Two-decade trends in primary Helicobacter pylori resistance to antibiotics in Bulgaria

Boyanova, Lyudmila; Nikolov, Rossen; Gergova, Galina; Evstatiev, Ivailo; Lazarova, Elena; Kamburov, Victor; Panteleeva, Emilia; Spassova, Zoya; Mitov, Ivan

doi:10.1016/j.diagmicrobio.2010.03.010

Cited by 27 publications

(30 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was the most obvious for fluoroquinolones, since these molecules are rarely used to treat children. A Bulgarian survey also found lower rates of MET r in isolates from children than in isolates from adults (6). Concerning CLR, our findings contrast with the results reported previously for other studies that disclosed a higher CLR resistance rate for strains isolated from children (1,2,6,8,19,46).…”

Section: Discussioncontrasting

confidence: 57%

“…A Bulgarian survey also found lower rates of MET r in isolates from children than in isolates from adults (6). Concerning CLR, our findings contrast with the results reported previously for other studies that disclosed a higher CLR resistance rate for strains isolated from children (1,2,6,8,19,46). Even after the further stratification of children into subgroups (Ͻ6 years, 6 to 12 years, and 13 to 17 years of age), resistance rates were lower for children below the age of 6 years, but the difference did not reach any significance through these subgroups.…”

Section: Discussionmentioning

confidence: 99%

“…As found for many other countries, H. pylori resistance to TET and AMX was very infrequent in our population (6,14,31,44,50). Therefore, our analysis focused on resistance to CLR, MET, and CIP.…”

Section: Discussionmentioning

confidence: 99%

“…H. pylori strains were considered CLR resistant when the MICs were Ն1 g/ml (34). In the absence of standard breakpoints, isolates were arbitrarily classified as resistant for cutoff values of Ն8 g/ml, Ն2 g/ml, and Ն1 g/ml for MET, AMX, and moxifloxacin, respectively, as suggested previously by several authors (3,6,19,31,43).…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium

et al. 2011

View full text Add to dashboard Cite

We analyzed the rates of antimicrobial resistance of Helicobacter pylori strains isolated from patients from 1990 to 2009 and identified risk factors associated with resistance. Gastric biopsy specimens were collected from several digestive disease centers in Brussels, Belgium. We routinely performed antimicrobial susceptibility testing for clarithromycin (CLR), metronidazole, amoxicillin, tetracycline, and ciprofloxacin. Evaluable susceptibility testing was obtained for 9,430 strains isolated from patients who were not previously treated for Helicobacter pylori infection (1,527 isolates from children and 7,903 from adults) and 1,371 strains from patients who were previously treated (162 isolates from children and 1,209 from adults). No resistance to amoxicillin was observed, and tetracycline resistance was very rare (<0.01%). Primary metronidazole resistance remained stable over the years, with significantly lower rates for isolates from children (23.4%) than for isolates from adults (30.6%). Ciprofloxacin resistance remained rare in children, while it increased significantly over the last years in adults. Primary clarithromycin resistance increased significantly, reaching peaks in 2000 for children (16.9%) and in 2003 for adults (23.7%). A subsequent decrease of resistance rates down to 10% in both groups corresponded to a parallel decrease in macrolide consumption during the same period. Multivariate logistic regression revealed that female gender, age of the patient of 40 to 64 years, ethnic background, the number of previously unsuccessful eradication attempts, and the different time periods studied were independent risk factors of resistance to clarithromycin, metronidazole, and ciprofloxacin. Our study highlights the need to update local epidemiological data. Thus, the empirical CLR-based triple therapy proposed by the Maastricht III consensus report remains currently applicable to our population.

show abstract

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Although the combination of a proton pump inhibitor with clarithromycin and amoxicillin is still very effective in the treatment of H. pylori infection and remains the treatment of choice, it would be prudent to preempt the resistance problem by searching for alternatives, as resistance to clarithromycin is increasingly reported 34 . Consequently, propolis extract exhibits good potential regarding the inhibition of H. pylori and its urease activity.…”

Section: Resultsmentioning

confidence: 99%

Effect of propolis in gastric disorders: inhibition studies on the growth ofHelicobacter pyloriand production of its urease

Baltaş¹,

Karaoğlu

Tarakçı

et al. 2016

Journal of Enzyme Inhibition and Medicinal Chemistry

View full text Add to dashboard Cite

There is considerable interest in alternative approaches to inhibit Helicobacter pylori (H. pylori) and thus treat many stomach diseases. Propolis is a pharmaceutical mixture containing many natural bioactive substances. The aim of this study was to use propolis samples to treat H. pylori. The anti-H. pylori and anti-urease activities of 15 different ethanolic propolis extracts (EPEs) were tested. The total phenolic contents and total flavonoid contents of the EPE were also measured. The agar-well diffusion assay was carried out on H. pylori strain J99 and the inhibition zones were measured and compared with standards. All propolis extracts showed high inhibition of H. pylori J99, with inhibition diameters ranging from 31.0 to 47.0 mm. Helicobacter pylori urease inhibitory activity was measured using the phenol-hypochlorite assay; all EPEs showed significant inhibition against the enzyme, with inhibition concentrations (IC 50 ; mg/mL) ranging from 0.260 to 1.525 mg/mL. The degree of inhibition was related to the phenolic content of the EPE. In conclusion, propolis extract was found to be a good inhibitor that can be used in H. pylori treatment to improve human health.

show abstract

Antibiotic resistance of Helicobacter pylori in pediatric patients — 10 years’ experience

et al. 2012

View full text Add to dashboard Cite

The aim of this study was to assess the pattern of evolution of resistance to antibiotics in Helicobacter pylori isolated from children who underwent upper endoscopy with antral biopsy during a 10-year period (2001-2010). We retrospectively analyzed data of all children (n = 3,008) who underwent upper endoscopy during the observed period at the Children's Hospital Zagreb, a university tertiary medical center. We calculated the rate, antibiotic susceptibility and risk factors for the H. pylori infection in our cohort. Antral biopsy was performed in 2,313 (76.89%) patients. Altogether, 382 (16.51%) children had positive biopsy for H. pylori (histology and/or culture). There was no significant difference in the incidence of H. pylori during 10 years of observation (p = 0.21). Infected children compared to non-infected group were older (p = 0.005), and had more often antral nodularity (p < 0.0001), and duodenal ulcer (p = 0.002). Altogether, 22.4% of treatment-naïve patients had strains resistant to tested antibiotics: majority to azithromycin (17.9%), followed by clarithromycin (11.9%), metronidazole (10.1%) and amoxicillin (0.6%). In the eradication failure group, 9/11 of children had strains resistant to tested antibiotics, mostly to metronidazole (7/11), followed by azithromycin (3/11) and clarithromycin (1/11). No correlation was found between age or gender and antibiotic resistance (p = 0.32, for both). In conclusion, our data strongly support current guidelines which recommend antibiotic susceptibility testing prior to eradication therapy. Based on our results we recommend the use of amoxicillin-metronidazole-based regimen as the first-line therapy in our study population.

show abstract

Two-decade trends in primary Helicobacter pylori resistance to antibiotics in Bulgaria

Cited by 27 publications

References 30 publications

Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium

Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium

Effect of propolis in gastric disorders: inhibition studies on the growth ofHelicobacter pyloriand production of its urease

Antibiotic resistance of Helicobacter pylori in pediatric patients — 10 years’ experience

Contact Info

Product

Resources

About