Antibacterial Resistance Patterns of Helicobacter pylori Clinical Isolates From Gastric Biopsy of Patients in Yazd

Navidifar, Tahereh; Eslami, Gita; Akhondi, Mohsen; Baghbanian, Mahmud; Zadeh, Hossein Fallah; Zandi, Hengameh

doi:10.17795/ijep17791

Cited by 5 publications

(13 citation statements)

References 20 publications

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“…The resistance rate in our study was much higher than those reported from Europe (7% -33.9%) and lower than those from Asia (2.6% -57%) (29). Even though the rates of ciprofloxacin resistance among patients with gastritis and duodenal ulcers were 24.1% and 20%, respectively, there was no meaningful correlation between resistance rates and clinical parameters (17). Additionally, just like the present study, Llanes et al in Cuba and Shokrzadeh et al in Iran found no correlation between ciprofloxacin resistance and patients' gender (30,31).…”

Section: Discussioncontrasting

confidence: 83%

“…The extent of metronidazole resistance was detected to be 76% in the current study that was associated with more severe clinical complications; however, in other recent investigations in Iran, this rate was reported from 33% to 78.6% (9). However, in a previous study, no statistically meaningful relationship was found between metronidazole resistance and clinical findings (17). This rate was claimed to be 80% to 100% in Africa and 50% to 95% in Asia (18).…”

Section: Discussionmentioning

confidence: 90%

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Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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Background:The extent of antibiotic resistance among Helicobacter pylori strains influences current clinical therapeutic regimens in each region. Objectives: This cross-sectional study aimed to determine the resistance property and minimum inhibitory concentration (MIC50-90) of Helicobacter pylori strains toward metronidazole, clarithromycin, and ciprofloxacin in patients with distinct gastric histopathological changes in Tehran, Iran. Methods: This study was conducted on 170 patients suffering from gastric complications in three hospitals in Tehran from October 2014 until March 2015. Two separate biopsy samples were collected from each patient and used for pathological and microbiological examinations. Antimicrobial susceptibility tests were performed by agar dilution method according to the CLSI guidelines.The MIC values and susceptibility to varying concentrations of metronidazole (4 to 64 µg/mL), ciprofloxacin (0.5 to 16 µg/mL), and clarithromycin (0.25 to 16 µg/mL) were determined based on EUCAST recommendations. Results:Our results indicated the infection with H. pylori in a frequency of 32% (55/170) among the study patients (female, 51% and male, 49%). Endoscopic findings indicated that 42% of the patients suffered from peptic ulcers, 33% from duodenal ulcers, and 25% with a non-ulcer disease. Pathological findings indicated 58% of the patients had chronic gastritis, 33% had active chronic gastritis, and 9% suffered from intestinal metaplasia. In terms of antibiotic susceptibility, nearly 76.3%, 49%, and 45.5% of the strains were resistant to metronidazole, clarithromycin, and ciprofloxacin, respectively. The MIC values at which the growth of 50% and 90% of the strains was inhibited (MIC50-90) were 32 -64 µg/mL for metronidazole, 0.5 -16 µg/mL for clarithromycin, and 2 -16 µg/mL for ciprofloxacin. Conclusions: The overall resistance levels were relatively high among the study patients. Accordingly, the administration of other anti-Helicobacter drugs, as well as more appropriate therapeutic regimens based on laboratory results, is recommended in patients with a history of treatment failure. Patient Consent:All patients announced their agreement with this study by signing informed consent forms.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 90%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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“…A recent study in Yazd, Iran revealed that H . pylori is more resistant to tetracycline than amoxicillin[ 43 ]. In a study in China, amoxicillin, in combination with metronidazole, bismuth, and lansoprazole, eradicated metronidazole-resistant H .…”

Section: Discussionmentioning

confidence: 99%

“…pylori antimicrobial resistance patterns was one of the main limitations of this study; howevera recent regional study indicated that H . pylori resistance to tetracycline was more common than that to amoxicillin, which might explain the 16% failure rate in the tetracycline groupcompared to the 5% failure rate in the amoxicillin group based on the PP analysis[ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Tolerability of Two Quadruple Regimens: Bismuth, Omeprazole, Metronidazole with Amoxicillin or Tetracycline as First-Line Treatment for Eradication of Helicobacter Pylori in Patients with Duodenal Ulcer: A Randomized Clinical Trial

et al. 2018

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AimTo evaluate the efficacy and tolerability of tetracycline vs. high-dose amoxicillin in bismuth-based quadruple therapy for Helicobacter pylori(H. pylori) eradication.MethodsThis randomized, open-label clinical trial included 228 patients with H.pylori infection and duodenal ulcer without a history of H.pylori treatment. Patients were randomly divided into two groups. The amoxicillin group received metronidazole 500mg, bismuth subcitrate 240mg, and amoxicillin 1000mg, all three times a day, plus omeprazole 20 mg twice a day, for 14 days. The tetracycline group received metronidazole 500mg three times a day; bismuth subcitrate240mg and tetracycline HCl 500mg, both four times a day; and omeprazole 20 mg twice a day, for 14 days. Evaluation for compliance and drug-relatedadverse effects were evaluated at the end of two weeks. Eight weeks after the end of treatment, the rate of H.pylori eradication was assessed by the C13urease breath test.ResultsThere were no significant demographic differences between the two groups. Eradication rate was higher with the amoxicillin-containing regimen than the tetracycline-containing regimen: 105/110 (95.51%; 95% confidence interval, 91.5%–99.3%) vs. 88/105 (83.8%; 95%CI, 76.7%–90.8%) by per-protocol analysis (p = 0.005) and 92.9% (95%CI, 88.1%–97.6%) vs. 76.5% (95%CI, 68.7%–84.2%) by intention-to-treat analysis (ITT, p = 0.001). Adverse effects were significant higher in the tetracycline groupthan in the amoxicillin group (65.2% vs. 43.4%; p = 0.001).ConclusionBismuth-based quadruple therapy including high-dose amoxicillin and metronidazole achieved an acceptable rate of H.pylori infection eradication with good tolerance in patients with duodenal ulcer. This regimen can overcome treatment resistance in areas with high prevalence of metronidazole and clarithromycin resistance.Trial registrationThe Thai Clinical Trial Registry (TCTR) 20170623004

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“…Confirmed isolates were suspended in Eppendorf tubes, comprising of brain heart infusion (BHI) broth supplemented with 5% horse serum and 20% glycerol. The tubes were stored at − 80 °C until future use [ 15 ]. A standard control strain, NCTC 11638, was used to confirm the identity of the isolates and to affirm antimicrobial assays.…”

Section: Main Textmentioning

confidence: 99%

Antibiotic resistance pattern and frequency of cagA and vacA genes in Helicobacter pylori strains isolated from patients in Tabriz city, Iran

et al. 2021

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Objective Helicobacter pylori is one of the most common causes of gastric infections in humans. It is estimated that approximately 50% of people around the world are infected with this bacterium. This study aimed to determine the antibiotic resistance pattern, as well as the frequency of cagA and vacA genes in H. pylori isolates obtained from patients in the clinical centers in Tabriz city, Iran. Results The culture method detected 100 (45.25%) H. pylori isolates from 221 biopsy samples during 3 years. The results showed that 63% and 81% of the isolates were positive for cagA and vacA genes, respectively. The highest resistance of isolates was seen against metronidazole (79%) and amoxicillin (36%), respectively. Also, the isolates showed the least resistance to tetracycline (8%).

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Antibacterial Resistance Patterns of Helicobacter pylori Clinical Isolates From Gastric Biopsy of Patients in Yazd

Cited by 5 publications

References 20 publications

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Efficacy and Tolerability of Two Quadruple Regimens: Bismuth, Omeprazole, Metronidazole with Amoxicillin or Tetracycline as First-Line Treatment for Eradication of Helicobacter Pylori in Patients with Duodenal Ulcer: A Randomized Clinical Trial

Antibiotic resistance pattern and frequency of cagA and vacA genes in Helicobacter pylori strains isolated from patients in Tabriz city, Iran

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