori to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline were 41.0%, 44.9%, 38.8%, 6.3% and 1.1%. In addition, sixteen multiple resistance patterns were detected, and fortunately there were no strains resistant to all five antibiotics. The vacA s1 allele was detected in each strain, 64.0% of the isolates were s1/m2 genotype, 36.0% s1/m1 genotype. In multivariate analysis, history of chronic superficial gastritis was significantly associated with clarithromycin resistance, strains isolated from subjects with gastrointestinal symptoms had a significantly higher likelihood of metronidazole resistance, and antibiotic resistance of H. pylori was independent of both sex and age.Conclusion: The resistance rate of H. pylori to clarithromycin, levofloxacin and metronidazole were very high in Yangzhou, the results will help in selecting effective eradication regimens.

Surveillance of the Antimicrobial Resistance Rates of Helicobacter pylori Ten Years Later in the Western Central Region, Colombia

2019 ◽  
Vol 38 (3) ◽  
pp. 196-203
Author(s):  
Ingrid Johanna Bedoya-Gómez ◽  
Adalucy Alvarez-Aldana ◽  
José Ignacio Moncayo-Ortiz ◽  
Yina Marcela Guaca-González ◽  
Jorge Javier Santacruz-Ibarra ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Antimicrobial Drug ◽  
Test Method ◽  
Clinical Isolates ◽  
Moderate Increase ◽  
Antimicrobial Drugs ◽  
Antimicrobial Drug Resistance ◽  
H Pylori ◽  
Resistance Rates

Background: Helicobacter pylori is a bacterium associated with gastroduodenal disease and gastric cancer. Empirical therapy in the treatment of H. pylori infection increases the risk of apparition of antimicrobial drug resistance. In a previous report, in H. pylori clinical isolates, resistance rates to commonly used antimicrobial drugs were as follows: metronidazole 82%, clarithromycin 3.8%, and amoxicillin 1.9%. The aim was to establish the variation of resistance rates and the detection of H. pylori genetic mutations isolated from dyspeptic patients. Methods: Antimicrobial susceptibility profiles were performed by the E-test method for metronidazole, clarithromycin, amoxicillin, and tetracycline in 61 clinical isolates. Sequencing was performed to detect mutations associated with resistance to clarithromycin. Results: According to our results, resistance rates found in the 61 isolates were 78.60% for metronidazole and 8.20% for clarithromycin. None of the studied isolates had resistance to tetracycline and amoxicillin. Secondary resistance rates displayed an increase when compared to primary rates for metronidazole (87.50 vs. 77.35%) and for clarithromycin (25.66 vs. 5.66%). Of 5 isolates resistant to clarithromycin, 3 had the A2143G mutation. By comparing the results in this work with previous reports, antimicrobial drug resistance rates did not show major modifications for metronidazole, amoxicillin, and tetracycline during the last 10 years. For clarithromycin, the resistance rate showed a moderate increase; nevertheless, it remains low (<15%) and this change was not statistically significant. Conclusion: Together, all findings in this work indicate that these antimicrobial drugs can still be used as first line of defense on infected patients living in this region of the country.

scholarly journals Trend of changes in antibiotic resistance in Helicobacter pylori from 2013 to 2019: a multicentre report from Taiwan

2020 ◽  
Vol 13 ◽  
pp. 175628482097699
Author(s):  
Chih-Ming Liang ◽  
Wei-Chen Tai ◽  
Pin-I Hsu ◽  
Deng-Chyang Wu ◽  
Chao-Hung Kuo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Linear Trend ◽  
Eradication Therapy ◽  
Resistance Rate ◽  
Test Method ◽  
Success Rates ◽  
Primary Resistance ◽  
Secondary Resistance ◽  
H Pylori

Background: Antibiotic resistance plays a crucial role in the treatment failure of Helicobacter pylori (H. pylori) infection. This study aimed to determine the trend of changes in the primary, secondary and tertiary antibiotic resistance of H. pylori in Taiwan over the last 7 years. Methods: We retrospectively analysed H. pylori-infected isolates from patients with primary resistance ( n = 1369), secondary resistance ( n = 196) and tertiary resistance ( n = 184) from January 2013 to December 2019. The H. pylori strains were tested for susceptibility to amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline using the Epsilometer test method. Results: A progressively higher primary resistance rate was observed for clarithromycin (11.8–20.4%, p = 0.039 in χ2 test for linear trend), levofloxacin (17.3–38.8%, p < 0.001) and metronidazole (25.6–42.3%, p < 0.001) among naïve patients who received first-line eradication therapy. The dual primary resistance to clarithromycin and metronidazole also progressively increased in a linear trend (2.4–10.4%, p = 0.009). For secondary resistance, an increase was observed for levofloxacin (30.5–64.7%, p = 0.006) and metronidazole (40.5–77.4%, p < 0.001). For tertiary resistance, the observed increase was even more significant for levofloxacin (65.9–100.0%, p = 0.106) and metronidazole (44.4–88.2%, p < 0.001). The resistance to amoxicillin and tetracycline remained very low in Taiwan regardless of primary, secondary and tertiary resistance. Conclusion: Primary, secondary and tertiary antibiotic resistance to clarithromycin, levofloxacin and metronidazole for H. pylori has been increasing in Taiwan since 2013. Treatment should be targeted for eradication success rates of more than 90%. Third-line treatment should be based on antibiotic susceptibility.

scholarly journals Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 436 ◽  
Author(s):  
Su Young Kim ◽  
Jun-Won Chung
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Resistance Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
First Line Therapy ◽  
Standard Triple Therapy ◽  
Eradication Strategy ◽  
Helicobacter Pylori Treatment ◽  
H Pylori

Antibiotic resistance is the major reason for Helicobacter pylori treatment failure, and the increasing frequency of antibiotic resistance is a challenge for clinicians. Resistance to clarithromycin and metronidazole is a particular problem. The standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) is no longer appropriate as the first-line treatment in most areas. Recent guidelines for the treatment of H. pylori infection recommend a quadruple regimen (bismuth or non-bismuth) as the first-line therapy. This treatment strategy is effective for areas with high resistance to clarithromycin or metronidazole, but the resistance rate inevitably increases as a result of prolonged therapy with multiple antibiotics. Novel potassium-competitive acid blocker-based therapy may be effective, but the data are limited. Tailored therapy based on antimicrobial susceptibility test results is ideal. This review discussed the current important regimens for H. pylori treatment and the optimum H. pylori eradication strategy.

scholarly journals Helicobacter pylori Eradication Therapy - Recent Trend in Research

2020 ◽  
Vol 20 (3) ◽  
pp. 210-217
Author(s):  
Heung Up Kim
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Gastric Mucosa ◽  
Drug Exposure ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Resistance Rate ◽  
H Pylori ◽  
Selection Of

It is well known that <i>Helicobacter pylori (H. pylori)</i> can cause peptic ulcer, mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, intestinal metaplasia, and ultimately, gastric cancer. Various studies have proven that <i>H. pylori</i>, which attaches to the gastric mucosa, is the cause of gastric cancer and can be eradicated using appropriate antibiotics. Since 2013, Japan has been carrying out national-led eradication treatment of <i>H. pylori</i> for the whole population. However, as drug exposure increases, the resistance rate to some antibiotics increases, and the pattern of antibiotic resistance varies from region to region. Therefore, the development of individualized antimicrobial therapies has become important since antibiotic resistance to <i>H. pylori</i> eradication is a problem worldwide. To help overcome this, remedies such as selection of antibiotics through susceptibility testing, selection of empirical treatment combinations appropriate for the region, dual therapy with high doses of amoxicillin, and the use of rifabutin or sitafloxacin with low antibiotic resistance have been studied. Potassium-competitive acid blocker has been reported to be more potent in inhibiting acid secretion than proton pump inhibitor, and its role in <i>H. pylori</i> eradication is expected. Drug formulations and regimens that are easy to take are being developed to increase compliance. New treatments such as spraying antibiotics directly to the gastric mucosa are being developed and studied.

scholarly journals Phenotypic and Genotypic Antibiotic Resistance Patterns in Helicobacter pylori Strains From Ethnically Diverse Population in México

2021 ◽  
Vol 10 ◽  
Author(s):  
Margarita Camorlinga-Ponce ◽  
Alejandro Gómez-Delgado ◽  
Emmanuel Aguilar-Zamora ◽  
Roberto C. Torres ◽  
Silvia Giono-Cerezo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Indigenous Communities ◽  
Drug Susceptibility ◽  
23S Rrna ◽  
Whole Genome ◽  
Phenotypic Resistance ◽  
H Pylori

Helicobacter pylori strains carry a range of mutations in genes that confer antimicrobial resistance and restrict the available options to treat the infection. Latin America is a region that conserve a large number of indigenous communities relatively isolated that practice a traditional medicine without consumption of drugs. We hypothesized that rates of antibiotic resistance are lower in these communities. Recent progress in whole-genome sequencing has allowed the study of drug susceptibility by searching for the known mutations associated with antibiotic resistance. The aim of this work was to study trends of antibiotic resistance over a 20-year period in Mexican H. pylori strains and to compare susceptibility between strains from Mexican mestizos and from indigenous population; we also aimed to learn the prevalence of mutational patterns in genes gyrA, gyrB, rdxA, frxA, rpsU, omp11, dppA, and 23S rRNA and its association with phenotypic tests. Resistance to clarithromycin, metronidazole, amoxicillin and levofloxacin was determined in167 H. pylori isolates by E-test, and the occurrence of mutational patterns in specific genes was determined by whole genome sequencing (WGS). The trend of resistance over 20 years in mestizo isolates showed significant resistant increase for clarithromycin and levofloxacin to frequencies that banned its clinical use. Resistance in H. pylori isolates of native communities was lower for all antibiotics tested. Phenotypic resistance showed good to moderate correlation with genotypic tests. Genetic methods for characterizing antibiotic resistance require further validation in each population.

scholarly journals Analysis of the primary and post-treatment antibiotic resistance of Helicobacter pylori in Nanjing area

2020 ◽  
Author(s):  
jiang zongdan ◽  
Bang-Shun He ◽  
Zhen-Yu Zhang ◽  
Shu-Kui Wang ◽  
Dan Ran ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Resistance Rate ◽  
Post Treatment ◽  
Current Status ◽  
Antibiotics Resistance ◽  
Rapid Urease Test ◽  
Urease Test ◽  
H Pylori ◽  
Resistance Rates

Abstract Background To investigate the current status and trend of Helicobacter pylori(H. pylori)antibiotics resistance over 5 years in Nanjing area.Then we evaluated the primary and post-treatment antibiotic resistance of H. pylori in Nanjing area. Methods During the period from July 2017 to December 2019, 1533 gastric mucosal specimens from patients with positive H. pylori confirmed by breath test or rapid urease test were collected for isolation and identify H. pylori. The agar dilution method was used for antibiotic resistance test. The antibiotic resistance of H. pylori were compared with that in the period from May 2014 to May 2015. Results The result showed that the resistance rates of H. pylori to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 2.74%, 47.03%, 33.59%, 0.91%, 0.52% and 80.76%, respectively in the period of July 2017 to December 2019. Compared with the period of May 2014 to May 2015, the resistance rate of metronidazole was the most obvious, from 60.5% to 80.76% in the period of July 2017 to December 2019, followed by clarithromycin from 29.5% to 47.03%, and levofloxacin from 14.7% to 33.59%. The resistance rates of H. pylori (primary Vs post-treatment) to amoxicillin, clarithromycin, levofloxacin, furazolidone, tetracycline and metronidazole were 1.83% Vs 6.08%, 38.62% Vs 77.81%, 27.41% Vs 56.23%, 0.58% Vs 2.13%, 0.33% Vs 1.22%, 78.57% Vs 88.75%, respectively during the period of July 2017 to December 2019. Conclusions Antibiotic resistance of H. pylori remained a problem for the effective eradication of this pathogen and its associated diseases in Nanjing area. For post-treatment eradication patients, clinicians should took into account regional antibiotic resistance rate, personal antibiotic exposure history, economic benefit ratio, adverse antibiotic reactions, antibiotic availability and other aspects.

DIFFUSION METHODS FOR CLARITHROMYCIN AND LEVOFLOXACIN SUSCEPTIBILITY TESTING OF HELICOBACTER PYLORI

2014 ◽  
pp. 63-70
Author(s):  
Trung Nam Phan ◽  
Van Huy Tran ◽  
Thi Nhu Hoa Tran ◽  
Van An Le
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Alternative Therapy ◽  
Resistance Rate ◽  
Disk Diffusion ◽  
Primary Resistance ◽  
Secondary Resistance ◽  
Central Vietnam ◽  
Resistant Strains ◽  
H Pylori

Background: The rate of antibiotic resistance in H. pylori is increasing and has become a main cause for failure of treatment. Antibiogram is very important to provide optimal regimens for eradication of H.pylori infected patients. Objective: To determine the resistance prevalence to clarithromycin, levofloxacin of H.pylori strains from patients in Central Vietnam by E-test and disk diffusion isolated, assess the relationship between two diffusion methods. Methods: 56 H.pylori strains were isolated from gastric biopsies of H.pylori infected patients from 7/2012 to 8/2013, of which 13 strains originated from patients in whom eradication of the infection failed after treatment. E-test was used to determine the minimum inhibitory concentrations of clarithromycin (CH) and levofloxacin (LE). Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results. Results: In total, the resistant strains (regardless of previous eradication history) to CH, LE were 42,9% and 44,6%, respectively. The ratio of strains with secondary resistance was significantly greater than that of the strains with primary resistance, CH: 84.6% vs. 30.2%, LE: 61.5% vs 39,5% (p < 0.05). The resistance rate to LE in female was significantly higher than in male (p < 0.05). All CH-sensitive strains by E-test had the inhibition diameters of CH was ≥ 24mm and all CH-resistant strains had the inhibition diameters was ≤ 18mm (breakpoint for MIC: 1µg/ml). To LE, the inhibition diameters was ≥ 30mm can determine all LE-sensitive strains and the inhibition diameters was ≤ 26mm can determine all LE-resistant strains by E-test (breakpoint for MIC: 1µg/ml). Conclusions: High resistance rate to CH and LE, suggests that standard CH-based triple therapie may not be useful as the first-line treatment and LE-based triple therapy should not use as an alternative therapy in Central Vietnam. The disk diffusion can use as alternative phenotypic method to determine the susceptbility of H.pylori, which is more practical and inexpensive. Keywords: Helicobacter pylori, levofloxacin, clarithromycin, E-test antibiotic resistance, disk diffusion.

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