Antibiotic resistance patterns of <i>Helicobacter pylori</i> in North Israel – A six‐year study

Azrad, Maya; Vazana, Dafna; On, Avi; Paritski, Maya; Rohana, Hanan; Roshrosh, Halim; Agay-Shay, Keren; Peretz, Avi

doi:10.1111/hel.12932

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…3,12 Meta-analyses from the wider Asia-Pacific region have reported a substantial increase in levofloxacin resistance in recent decades, with the prevalence of levofloxacin-resistant H. pylori increasing from 7% before 2000 to 21% during 2011-2015. 13 Studies in the Middle East, 14 Italy, 15 Taiwan 16 and Southern Asia 17 have also demonstrated substantial increases in levofloxacin resistance within the past decade. The levels of levofloxacin resistance demonstrated in the current study exceed the limit of 15% recommended by the Maastricht VI/Florence Consensus Report for the use of empiric levofloxacin-based eradication therapy for refractory infection, since this antibiotic would be unlikely to achieve adequate (≥80%) eradication rates.…”

Section: Discussionmentioning

confidence: 99%

Refractory Helicobacter pylori infection in Australia: updated multicentre antimicrobial resistance

Schubert,

Ingram,

Warner

et al. 2023

Internal Medicine Journal

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Background and AimHelicobacter pylori infection is responsible for considerable morbidity and mortality worldwide and eradication rates are falling globally because of increasing antimicrobial resistance. However, there is a paucity of local data to guide the choice of eradication therapy in Australia. This study aimed to evaluate current Australian rates of H. pylori antibiotic resistance in patients who had failed prior eradication therapy.MethodsA retrospective analysis of routine culture and antibiotic susceptibility data from two pathology laboratories servicing multiple tertiary referral hospitals in Western Australia (WA) and South Australia (SA), between 2018 and 2022, was performed. Rates of antimicrobial resistance and prevalence of multiresistant isolates in both SA and WA were calculated and comparison of temporal trends and differences between the two states was conducted.ResultsA total of 796 H. pylori isolates revealed a clarithromycin resistance rate of 82%, metronidazole 68%, amoxicillin 4.4% and tetracycline 0.5%. Resistance to levofloxacin was observed in 22% and rifampicin 14%. Rates of resistance to clarithromycin were lower in SA compared with WA (incidence rate ratio [IRR]: 0.69, P = 0.0001). Multiresistant isolates were discovered in 63% of patients, with lower rates in SA compared with WA (IRR: 0.74, P = 0.002).ConclusionThis first multicentre, multistate study of H. pylori resistance in Australian patients exposed to prior therapy demonstrated high rates of antimicrobial resistance, including levofloxacin (>20%). This raises concern about recommending levofloxacin in empirical second‐line therapies. Increased monitoring and awareness of current H. pylori resistance rates in Australia are needed to guide local eradication practices.

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Section: Discussionmentioning

confidence: 99%

Refractory Helicobacter pylori infection in Australia: updated multicentre antimicrobial resistance

Schubert,

Ingram,

Warner

et al. 2023

Internal Medicine Journal

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“…Clarithromycin and metronidazole resistance rates have been the highest-46.3% and 16.3%, resp. It is noteworthy that multi-resistance has been statistically higher in Arab in comparison to Jewish patients [18].…”

Section: Geographic Distribution Of Helicobacter Pylori Resistance To...mentioning

confidence: 90%

Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review)

Mladenova

2023

Antibiotics

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Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide and one of the main etiological factors of chronic gastritis, peptic ulcer disease, and stomach neoplasms. The mass application of antibiotics without testing, especially during the last years of the pandemic of SARS-CoV-2, could lead to a dramatic increase in antibiotic resistance and reduced effectiveness of eradication regimens for H. pylori infection. The epidemiology of H. pylori resistance to antibiotics still has unclear mechanisms. Antibiotic policy should be intensified to optimize treatment, and regular monitoring of resistance of H. pylori in different geographical regions should be conducted. Individualized treatment according to susceptibility testing is strongly advisable, and the best treatment regimens should be selected. The mutations in the genes encoding the antibiotic target protein are significant risk factors for H. pylori resistance. Iatrogenic errors in diagnosis and prescribing treatment for the failure of H. pylori eradication are other important risk factors. The low level of awareness and compliance with the correct treatment influence the rate of H. pylori resistance. Epidemiological surveillance of antibiotic resistance and the adoption of new treatment strategies are needed. The discovery of an efficient vaccine against H. pylori could reduce the pressure of the world’s growing antibiotic resistance.

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“…This study highlights the importance of continuous monitoring of H. pylori antibiotic resistance for increasing eradication rates of this bacterium. Therapy for H. pylori infection should be revisited and updated based on data on antibiotic resistance [62].…”

Section: Regional Characteristics Of H Pylori Resistancementioning

confidence: 99%

Helicobacter pylori Antibiotic Resistance: Molecular Basis and Diagnostic Methods

Medakina,

Tsapkova,

Polyakova

et al. 2023

IJMS

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Helicobacter pylori is one of the most common cause of human infections. Infected patients develop chronic active gastritis in all cases, which can lead to peptic ulcer, atrophic gastritis, gastric cancer and gastric MALT-lymphoma. The prevalence of H. pylori infection in the population has regional characteristics and can reach 80%. Constantly increasing antibiotic resistance of H. pylori is a major cause of treatment failure and a major problem. According to the VI Maastricht Consensus, two main strategies for choosing eradication therapy are recommended: individualized based on evaluating sensitivity to antibacterial drugs (phenotypic or molecular genetic method) prior to their appointment, and empirical, which takes into account data on local H. pylori resistance to clarithromycin and monitoring effectiveness schemes in the region. Therefore, the determination of H. pylori resistance to antibiotics, especially clarithromycin, prior to choosing therapeutic strategy is extremely important for the implementation of these treatment regimens.

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Antibiotic resistance patterns of Helicobacter pylori in North Israel – A six‐year study

Cited by 6 publications

References 29 publications

Refractory Helicobacter pylori infection in Australia: updated multicentre antimicrobial resistance

Refractory Helicobacter pylori infection in Australia: updated multicentre antimicrobial resistance

Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review)

Helicobacter pylori Antibiotic Resistance: Molecular Basis and Diagnostic Methods

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