Antimicrobial susceptibility of<i>Helicobacter pylori</i>strains isolated from patients in Shiraz, Southern Iran

Farshad, Shohreh; Alborzi, Abdolvahab; Japoni, Aziz; Ranjbar, Reza; Asl, Kazem Hosseini; Badiee, Parisa; Shahidi, Maneli Amin; Hosseini, Mona

doi:10.3748/wjg.v16.i45.5746

Cited by 34 publications

(30 citation statements)

References 39 publications

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“…These breakpoints were used based on the recommendations of the National Committee for Clinical Laboratory Standards (NCCLS) (11,(18)(19)(20)(21)(22).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Mirzaei

Poursina

Faghri

et al. 2013

Jundishapur J Microbiol

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Background:Helicobacter pylori (H. pylori) is one of the most common infectious diseases in the world. It colonizes about 50-60% of the world's population. The estimated prevalence of H. pylori infection is approximately 65% in Iran. Objectives: The aim of the present study was to investigate the antimicrobial resistance of H. pylori to metronidazole, clarithromycin and amoxicillin. Materials and Methods: A total of 110 biopsy specimens were collected from patients with clinical symptoms of gastrointestinal disorders who were referred to the endoscopy unit at Al-Zahra Hospital, Isfahan, Iran. We investigated the frequency of H. pylori resistance to metronidazole, clarithromycin and amoxicillin among 48 positive isolates of H. pylori from the referred patients. After the culture of biopsy specimens and identification of H. pylori strains, susceptibility tests were done using the E test (epsilometer test) Results: The overall rates of resistance to metronidazole, clarithromycin and amoxicillin were 56.3%, 14.6% and 4.2% respectively. In our study, there was a significant correlation between resistance to metronidazole and gender (P < 0.05) but there was no significant correlation between resistance to amoxicillin and clarithromycin and gender (P ˃ 0.05). Conclusions: Information on antibiotic susceptibility profile plays an important role in empiric antibiotic treatment and management of refractive cases. With regards to this study, using metronidazole in the Isfahan region, can lead to eradication failure in clinical therapies due to having the highest rate of resistance but amoxicillin and clarithromycin are prescribed for first and second lines of treatment against H. pylori. Actually, susceptibility testing of H. pylori isolates in different geographical areas is advised because it aids the selection of optimal therapy regimens.

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“…These breakpoints were used based on the recommendations of the National Committee for Clinical Laboratory Standards (NCCLS) (11,(18)(19)(20)(21)(22).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Mirzaei

Poursina

Faghri

et al. 2013

Jundishapur J Microbiol

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“…MNZ is an inexpensive drug frequently used to treat not only H. pylori infection but also other infections such as intestinal parasites and periodontal and gynecologic diseases, which are common in developing countries such as Bangladesh [21,23]. Although in vitro resistance to MNZ may not accurately reflect in vivo resistance and should be confirmed by measuring blood drug concentrations [27], regimens that include MNZ are not a preferable choice in populations with >40% resistance to this drug [28]. In Asia, only Japan, Thailand, and Malaysia have populations with <40% MNZ resistance [7], and preferentially use the PPI + CAM + MNZ regimen recommended by the Maastricht III Consensus Report.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Aftab

Miftahussurur

Subsomwong

et al. 2016

J Infect Dev Ctries

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Introduction: The most recent study to report Helicobacter pylori antibiotic resistance rates in Bangladesh was published 15 years ago and did not include levofloxacin. We therefore aimed to determine the current antibiotic susceptibility of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline and levofloxacin in Bangladesh. Methodology: This study included 133 consecutive patients who underwent endoscopy examination at Dhaka Medical College in November 2014. The serial two-fold agar dilution method was used to determine the minimum inhibitory concentrations of the five antibiotics. Results: Among 56 cultured strains, H. pylori showed high rates of resistance to clarithromycin and metronidazole (39.3% and 94.6%, respectively). Moreover, levofloxacin showed an emerging antimicrobial resistance pattern (66.1%), which was higher in patients with gastritis than that in those with peptic ulcers (p = 0.02). The resistance rate of levofloxacin was significantly higher in patients living in Dhaka city compared to those living in the village (p = 0.049). However, amoxicillin and tetracycline resistance rates were very low. Resistance to both metronidazole and levofloxacin was most commonly observed. Conclusions: The rates of resistance to clarithromycin, metronidazole, and levofloxacin were high in Bangladesh, which suggests that triple therapy based on these drugs may not be useful as first-line therapies in Bangladesh. Alternative strategies such as furazolidone-based triple therapy, bismuth-based quadruple therapies, or sequential therapy may be more effective for patients in in Bangladesh.

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“…Multiple antibiotic resistances were observed in 8 of 27(29.6%) resistant isolates (17). In Shiraz, South of Iran, resistances of H.pylori were 44%, 20%, 3%, and 5% for metronidazole, clarithromycin, tetracycline, and amoxicillin, respectively (18). The prevalence rate of metronidazole resistance between H. pylori strains is greatly variable, and is higher in developing countries than developed worlds (19).…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Susceptibility of Helicobacter pylori Clinical Isolates in Hamadan, West of Iran

Majlesi¹,

Khorasani²,

Khalilian³

et al. 2013

Int J Enteric Pathog

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A B S T R A C TBackground: Surveillance data on Helicobacter pylori antibiotic susceptibilities are limited in Hamadan, Iran. Since antibiotic resistance is one of the reasons in therapies failure. Objectives: Thus the resistance patterns of H. pylori strains to the antibiotics metronidazole, clarithromycin, amoxicillin and tetracycline were evaluated. Patients and Methods: Gastric biopsy specimens of 153 patients with nonulcer dyspepsia, peptic ulcer dyspepsia, and peptic cancer collected during May 2010 to February of 2011, and were cultured on Brucella agar (Merck, Germany) under microaerophilic conditions. H. pylori isolates were identified using standard biochemical test. Eighty three (54.2 %) specimens had positive results by culture. Antimicrobial susceptibility testing was performed by disc diffusion method. Results: Totally in vitro resistance rates were 63.8% for metronidazole, 26.5% for clarithromycin, and 7.2% for amoxicillin. Although, 25.3% of strains showed resistance to two antibiotics, and 3.6% to three antibiotics. Tetracycline resistance was identified in only two isolates. Fifty nine percent of the clarithromycin resistant strains also showed resistance to metronidazole. No gender and age associations with resistance were detected. Conclusion: Our results showed a high incidence of metronidazole resistance (often combined with clarithromycin-resistance) in the isolates. Continuous surveillance is recommended to examine the treatment strategies for H. pylori eradication.

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Antimicrobial susceptibility ofHelicobacter pyloristrains isolated from patients in Shiraz, Southern Iran

Cited by 34 publications

References 39 publications

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran

Helicobacter pylori antibiotic susceptibility patterns in Bangladesh: Emerging levofloxacin resistance

Antibiotic Susceptibility of Helicobacter pylori Clinical Isolates in Hamadan, West of Iran

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