Helicobacter pylori are flagellated, spiral Gram-negative bacteria that persistently colonize the human stomach of approximately more than 50% of the population worldwide, 1,2 and up to 90% in Africa. 3 H. pylori is linked with a wide variety of diseases, such as gastro-duodenal diseases varying from chronic gastritis, gastric ulcers up to mucosa associated lymphoid tissue (MALT) lymphoma, and gastric cancer. H. pylori was the first bacteria proven to cause cancerous transformations and is currently classified as a group I carcinogen by the International Agency for Research on Cancer. 4
The successful treatment rate of Helicobacter pylori is facing many challenges, mainly due to antimicrobial resistance as a result of antibiotics abuse. To assesse the burden of resistance-associated treatment failure, the efficacy of culture-based antimicrobial susceptibility was tested for all antimicrobial used as treatment guidelines for eradication of Helicobacter pylori infection. Methods: In this study, incidence of Helicobacter pylori infection in Minia University hospital was determined by testing a random sample of 40 patients undergoing upper gastrointestinal endoscopy for Helicobacter pylori infection. Then, the agar dilution method was used to determine the minimal inhibitory concentration of 6 alternative antibiotics, patterns of antimicrobial resistance and efficacy of commercial antibiotics in treatment of Helicobacter pylori infection. Results: Prevalence of Helicobacter pylori infection was 47.5% among our patients. Antibiotic resistance rates were alarmingly high, up to 100% in amoxicillin, rifampicin, and levofloxacin, 94.7% in tetracycline and clarithromycin, and 89.4% in metronidazole. Discussion: This Study showed unprecedented antimicrobial resistance rates of Helicobacter pylori. New alternative treatment regimens should be considered and investigated to replace the current ineffective therapies.
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