Antimicrobial resistance in Helicobacter pylori: current situation and management strategy in Vietnam

Phan, Trung Nam; Tran, Van Huy; Tran, Thi Ngoc Anh; Lê, Văn An; Santona, Antonella; Rubino, Salvatore; Paglietti, Bianca

doi:10.3855/jidc.6942

Cited by 10 publications

(16 citation statements)

References 26 publications

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“…Agar dilution could be performed reliably and is usually considered a reference assay compared with other techniques. Although its routine application is difficult[67], the method is adaptable for the testing of large numbers of strains[11]. The simplest, most cost-effective and most frequently used method for routine susceptibility testing is the disc-diffusion method.…”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

“…The simplest, most cost-effective and most frequently used method for routine susceptibility testing is the disc-diffusion method. However, it has not been recommended for slow-growing microorganisms, such as H. pylori , due to unstable antibiotic patterns released from the discs[37,67]. E-test is a quantitative variant of the disc diffusion method[25,33,37] and is useful for slow-growing bacteria[67].…”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

“…Its sensitivity and specificity are 45% and 98%, respectively[11]. Excellent correlation has been found between agar dilution and E-test MIC results for most antibiotics except metronidazole[23,29,37,67]. The rate of metronidazole resistance detected by an E-test might be overestimated by 10%-20% according to agar dilution-based results.…”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

“…There is no specific molecular method for the detection of rifabutin resistance, which can only be determined by sequencing[42]. Genotypic assays for antimicrobial resistance, such as PCR-restriction fragment length polymorphism (RFLP) and real-time PCR, dual-priming oligonucleotide (DPO)-based multiplex PCR, and DNA strip tests, might depend on the detection of A2143G in the 23S rRNA gene and Asn-87 or Asp-91 in GyrA[67]. …”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

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Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Arslan

Yılmaz

Demiray-Gürbüz

2017

WJG

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The management of Helicobacter pylori (H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture- or molecular-guided approaches face several practical issues, such as the invasive procedures required to obtain gastric biopsy specimens and the lack of availability of routine laboratory testing in some places, H. pylori treatment includes the administration of two or three empirically selected antibiotics combined with a proton pump inhibitor rather than evidence-based eradication treatment. The efficacy of empirical therapy is decreasing, mostly due to increasing multiple resistance. Multiresistance to levofloxacin, clarithromycin, and metronidazole, which are commonly used in empirical treatments, appears to have increased in many countries. Mutations play a primary role in the antimicrobial resistance of H. pylori, but many different mechanisms can be involved in the development of antibiotic resistance. Determining and understanding these possible mechanisms might allow the development of new methods for the detection of H. pylori and the determination of antimicrobial resistance. A treatment based on the detection of antimicrobial resistance is usually more effective than empirical treatment. Nevertheless, such an approach before treatment is still not recommended in the Maastricht guidelines due to the difficulty associated with the routine application of available culture- or molecular-based susceptibility tests, which are usually administered in cases of treatment failure. The management of first and rescue treatments requires further research due to the steadily increase in antimicrobial resistance.

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Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

See 2 more Smart Citations

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Arslan

Yılmaz

Demiray-Gürbüz

2017

WJG

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“…In a previous study we highlighted a high rate of primary and secondary resistance to clarithromycin in the central region of Vietnam precluding the use of this drug for the treatment of H. pylori infection [11]. Its detection and surveillance is therefore mandatory in order to adapt the antibiotic combination to local resistance patterns.…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori 23S rRNA gene mutations associated with clarithromycin resistance in chronic gastritis in Vietnam

Tran

et al. 2018

J Infect Dev Ctries

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Introduction: Data about the prevalence of the A2142C, A2142G, and A2143G mutations in 23S rRNA gene is still limited. The aim of this study was to determine the prevalence of these mutations in 23S rRNA gene of H. pylori vietnamese strains. Methodology: One hundred and sixty-nine patients with H. pylori-positive chronic gastritis were examined. H. pylori was detected by rapid urease test and Polymerase chain reaction (PCR). Total DNA was extracted from gastric biopsy specimens. A2142C, A2142G, and A2143G mutations were detected by DNA sequencing and PCR-restriction fragment length polymorphism (PCR-RFLP). Results: A2143G mutation was detected in 36.1% of samples, A2142G mutation in 3.6%, while A2142C mutation was not found in any case. The mixture of wild-type and mutation strains was found in 50% of specimens with A2142G, in 23% of specimens with A2143G mutation. There was no association of 23S rRNA gene point mutations with gender or age. However, an association between the heterogeneity of mutation and age was evidenced, with mean age of the group of pure A2143G higher than the group of wild-type/A2143G mixture, and rate of the wildtype/A2143G mixture higher in patients under 40 years of age. Conclusion: A2143G mutation was prominent, while A2142C mutation was not found in the 23S rRNA gene. PCR-RFLP has revealed a reliable assay allowing a rapid and cost-effective detection of clarithromycin-resistant strains. This is useful in countries as Vietnam with high prevalence of clarithromycin-resistance before choosing optimal therapy for H. pylori eradication.

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High incidence of antibiotic resistance amongst isolates of Helicobacter pylori collected in Nottingham, UK, between 2001 and 2018

Garvey,

Rhead,

Suffian

et al. 2023

Journal of Medical Microbiology

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Introduction. Helicobacter pylori is the leading cause of peptic ulcers and gastric cancer. The most common treatment regimens use combinations of two or three antibiotics and a proton pump inhibitor (PPI) to suppress stomach acid. The World Health Organization designated clarithromycin-resistant H. pylori as a high priority pathogen for drug development, due to increasing antibiotic resistance globally. Hypothesis/Gap Statement. There is no routine surveillance of H. pylori primary antimicrobial sensitivities in the UK, and published data are lacking. Aim. This study aimed to characterize antimicrobial sensitivities of isolates collected in Nottingham, UK, between 2001 and 2018. Methodology. Gastric biopsy samples were collected, with informed written consent and ethics approval, from 162 patients attending the Queen’s Medical Centre in Nottingham for an upper GI tract endoscopy. Antibiotic sensitivity was assessed using E-Tests and a more cost-effective disc diffusion test. Results. The clarithromycin, amoxicillin and levofloxacin disc diffusion tests provided identical results to E-Tests on a subset of 30 isolates. Disparities were observed in the metronidazole test results, however. In total, 241 isolates from 162 patients were tested using at least one method. Of all isolates, 28 % were resistant to clarithromycin, 62 % to metronidazole and 3 % to amoxicillin, which are used in first-line therapies. For those antibiotics used in second- and third-line therapies, 4 % were resistant to levofloxacin and none of the isolates were resistant to tetracycline. Resistance to more than one antibiotic was found in 27 % of isolates. The frequency of patients with a clarithromycin-resistant strain increased dramatically over time: from 16 % between 2001 and 2005 to 40 % between 2011 and 2018 (P=0.011). For the same time periods, there was also an increase in those with a metronidazole-resistant strain (from 58 to 78 %; P=0.05). The frequencies of clarithromycin and metronidazole resistance were higher in isolates from patients who had previously received eradication therapy, compared to those who had not (40 % versus 77 %, and 80 % versus 92 %, respectively). Of 79 pairs of isolates from the antrum and corpus regions of the same patient’s stomach, only six had differences in their antimicrobial susceptibility profiles. Conclusion. Although there was high and increasing resistance to clarithromycin and metronidazole, there was no resistance to tetracycline and the frequencies of amoxicillin and levofloxacin resistance were very low.

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Antimicrobial resistance in Helicobacter pylori: current situation and management strategy in Vietnam

Cited by 10 publications

References 26 publications

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Importance of antimicrobial susceptibility testing for the management of eradication inHelicobacter pyloriinfection

Helicobacter pylori 23S rRNA gene mutations associated with clarithromycin resistance in chronic gastritis in Vietnam

High incidence of antibiotic resistance amongst isolates of Helicobacter pylori collected in Nottingham, UK, between 2001 and 2018

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