PRIMARY ANTIMICROBIAL RESISTANCE OFHELICOBACTER PYLORIIN BELGIUM

Abstract

The increasing antimicrobial resistance of Helicobacter pylori jeopardizes the efficiency of the classical eradication triple therapy. In this article we assessed the primary resistance rates of Helicobacter pylori to the commonly used antibiotics for eradication in the area of Brussels and determined prospectively, through a questionnaire, the possible risk factors for resistance. Gastric biopsies were taken for histology and culture in all adult patients in whom Helicobacter pylori was searched from February 2009 to April 2010 at the UZBrussel hospital. Clinical and demographic data were collected through a questionnaire. Histology was positive in 222 out of 507 patients tested (43.7%). Culture was successful in 189 patients with a positive histology (85.1%), 4 patients had a positive culture with a negative histology. Resistance to clarithromycin, metronidazole, ciprofloxacin, and amoxicillin was tested. Primary resistance rates were 13.3% for clarithromycin, 26.1% for metronidazole, 23.9% for ciprofloxacin, 0.8% for amoxicillin. Dual resistance to claritromycin and metronidazole was seen in 3.9%, triple resistance (claritromycin, metronidazole and ciprofloxacin) in 1.7% and resistance to the 4 antibiotics in 0.6% of patients. We conclude that there is a decreasing resistance for clarithromycin, metronidazole resistance is stable and rapidly increasing ciprofloxacin resistance. Resistance to any of the tested antibiotics was not associated with origin, age, gender, number of siblings, level of education or status (p > 0.05).

Treatment of Helicobacter pylori Infection 2014

“…This was corroborated by a Brazilian study . However, it was in contrast to other studies from outside the Latin America region that showed rising resistance rates to certain antibiotics over time, especially with regard to levofloxacin resistance . Regarding secondary resistance, a large German study of over 5000 strains found this to be also a major problem, especially with reference to fluoroquinolones.…”

“…There were many studies on H. pylori resistance levels in the last year. These studies on resistance over the last year are summarized in Table 2 [54][55][56][57][58][59][60][61][62]. One of the most significant of these was a systematic review of studies on resistance in Latin American countries [54].…”

Dynamics of antimicrobial resistance of Helicobacter pylori isolates in the Smolensk region of Russian Federation

“…In 2014, 10.1% of H. pylori strains were resistant to clarithromycin in Germany, 9% in Iceland, and 13.3% in Belgium. [25][26][27] In the United States in 2009-2013, 16.4% strains were resistant to clarithromycin, 28 28.1% of strains were resistant to clarithromycin in Bulgaria in 2015, 29% and 38.5% strains were resistant to clarithromycin in Japan in 2013-2014. 29 In Italy in 2016, 72.4% of isolates were resistant to clarithromycin, 30 9.6% and 4% strains were resistant to levofloxacin in Germany and Iceland, respectively.…”

“…25,26 Reported rates of resistance to metronidazole in different countries were: Japan (3%), Iceland (1%), United States (20.3%), Belgium (26.1%), Bulgaria (33.8%), and Italy (34.7%). [26][27][28][29][30][31] In conclusion, H. pylori resistance to clarithromycin remained low substantially between 2009 and 2017, so we suggest using bismuthcontaining quadruple regimen but not levofloxacin-based triple therapy as a second-line empiric treatment.…”

The Effect of L. Reuteri (ProGastria) on the Eradication Rate in Elderly Patients Infected with H. Pylori: a Randomized, Double-Blinded, Placebo Controlled Trial

“…On the other hand, antibiotic resistance should not be underestimated. Primary clarithromycin resistance for Europe is reaching 17.6% [29], for metronidazole it is 26%, while for amoxicillin is below 1% [30]. Data from a national study analyzing the prevalence of multidrug-resistant H. pylori in Bulgaria showed that resistance to clarithromycin, metronidazole and amoxicillin was 18.4%, 26.5% and 4.4%, respectively.…”