Antibiotic Resistance in Helicobacter pylori Strains and its Effect on H. pylori Eradication Rates in a Single Center in Korea.
10.3343/alm.2013.33.6.415
- Author:
Byoungrak AN
1
;
Byung Soo MOON
;
Heejung KIM
;
Hyun Chul LIM
;
Yong Chan LEE
;
Gyusang LEE
;
Sa Hyun KIM
;
Min PARK
;
Jong Bae KIM
Author Information
1. Department of Laboratory Medicine, Yongin Severance Hospital, Yongin, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Helicobacter pylori;
Antibiotic resistance;
Eradication
- MeSH:
Adult;
Aged;
Anti-Bacterial Agents/*pharmacology/therapeutic use;
Drug Resistance, Multiple, Bacterial/*drug effects;
Female;
Helicobacter Infections/drug therapy/*microbiology;
Helicobacter pylori/*drug effects/isolation & purification;
Humans;
Male;
Microbial Sensitivity Tests;
Middle Aged;
Peptic Ulcer/diagnosis/microbiology;
Republic of Korea;
Retrospective Studies;
Treatment Outcome
- From:Annals of Laboratory Medicine
2013;33(6):415-419
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. METHODS: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. RESULTS: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0% (5/71), 2.8% (2/71), 0% (0/71), 45.1% (32/71), and 26.8% (19/71), respectively, and for the 2011-2012 isolates were 16.0% (15/94), 2.1% (2/94), 0% (0/94), 56.3% (53/94), and 22.3% (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9% (12/71) in the 2009-2010 isolates to 23.4% (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8%) and failed in 4 of 7 patients (57.1%) in a clarithromycin-resistant and amoxicillin-susceptible group. CONCLUSIONS: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.
