High frequency of metronidazole and clarithromycin-resistantHelicobacter pyloriin formalin-fixed, paraffin-embedded gastric biopsies

Pourakbari, Babak; Mahmoudi, Shima; Parhiz, Jabar; Sadeghi, RH; Monajemzadeh, Maryam; Mamishi, Setareh

doi:10.1080/09674845.2017.1391466

Cited by 18 publications

(12 citation statements)

References 31 publications

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“…From the 131 articles, 65 were excluded for the following reasons: meta‐analysis, review, non‐original research, conference abstract and article without full text (n = 55), and non‐relevant data or no data for susceptibility testing or no resistance data (n = 10). Finally, 66 studies 4,16‐80 were included in this systematic review and meta‐analysis (Supplementary Table ).…”

Section: Resultsmentioning

confidence: 99%

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

et al. 2020

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Background Antimicrobial resistance of Helicobacter pylori can result in eradication failure. Metadata on the antimicrobial resistance of H pylori in Iran could help to formulate H pylori eradication strategies in Iran. Methods A systematic review was performed after searching in MEDLINE, Scopus, Embase, Web of Science, and the Cochrane Library. A meta‐analysis was performed, and a comparison of the rates between children and adults; time periods (1999‐2010, 2011‐2016, 2017‐2019); and the methods used was carried out. Results A total of 66 studies investigating 5936 H pylori isolates were analyzed. The weighted pooled resistance (WPR) rates were as follows: clarithromycin 21% (95% CI 16‐26), metronidazole 62% (95% 57‐67), clarithromycin in combination with metronidazole 16% (95% CI 10‐23), ciprofloxacin 24% (95% CI 15‐33), levofloxacin 18% (95% CI 9‐30), erythromycin 29% (95% CI 12‐50), furazolidone 13% (95% CI 4‐27), tetracycline 8% (95% CI 5‐13), and amoxicillin 15% (95% CI 9‐22). During the three time periods, there was an increased resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline (P ˂ .05). Furazolidone and a clarithromycin/metronidazole combination had the higher resistance rates in children (P ˂ .05). Conclusion An increasing rate of resistance to amoxicillin, clarithromycin, ciprofloxacin, furazolidone, and tetracycline in Iranian H pylori isolates was identified. In children, the resistance to furazolidone and a combination of clarithromycin and metronidazole is higher compared to adults. As a stable, high resistance to metronidazole was found in children and adults in all Iranian provinces, we suggest that metronidazole should not be included in the Iranian H pylori eradication scheme.

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Section: Resultsmentioning

confidence: 99%

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

et al. 2020

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“…Three main 23S rRNA point mutations, including A2143G, A2142G and A2142C of domain V (Supplementary Table 1), have been found to be associated with more than 90% of patients with clarithromycin resistance. [13][14][15]20 A TaqMan real-time PCR allelic discrimination assay (NewLife, Beijing, China) was used to determine these point mutations, according to the description provided by previously published references. 15,20 Primers and probes were designed for both DNA wild type and mutated DNA, and the sequences are shown in Supplementary Table 2.…”

Section: Real-time Pcr Detection Of Mutations Associated With Clarithmentioning

confidence: 99%

“…8,12 With the rapid development of molecular pathology, some molecular markers have been confirmed to be associated with antibiotic resistance, for example the 23S rRNA point mutations, including A2143G, A2142G and A2142C of domain V, which have been found in more than 90% of patients with clarithromycin resistance. [13][14][15] For the antibiotic resistance in H. pylori infection, bacterial culture and disc diffusion method are recommended by the Clinical Laboratory Standard Institute (CLSI). [16][17][18] However, compared with H. pylori culture, molecular pathological detection based on molecular markers, such as real-time polymerase chain reaction (PCR) and conventional PCR analysis, is a very simple and economic approach which also takes less time.…”

Section: Introductionmentioning

confidence: 99%

Eradication Treatment of Helicobacter pylori Infection Based on Molecular Pathologic Antibiotic Resistance

Gao¹,

Du²,

Long³

et al. 2020

IDR

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Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance. Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups. Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98-97.60%, n=111) and 98.10% (95% CI, 95.48-100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01-95.32%, n=150) and 95.10% (95% CI, 91.57-98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found. Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and retreated patients.

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“…The treatment success should be over 90% in per‐protocol analysis to prevent the induction of secondary antimicrobial resistance and reduce expensive and risky procedures required by rescue treatment. This number is rarely described in pediatric trials, also because of the high rate of antibiotic resistance of H pylori . Furthermore, high multiple resistance and secondary resistance rates significantly affect H pylori eradication .…”

Section: Diagnosismentioning

confidence: 99%

Review: Helicobacter pylori in pediatrics

2019

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Despite a decrease in the prevalence of Helicobacter pylori infection, it still poses a significant health burden worldwide. This review summarizes important pediatric studies on H pylori published from April 2018 to March 2019. Epidemiologic studies have reported different prevalences in different parts of the world and have mainly confirmed traditional risk factors. Several studies on pathophysiology attempted to identify risk markers in childhood for gastric cancer development later in life. One of the most interesting studies evaluated the relationship between eosinophilic esophagitis and H pylori infection; however, an inverse relationship was not confirmed. The high resistance of H pylori and, consequently, low eradication rates, is still a major concern and susceptibility testing before treatment has again been highlighted. Potassium‐competitive acid blockers are promising new acid‐suppressant drugs but their role in H pylori eradication schemes is still to be determined.

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High frequency of metronidazole and clarithromycin-resistantHelicobacter pyloriin formalin-fixed, paraffin-embedded gastric biopsies

Cited by 18 publications

References 31 publications

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta‐analysis

<p>Eradication Treatment of <em>Helicobacter pylori</em> Infection Based on Molecular Pathologic Antibiotic Resistance</p>

Review: Helicobacter pylori in pediatrics

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