High primary antibiotic resistance of <i>Helicobacter Pylori</i> strains isolated from dyspeptic patients: A prevalence cross‐sectional study in Spain

Macias-García, Fernando; Llovo-Taboada, José; Díaz-López, Mario; Baston‐Rey, Iria; Domínguez–Muñoz, J. Enrique

doi:10.1111/hel.12440

Cited by 38 publications

(42 citation statements)

References 48 publications

(87 reference statements)

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“…18 Our LV-R isolates showed the mutation D91N and N87K in 84.6%. 3,25,26 No resistance to amoxicillin or tetracycline was observed, in line with the very low resistance rates described by other authors. These results emphasized the importance of phenotypic antimicrobial susceptibility testing prior treatment since molecular techniques available only detect the most frequent mutations associated with resistance.…”

Section: Discussionsupporting

confidence: 89%

“…Two LV-R isolates (15.4%) had no mutation in the QRDR, suggesting a different resistance mechanism like mutation in the GyrB or an efflux pump. 3,10 To know the antimicrobial resistance of a given geographical area allows choosing the most appropriate first-line eradication regimen and avoids treatment failure with the consequent development of secondary resistance. 17,27 Metronidazole is widely used to treat protozoa or gynaecological infections, contributing to high resistance rates in different areas.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Persistent infection is associated with a range of gastrointestinal conditions, including chronic gastritis, peptic and duodenal ulcer and gastric adenocarcinoma. The prevalence of infection is highly variable among regions, being higher than 80% in developing countries and 20% in industrialized countries.…”

Section: Introductionmentioning

confidence: 99%

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Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

Fernández‐Reyes

Tamayo

Rojas-Rengifo

et al. 2019

Eur J Clin Investigation

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Background:Helicobacter pylori infection is associated with chronic gastritis, ulcers and gastric cancer. Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. Materials and Methods: Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild-disease symptoms and in 22 isolates from patients with severe-disease symptoms. Results: Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild-and severe-disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. Conclusions: Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. The prevalence of H pylori carrying the virulent genotype cagA/vacAs1m1 was higher than 20% in the mild-disease and 54% in the severe-disease symptom group.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

Fernández‐Reyes

Tamayo

Rojas-Rengifo

et al. 2019

Eur J Clin Investigation

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“…6 Poor treatment adherence is secondary to several factors, mainly complex treatment regimens requiring multiple daily doses of different drugs and adverse effects of antimicrobial drugs. In this sense, we have recently published a high H. pylori resistance to clarithromycin (22.4%) but still acceptable low dual resistance to clarithromycin and metronidazole (9.9%) in the northwest of Spain.…”

Section: Discussionmentioning

confidence: 99%

“…1 In this context, the use of empiric triple clarithromycin-containing regimens is discouraged by most recent guidelines if local resistance to clarithromycin is >15%. 6 In this scenario, we aimed at comparing the eradication rate of CQT and BQT as the first-line H. pylori eradication treatment in clinical practice in our area. 5 We have recently reported a high H pylori resistance to clarithromycin (22.4%), but still an acceptable low dual resistance to clarithromycin and metronidazole (9.9%), in the northwest of Spain.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

et al. 2018

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Background Concomitant quadruple (CQT) or bismuth‐containing quadruple therapy (BQT) is recommended as first‐line treatment for Helicobacter pylori infection depending on antibiotic resistance. Aim To compare the efficacy, safety, and compliance of CQT and BQT as first‐line therapy for H. pylori eradication in real clinical practice in an area of high resistance to clarithromycin. Methods A prospective, open, comparative cross‐sectional study including dyspeptic patients >18 years with H. pylori infection and with no previous eradication treatment was performed. CQT (omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1 g + metronidazole 500 mg, all given twice daily, for 14 days) or BQT (omeprazole 20 mg twice daily + 3 capsules of Pylera® 4 times a day, for 10 days) was prescribed at the discretion of the prescribing physician. Eradication was tested by 13C‐urea breath test. Efficacy was assessed by intention‐to‐treat (ITT) and per‐protocol (PP) analyses. Results One hundred and four consecutive patients were included (64.4% female, age 52.9 years). Fifty patients received CQT and 54 BQT. Eradication rate was similar with both therapies at the PP (CQT 97.9%, 95% CI: 93.9‐100 vs BQT 96.2%, 95% CI: 90.9‐100, P = 0.605) and ITT analyses (CQT 98.0%, 95% CI: 94‐100 vs BQT 94.4%, 95% CI: 88.1‐100, P = 0.346). The rate of adverse events was also similar with CQT (56%) and BQT (46.3%). One patient in each group discontinued the treatment due to significant adverse events. Conclusion The use of CQT and BQT as first‐line treatment against H. pylori is similarly effective and safe strategy in an area of high clarithromycin resistance.

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Antibiotic resistance in Helicobacter pylori: From potential biomolecular mechanisms to clinical practice

Lin

Shao

Yan

et al. 2023

Clinical Laboratory Analysis

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Helicobacter pylori (H. pylori) is a gram-negative microaerobic bacterium that is a common pathogen widely distributed around the world, especially in developing countries. 1 According to statistics from recent years, the H. pylori infection rate in developing countries exceeds 50%. 2 In West Asia, Africa, and South America, the H. pylori infection rate has been reported to be as high as 66.6%, 70.1%, and 69.4%, respectively. 3 H. pylori infection causes persistent damage to human gastric mucosa, leading to a variety of digestive

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High primary antibiotic resistance of Helicobacter Pylori strains isolated from dyspeptic patients: A prevalence cross‐sectional study in Spain

Abstract: Resistance rate of H. pylori to antibiotics is high in the northwest of Spain. The high resistance to levofloxacin and clarithromycin advises against their wide empirical use of these antibiotics in eradication regimens.

Cited by 38 publications

References 48 publications

Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

Antibiotic resistance in Helicobacter pylori: From potential biomolecular mechanisms to clinical practice

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