Evolution of metronidazole and tetracycline susceptibility pattern in Helicobacter pylori at a hospital in Saudi Arabia

Al-Qurashi, Abdul Rahman; El-Morsy, Fikry; Al-Quorain, Abdulaziz

doi:10.1016/s0924-8579(00)00336-8

Cited by 24 publications

(22 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the prevalence is within the range reported from much of the developing world as well as previous research in Egypt (3,10,14,20). Additionally, we have demonstrated that the antimicrobial resistance patterns for H. pylori isolates tested in the present study are consistent with other studies from the region and the developing world in general (1,5,21). …”

supporting

confidence: 91%

Universal High-Level Primary Metronidazole Resistance in Helicobacter pylori Isolated from Children in Egypt

Sherif

Mohran

Fathy³

et al. 2004

J Clin Microbiol

View full text Add to dashboard Cite

Antimicrobial susceptibility testing was performed on 48 isolates of Helicobacter pylori recovered from Egyptian children undergoing routine endoscopies. The isolates were universally highly resistant to metronidazole, but resistance to other tested antimicrobial agents was rare (4% for clarithromycin, erythromycin, and azithromycin resistance versus 2% for ciprofloxacin and ampicillin resistance). Use of metronidazole for the treatment of H. pylori in Egypt should be avoided.Helicobacter pylori is currently recognized as one of the most common chronic bacterial infections worldwide (6). While the majority of infections are asymptomatic (12, 13), the association of H. pylori colonization of the stomach with chronic gastritis, peptic ulcer disease, and gastric malignancies is now well documented in both adults and children (11,18). Eradication of bacteria is effective in healing peptic ulcers, preventing ulcer relapses, and potentially decreasing the risk of progression to gastric carcinoma (7,9,16). Current practice dictates treatment of symptomatic individuals with a regimen containing two antimicrobial agents along with a proton pump inhibitor (18). For successful eradication of bacteria, it is imperative that the clinician be aware of the current antimicrobial susceptibility profiles of isolates within the region. Therefore, this study was initiated to determine antimicrobial susceptibility patterns among H. pylori isolates recovered from children in Egypt.Children aged 2 to 17 years requiring endoscopy for evaluation of their gastrointestinal complaints were enrolled in this study. Prior to endoscopy, written informed consent was obtained from the parent of the study subject allowing their child to be enrolled. Children who had taken antimicrobials, antacids, H 2 blockers, proton pump inhibitors, or bismuth subsalicylate within the 4 weeks prior to endoscopy were excluded from the study. Similarly, children with a history of infection with H. pylori, a known bleeding disorder, or previous endoscopy were also excluded from the study. At the time of endoscopy, a gastric antral biopsy sample was obtained for culture and stored in normal saline on ice until delivered to the laboratory within 2 to 3 h of collection. The biopsy sample was ground using a sterile, disposable plastic pestle and inoculated onto Columbia agar (Campy-Pak Systems; Becton Dickinson, BBL, Cockeysville, Md.) plates enriched with 5% sheep blood, one of which was supplemented with antimicrobials to selectively inhibit growth of bacteria other than H. pylori. Cultures were incubated at 37°C under microaerophilic conditions. H. pylori isolates were harvested, suspended in tryptic soy broth with 15% glycerol, and stored frozen at Ϫ70°C pending further testing.Antimicrobial susceptibilities to erythromycin, clarithromycin, azithromycin, ciprofloxacin, ampicillin, and metronidazole were tested by using antimicrobial impregnated strips (E-test; AB Biodisk, Solna, Sweden). H. pylori isolates were thawed, inoculated onto Columbia agar, and incubated ...

show abstract

supporting

confidence: 91%

Universal High-Level Primary Metronidazole Resistance in Helicobacter pylori Isolated from Children in Egypt

Sherif

Mohran

Fathy³

et al. 2004

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…The possible underlying mechanism may be virulent strains causing severe inflammation, thereby increasing the infection, whereas cag A- strains acquire mutation more frequently under the selective pressure of MTZ. [61] Contrary to this, it was reported that there is no correlation between clarithromycin resistance and bacterial genotypic pattern and/or cag A positivity. [62]…”

Section: Resistance and Genotypesmentioning

confidence: 95%

Epidemiology and pattern of antibiotic resistance in Helicobacter pylori: Scenario from Saudi Arabia

Rizwan

Fatima

Alvi

2014

Saudi J Gastroenterol

View full text Add to dashboard Cite

Helicobacter pylori is recognized as a major cause of gastritis, peptic ulcer, gastric cancer, and mucosa-associated lymphoma. Infection with this gram-negative microaerophile has been treated using combination of antibiotics and proton pump inhibitors for different gastrointestinal diseases. The most commonly used treatment is triple therapy which consists of administration of a proton pump inhibitor, clarithromycin, and amoxicillin. Many factors contribute to treatment failure, but one of the main reasons is development of bacterial antibiotic resistance. The percent prevalence of antibiotic resistance varies among different countries; it appears to be partly determined by the geographic factors and its ability to undergo frequent homologous recombination. The aim of this paper is to review the prevalence of H. pylori infection, association of clinical outcomes with H. pylori genotypes, and current status of antibiotic resistance in H. pylori in Saudi Arabia. It also discusses the different alternative approaches for the treatment of H. pylori using antibiotics. In addition, association of antibiotic resistance with H. pylori virulent genotypes in Saudi population and its underlying resistance mechanism will also be discussed.

show abstract

“…The most commonly used treatments are triple therapies consisting of a proton pump inhibitor with clarithromycin and metronidazole or amoxicillin or quadruple therapy with a proton pump inhibitor, a bismuth compound, tetracycline, and metronidazole (3,8,21,39). The primary and secondary resistance rates reported worldwide vary from 1 to 58% for clarithromycin and from 5 to 76% for metronidazole (1,5,15,17,26,28,32,43). Resistance to one or both of these antibiotics significantly reduces treatment success (2,11,19,22,35,37,42,44).…”

mentioning

confidence: 99%

Multilaboratory Comparison of Proficiencies in Susceptibility Testing of Helicobacter pylori and Correlation between Agar Dilution and E Test Methods

Best

Haldane

Keelan

et al. 2003

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Susceptibility testing was performed at seven Canadian microbiology laboratories and the Helicobacter Reference Laboratory, Halifax, Nova Scotia, Canada, to assess susceptibility testing proficiency and the reproducibility of the results for clarithromycin and metronidazole and to compare the Epsilometer test (E test) method to the agar dilution reference method. Control strain Helicobacter pylori ATCC 43504 (American Type Culture Collection) and 13 clinical isolates (plus duplicates of four of these strains including ATCC 43504) were tested blindly. The National Committee for Clinical Laboratory Standards (NCCLS) guidelines for agar dilution testing were followed, and the same suspension of organisms was used for agar dilution and E test. Antimicrobials and E test strips were provided to the investigators. Methods were provided on a website (www.Helicobactercanada.org). Each center reported MICs within the stated range for strain ATCC 43504. Compared to the average MICs, interlaboratory agreements within 2 log 2 dilutions were 90% (range, 69 to 100%) for clarithromycin by agar dilution, with seven very major errors [VMEs], and 85% (range, 65 to 100%) by E test, with three VMEs. Interlaboratory agreements within 2 log 2 dilutions were 83% (range, 50 to 100%) for metronidazole by agar dilution, with six VMEs and eight major errors (MEs), and 75% (range, 50 to 94%) by E test, with four VMEs and four MEs. At lower and higher concentrations of antibiotic, E test MICs were slightly different from agar dilution MICs, but these differences did not result in errors. When a standardized protocol based on NCCLS guidelines was used, most participants in this study correctly identified clarithromycin-and metronidazole-susceptible and -resistant strains of H. pylori 93% of the time by either the agar dilution or E test method, and the numbers of errors were relatively equivalent by both methods.

show abstract

Evolution of metronidazole and tetracycline susceptibility pattern in Helicobacter pylori at a hospital in Saudi Arabia

Cited by 24 publications

References 13 publications

Universal High-Level Primary Metronidazole Resistance in Helicobacter pylori Isolated from Children in Egypt

Universal High-Level Primary Metronidazole Resistance in Helicobacter pylori Isolated from Children in Egypt

Epidemiology and pattern of antibiotic resistance in Helicobacter pylori: Scenario from Saudi Arabia

Multilaboratory Comparison of Proficiencies in Susceptibility Testing of Helicobacter pylori and Correlation between Agar Dilution and E Test Methods

Contact Info

Product

Resources

About