Antimicrobial susceptibility profiles of Helicobacter pylori isolated from patients in North India

Gehlot, Valentina; Mahant, Shweta; Mukhopadhyay, Asish K.; Das, Kunal; De, Ronita; Kar, Premashis; Das, Rajashree

doi:10.1016/j.jgar.2015.09.009

Cited by 30 publications

(47 citation statements)

References 23 publications

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“…Saracino et al reported almost similar observations in Italy (20). However, in a single study from India, higher metronidazole resistance rates were reported in women in comparison with male patients (21). The metronidazole MIC in our study was in the range of 4 µg to 64 µg, which was higher than that detected in a European survey performed by Megraud et al with MIC of 0.05 µg to 32 µg (22), but lower than that reported by An et al in Korea with 0.08 µg to 512 µg (23).…”

Section: Discussioncontrasting

confidence: 80%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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Background:The extent of antibiotic resistance among Helicobacter pylori strains influences current clinical therapeutic regimens in each region. Objectives: This cross-sectional study aimed to determine the resistance property and minimum inhibitory concentration (MIC50-90) of Helicobacter pylori strains toward metronidazole, clarithromycin, and ciprofloxacin in patients with distinct gastric histopathological changes in Tehran, Iran. Methods: This study was conducted on 170 patients suffering from gastric complications in three hospitals in Tehran from October 2014 until March 2015. Two separate biopsy samples were collected from each patient and used for pathological and microbiological examinations. Antimicrobial susceptibility tests were performed by agar dilution method according to the CLSI guidelines.The MIC values and susceptibility to varying concentrations of metronidazole (4 to 64 µg/mL), ciprofloxacin (0.5 to 16 µg/mL), and clarithromycin (0.25 to 16 µg/mL) were determined based on EUCAST recommendations. Results:Our results indicated the infection with H. pylori in a frequency of 32% (55/170) among the study patients (female, 51% and male, 49%). Endoscopic findings indicated that 42% of the patients suffered from peptic ulcers, 33% from duodenal ulcers, and 25% with a non-ulcer disease. Pathological findings indicated 58% of the patients had chronic gastritis, 33% had active chronic gastritis, and 9% suffered from intestinal metaplasia. In terms of antibiotic susceptibility, nearly 76.3%, 49%, and 45.5% of the strains were resistant to metronidazole, clarithromycin, and ciprofloxacin, respectively. The MIC values at which the growth of 50% and 90% of the strains was inhibited (MIC50-90) were 32 -64 µg/mL for metronidazole, 0.5 -16 µg/mL for clarithromycin, and 2 -16 µg/mL for ciprofloxacin. Conclusions: The overall resistance levels were relatively high among the study patients. Accordingly, the administration of other anti-Helicobacter drugs, as well as more appropriate therapeutic regimens based on laboratory results, is recommended in patients with a history of treatment failure. Patient Consent:All patients announced their agreement with this study by signing informed consent forms.

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Section: Discussioncontrasting

confidence: 80%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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“…AMX is one of the most commonly used antibiotics in recent years in Nepal as similar as ceftriaxone and gentamycin [36]. Additionally we observed no resistance to TCN, in contrast to studies from India and Pakistan [22, 32, 35, 37]. TCN is used as a salvage quadruple therapy [28, 38] and may be a useful alternative first-line regimen in Nepal.…”

Section: Discussionmentioning

confidence: 49%

Emerging Helicobacter pylori levofloxacin resistance and novel genetic mutation in Nepal

et al. 2016

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BackgroundThe prevalence of Helicobacter pylori antibiotic susceptibility in the Nepalese strains is untracked. We determined the antibiotic susceptibility for H. pylori and analyzed the presence of genetic mutations associated with antibiotic resistance in Nepalese strains.ResultsThis study included 146 consecutive patients who underwent gastroduodenal endoscopy in Kathmandu, Nepal. Among 42 isolated H. pylori, there was no resistance to amoxicillin and tetracycline. In contrast, similar with typical South Asian patterns; metronidazole resistance rate in Nepalese strains were extremely high (88.1 %, 37/42). Clarithromycin resistance rate in Nepalese strains were modestly high (21.4 %, 9/42). Most of metronidazole resistant strains had highly distributed rdxA and frxA mutations, but were relative coincidence without a synergistic effect to increase the minimum inhibitory concentration (MIC). Among strains with the high MIC, 63.6 % (7/11) were associated with frameshift mutation at position 18 of frxA with or without rdxA involvement. However, based on next generation sequencing data we found that one strain with the highest MIC value had a novel mutation in the form of amino acid substituted at Ala-212, Gln-382, Ile-485 of dppA and Leu-145, Thr-168, Glu-117, Val-121, Arg-221 in dapF aside from missense mutations in full-length rdxA. Mutations at Asn-87 and/or Asp-91 of the gyrA were predominantly in levofloxacin-resistant strains. The gyrB mutation had steady relationship with the gyrA 87–91 mutations. Although three (44.4 %) and two (22.2 %) of clarithromycin resistant strains had point mutation on A2143G and A2146G, we confirmed the involvement of rpl22 and infB in high MIC strains without an 23SrRNA mutation.ConclusionsThe rates of resistance to clarithromycin, metronidazole and levofloxacin were high in Nepalese strains, indicating that these antibiotics-based triple therapies are not useful as first-line treatment in Nepal. Bismuth or non-bismuth-based quadruple regimens, furazolidone-based triple therapy or rifabutin-based triple therapy may become alternative strategy in Nepal.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0873-6) contains supplementary material, which is available to authorized users.

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“…The MTZ resistance of H. pylori may be because of the extensive use of this inexpensive antibiotic for the treatment of parasitic, genital, and dental infections, especially in developing countries [29]. Studies comprehend that the resistance is due to inactivation of gene rdxA and frx gene [30,31].…”

Section: Discussionmentioning

confidence: 99%

Antibiogram Profiling of Helicobacter Pylori Strains and the Efficacy of Brassica Capitata Against Resistant Strains Isolated From the Patients Suffering From Gastroduodenal Diseases in Gauhati, Assam

Mahant

Gehlot

Bhatnagar

et al. 2018

Asian J Pharm Clin Res

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Objective: Helicobacter pylori resistance toward commonly used antibiotics is increasing leading to the treatment failure; hence, our aim is to determine the antibiogram susceptibility pattern of H. pylori strains isolated from Guwahati, Assam (Northeast India) and also to test the efficacy of the Brassica capitata against the multi and dual drug-resistant strains of North and Northeast India.Methods: Minimum inhibitory concentration of different antibiotics was determined by agar dilution method. Disc diffusion method was used to check the efficacy of B. capitata against clarithromycin (CLR), metronidazole (MTZ), and levofloxacin (LEV)-resistant H. pylori strains.Results: All the H. pylori strains were 100% sensitive to CLR, tetracycline, amoxicillin, and furazolidone. 72.8% of the strains were sensitive toward MTZ and 54.5% were sensitive toward LEV. B. capitata showed good efficacy against the resistant strains of H. pylori of North and Northeast India.Conclusion: Most of the H. pylori strains from Northeast India were sensitive toward the commonly used antibiotics for the treatment regime. B. capitata is effective against H. pylori infection, suggesting its potential as an alternative therapy, and opens the way for further studies on identification of novel antimicrobial targets of B. capitata.

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Antimicrobial susceptibility profiles of Helicobacter pylori isolated from patients in North India

Cited by 30 publications

References 23 publications

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Emerging Helicobacter pylori levofloxacin resistance and novel genetic mutation in Nepal

Antibiogram Profiling of Helicobacter Pylori Strains and the Efficacy of Brassica Capitata Against Resistant Strains Isolated From the Patients Suffering From Gastroduodenal Diseases in Gauhati, Assam

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