Most Helicobacter pylori strains of Kolkata in India are resistant to metronidazole but susceptible to other drugs commonly used for eradication and ulcer therapy

Abstract

SUMMARYBackground: Helicobacter pylori infection is very common in India, as in other developing countries, but few data exist on the susceptibility of H. pylori to antimicrobial agents commonly used for eradication here. Aim: To determine the antimicrobial susceptibility of H. pylori strains from Kolkata, in eastern India. Methods: A total of 67 H. pylori strains isolated from gastritis and peptic ulcer patients of Kolkata were examined in the study. Minimum inhibitory concentration to the antibiotics was determined by the agar dilution method.Results: Most of the strains (85%) were resistant to at least 8 lg/mL of metronidazole and 7.5% strains were resistant to tetracycline, which was high when compared with other reports in India. All Kolkata strains were highly sensitive to clarithromycin, furazolidone and amoxicillin. Conclusions: Our results differed significantly from the few available reports on drug sensitivity profile of H. pylori from other parts of India, namely, Hyderabad, Mumbai and Lucknow. This finding supports the need for rigorous susceptibility testing as a guide to empirical treatment and more generally, to define the resistance patterns of H. pylori in particular geographical areas.

Upper gastrointestinal endoscopic findings and prevalence of Helicobacter pylori infection among adult patients with dyspepsia in northern Tanzania

“…For instance, Metronidazole (the most frequently used drug by our patients), is also used to treat common parasitic and anaerobic bacterial infections; often empirically. Accordingly, studies from India and Senegal documented H. pylori resistance to metronidazole (Datta et al, 2005;Seck et al, 2009). Thus, the concern and uncertainty about our observation requires elaboration by further studies to evaluate the prevalence of H. pylori resistance to commonly used antimicrobial agents.…”

Antimicrobial Sensitivity Pattern of Helicobacter pylori Isolates among Subgroup of Bangladeshi Patients

“…An Indian study at Chennai shown that overall H. pylori resistance rate was 77.9% to Metronidazole, 44.7% to Clarithromycin and 32.8% to amoxicillin 19 . Another Indian study at Kolkata showed that 85% isolates were resistant to Metronidazole and 7.5% to tetracycline 20 . In present study we found 73.2% isolates were resistant to Metronidazole which is consistent with most of the study.…”

Drug resistance pattern and clonality in H. pylori strains

“…In contrast to these observations, two centers from the western part of Northern India have reported relatively lower prevalence of resistant strains (Delhi, 37.5% and Chandigarh, 38.2%) [9]. However, a report from Eastern India has shown high MTZ resistance (85%) in H. pylori [10]. Geographical variation in the prevalence of MTZ-resistant H. pylori may be attributed to (i) indiscriminate use of drugs in different areas and (ii) lack of uniformity in identification of the H. pylori strains as well as drug susceptibility testing in different laboratories.…”

“…The majority of the countries, including India, lack a regional surveillance program for antimicrobial susceptibility against H. pylori. The therapeutic recommendations are mostly based on either insufficient data or those obtained from other geographically unrelated regions [9,10].…”