Antibiotic susceptibility patterns inHelicobacter pyloristrains from patients with upper gastrointestinal pathology in western Nigeria

Abstract

A total of 186 Helicobacter pylori isolates and 532 gastric biopsies recovered from 532 patients with varying degrees of gastroduodenal pathology are subjected to in vitro antibiotic susceptibility testing using the disc-diffusion method, Etest (MIC breakpoints) and molecular testing using the polymerase chain reaction (PCR). In the isolates studied, antibiotic resistance was as follows: piperacillin (72%), amoxicillin (66%), erythromycin (78%), tetracycline (100%) and metronidazole (95%). All isolates were sensitive to ofloxacin, ciprofloxacin and norfloxacin. None of the 245 amplicons (positive for H. pylori) from the biopsies were digested with the Bbs1 and Bsal restriction enzyme used in the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique, showing sensitivity to clarithromycin. However, a 238 bp fragment from H. pylori chromosomal DNA (corresponding to the quinolone resistance determining region [QRDR]) of the gyrA gene was amplified successfully. Twelve (4.9%) of the 245 strains studied had the described mutation at position 91, from asparagine (Asn) to glycine (Gly). The study showed that all the H. pylori strains were sensitive to clarithromycin and ciprofloxacin. It also highlighted PCR as a potential tool for faster diagnosis and determination of antibiotic susceptibility (within 24 h) of H. pylori from biopsies and/or isolates recovered from peptic ulcer and gastritis patients.

Efficacy of Helicobacter pylori eradication regimens in Rwanda: a randomized controlled trial

“…This finding aligns nicely with studies conducted in Nigeria and South Africa which didn’t detect any resistance to ciprofloxacin, suggesting that a fluoroquinolone based regimen may be of utility in Africa [12, 27]. Pending more rigorous diagnostic tests for eradication, this finding offers hope that the combination of omeprazole, amoxicillin, ciprofloxacin and doxycycline could be used as a salvage therapy, particularly since bismuth combinations are still unaffordable in Rwanda.…”

Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium

“…In Africa, MET is often used to cure parasitological infections (amebiasis, giardiasis, and trichomoniasis), with dramatic consequences for H. pylori resistance. Indeed, the highest MET r rates (Ͼ90%) have been reported for Central Africa (35,39). This could also explain the higher MET r rates observed for H. pylori strains isolated from patients coming from West and Central African countries.…”

Efficacy and tolerability of Helicobacter pylori eradication regimes in South Kivu, Eastern of the Democratic Republic of Congo: A single center observational study

“…Their results decrease when the regimen is used as a second‐line regimen. This could suggest the possibility of some degree of fluoroquinolone resistance as previously suspected 17–21 …”

“…This could suggest the possibility of some degree of fluoroquinolone resistance as previously suspected. 17 , 18 , 19 , 20 , 21 …”

“…This could suggest the possibility of some degree of fluoroquinolone resistance as previously suspected. [17][18][19][20][21] Although the recent Maastricht VI/Florence Consensus Report suggests to extend therapy to 14 days to improve eradication rate, it also encouraged to evaluate the effectiveness of 10-days therapies. 5,18 That is why this duration was chosen in our study in addition to economic reasons.…”