Geographically Distinct North-East Indian Helicobacter pylori Strains are Highly Sensitive to Clarithromycin but are Levofloxacin Resistant

Mahant, Shweta; Sharma, Amresh Kumar; Gehlot, Valentina; Mukhopadhyay, Asish K.; Chhawchharia, Ayushi; Dutta, Sangitanjan; Agarwal, Anil; Som, Anup; Das, Kunal; Das, Rajashree

doi:10.4103/ijmm.ijmm_19_158

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…However, only 2192 samples of the 3249 isolates were taken to record antibiotic resistance (67.5%, 95%CI: 0.66–0.69). With the available data, the total antibiotic susceptibility was calculated to be 74.35% (95%CI: 0.72–0.76), the male-to-female ratio was 1.26:1 and all studies included symptomatic patients i.e., either dyspepsia, reflux disease, peptic ulcer, gastritis or duodenitis and gastric carcinoma, except for Mahant et al [ 20 ], who included both symptomatic and asymptomatic patients.…”

Section: Resultsmentioning

confidence: 99%

“…The exact reason for the variable degree of resistance among these quinolones has not been discussed in the literature. However, according to this meta-analysis, the studies of Mahant et al [ 20 ], Aftab et al [ 22 ], and Shetty et al [ 34 ] had a significant outlier effect while computing the pooled resistance for levofloxacin. This can be interpreted as a high rate of levofloxacin resistance in certain regions of India and Bangladesh.…”

Section: Discussionmentioning

confidence: 99%

“…The high levofloxacin resistance is probably due to the cross-resistance with high fluoroquinolone resistance in South Asia. Moreover, Mahant et al observed that the H. pylori strains from northeast India form a different cluster based on the partial sequence of 23S rRNA and gyrase A genes, resulting in high fluoroquinolone resistance [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“… Forest Plot Showing Clarithromycin Resistance. (Reference Studies: [ 15 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]). …”

Section: Figurementioning

confidence: 99%

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Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis

et al. 2023

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Background: In South Asia, resistance to commonly used antibiotics for the treatment of Helicobacter pylori infection is increasing. Despite this, accurate estimates of overall antibiotic resistance are missing. Thus, this review aims to analyze the resistance rates of commonly used antibiotics for the treatment of H. pylori in South Asia. Methods: The systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We searched five medical databases for relevant studies from inception to September 2022. A random effect model with a 95% confidence interval (CI) was used to calculate the pooled prevalence of antibiotic resistance. Results: This systematic review and meta-analysis included 23 articles, 6357 patients, 3294 Helicobacter pylori isolates, and 2192 samples for antibiotic resistance. The prevalences of antibiotic resistance to common antibiotics were clarithromycin: 27% (95%CI: 0.17–0.38), metronidazole: 69% (95%CI: 0.62–0.76), tetracycline: 16% (95%CI: 0.06–0.25), amoxicillin: 23% (95%CI: 0.15–0.30), ciprofloxacin: 12% (95%CI: 0.04–0.23), levofloxacin: 34% (95%CI: 0.22–0.47), and furazolidone: 14% (95%CI: 0.06–0.22). Subgroup analysis showed antibiotic resistances were more prevalent in Pakistan, India, and Bangladesh. Furthermore, a ten-year trend analysis showed the increasing resistance prevalence for clarithromycin (21% to 30%), ciprofloxacin (3% to 16%), and tetracycline (5% to 20%) from 2003 to 2022. Conclusion: This meta-analysis showed a high prevalence of resistance among the commonly used antibiotics for H. pylori in South Asian countries. Furthermore, antibiotic resistance has been increasing over the time of 20 years. In order to tackle this situation, a robust surveillance system, and strict adherence to antibiotic stewardship are required.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… Forest Plot Showing Clarithromycin Resistance. (Reference Studies: [ 15 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]). …”

Section: Figurementioning

confidence: 99%

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Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis

et al. 2023

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“…In Nigeria, an epidemiological study detected high frequency of bacterial resistance for metronidazole (99.1%) followed by commonly used treatments amoxicillin (33.3%), clarithromycin (14.4%) and tetracycline (4.5%) ( 96 ). In contrast, North-East Indian strains are highly resistant to levofloxacin, but highly sensitive to clarithromycin ( 97 ). Thus, antibiotic sensitivity varies regionally due to the predominant local antibiotic treatment options but may also be in part due to the underlying genetics of the different populations.…”

Section: The Co-evolution Hypothesismentioning

confidence: 99%

Helicobacter pylori infection causes both protective and deleterious effects in human health and disease

Miller

Williams

2021

Genes Immun

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Infection with Helicobacter pylori (H. pylori) is necessary but not sufficient for the development of gastric cancer, the third leading cause of cancer death globally. H. pylori infection affects over half of people globally; however, it does not affect populations uniformly. H. pylori infection rates are declining in Western industrialized countries but are plateauing in developing and newly industrialized countries where gastric cancer is most prevalent. Despite H. pylori infection being the primary causative agent for gastric cancer, H. pylori infection can also cause other effects, detrimental or beneficial, throughout an individual’s life, with the beneficial effects often being seen in childhood and the deleterious effects in adulthood. H. pylori is an ancient bacterium and its likelihood of affecting disease or health is dependent on both human and bacterial genetics that have co-evolved over millennia. In this review, we focus on the impact of infection and its genetic bases in different populations and diseases throughout an individual’s lifespan, highlighting the benefits of individualized treatment and argue that universal eradication of H. pylori in its host may cause more harm than good for those infected with H. pylori .

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Choosing optimum regimen for treating Helicobacter pylori infection: Regional data may be the quintessential guide

Dutta

2023

Indian J Gastroenterol

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Geographically Distinct North-East Indian Helicobacter pylori Strains are Highly Sensitive to Clarithromycin but are Levofloxacin Resistant

Cited by 6 publications

References 22 publications

Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis

Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis

Helicobacter pylori infection causes both protective and deleterious effects in human health and disease

Choosing optimum regimen for treating Helicobacter pylori infection: Regional data may be the quintessential guide

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