Antimicrobial susceptibility of Helicobacter pylori isolates from Lower Silesia, Poland

Abstract

IntroductionIn recent years the failure of standard therapy for Helicobacter pylori infections has been observed, which results primarily from the increasing resistance of H. pylori strains to antibiotics. The aim of the study was to estimate the prevalence of antimicrobial resistance of H. pylori strains isolated from adult symptomatic patients with primary infection in the Lower Silesia Region in Poland.Material and methodsOne hundred and seventy-eight adults aged 19–89 years with dyspeptic symptoms suggesting gastroduodenal pathology were enrolled in the study. The study was performed in the years 2008–2011. Fifty H. pylori strains were isolated from gastric biopsy samples of examined patients. Antimicrobial susceptibility to 6 drugs (amoxicillin (AM), clarithromycin (CH), metronidazole (MZ), tetracycline (TC), levofloxacin (LEV), and rifabutin (RB)) was tested by the gradient-diffusion method (E-test method).ResultsThe incidence of H. pylori infection among examined patients was 35%. From 50 isolated H. pylori strains, 24% showed resistance to CH, 42% to MZ and 8% to LEV alone. Multidrug resistance was detected in 26% of strains, whereas 20% of isolates were resistant to MZ and CH. Examined strains were fully susceptible to AM, TC and RB.ConclusionsResistance to clarithromycin strains isolated from adults of the Lower Silesia Region in Poland is high and is almost always associated with resistance to metronidazole (CH + MZ). It is necessary to continuously monitor H. pylori resistance to drugs used in therapy, especially to clarithromycin. Verification of the existing recommendations of eradication therapy is also needed.

Molecular diagnosis of Helicobacter pylori antibiotic resistance in the Taif region, Saudi Arabia

“…Similar results have been reported in other geographic regions, including in developed countries such as Italy (35%), Poland (24%) and Japan (27.7%) . In contrast, low rates of resistance have been reported from some European countries such as France (8.6%) and certain regions in Asia such as Taiwan (6.6%) . However, secondary resistance to CLA has increased significantly in these countries.…”

“…Fortunately, the worldwide prevalence of AM‐resistant H. pylori is low. Several studies from Europe, Asia, and Africa have identified very low rates of AM resistance in clinical H. pylori isolates . However, widespread use of β‐lactam antibiotics can result in H. pylori developing tolerance to these drugs .…”

The Prevalence of Helicobacter pylori Infection in Symptomatic Children: A 13-Year Observational Study in the Lower Silesian Region

“…In Poland, H. pylori strains resis-tant to amoxicillin have not yet been detected, and this was confirmed by previous and current observations [12,31].…”

“…H. pylori infection was defined as a positive culture for H. pylori and the presence of inflammation in the gastric mucosa (H. pylori-associated gastritis). The bacteriological examination consisted of direct microscopy assessment, culture and susceptibility testing as described elsewhere [12]. Briefly, the strains were identified as H. pylori by Gram stain morphology, a positive culture and positive catalase, oxidase and urease tests.…”

Drug Resistance in Helicobacter Pylori

“…For this reason, the latest Maastricht Consensus do not recommend the use of this antibiotic as first line of treatment in regions where resistance to clarithomycin rates are higher than 15%-20% (8) . This is the case, for example, of some regions in Italy and in Poland, where the first choice schemes no longer include the macrolide (1,10,13) . Cell culture methods are the most used to determine the bacterial sensitivity to antibiotics.…”