PREVALENCE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF HELICOBACTER PYLORI ISOLATES FROM GASTRIC BIOPSIES OF PATIENTS IN TERTIARY CARE HOSPITAL

S FATIMA; I ULLAH; M AYAZ; K MALIK; MNQ SHAIEA; X YAN; L HAN; L ZHAO

doi:10.54112/bcsrj.v2024i1.682

Authors

S FATIMA Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011. P. R. China
I ULLAH Deparment of Microbiology, Government Degree College Madyan Swat, Pakistan
M AYAZ Department of Immunology, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang (050017), Hebei Province, China
K MALIK Institute of Biological Sciences, Gomal University, D. I. Khan KP 29220, Pakistan
MNQ SHAIEA Department of Pharmacology, Hebei Medical University, China
X YAN Department of Clinical Laboratory, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011. P. R. China
L HAN Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011. P. R. China
L ZHAO Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011. P. R. China

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.682

Keywords:

Prevalence; Helicobacter pylori; Antibiotic Susceptibility Pattern; Resistance

Abstract

Worldwide, Helicobacter pylori is prevalent and is strongly associated with causing numerous digestive tract infections. Combination therapy for this pathogen includes a combination of antimicrobials such as amoxicillin, metronidazole, clarithromycin, levofloxacin, and proton pump inhibitors. Even though the present therapy is effective, treatment failure has been observed. This failure has been observed to be mainly due to point mutation, which in H. pylori is considered the primary developed resistance mechanism. This study investigated the prevalence and drug susceptibility of H. pylori in patients in Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan, from 2016 to 2017. A total of 100 gastric biopsies of patients were included in our study. All the samples were cultured and identified by biochemical testing for H. pylori to determine the prevalence. The disk diffusion method was used for the determination of the susceptibility pattern. Among 100 patients, H. pylori strains were isolated from 52 (52%) patient samples. To metronidazole (MTZ), maximum number of isolates (69.23%) shows resistance. Resistance to other antibiotics was also detected, including clarithromycin (CLR; 50%) and amoxicillin (AML; 57.69%). Comparatively low resistance was observed to tetracycline (TET; 7.69%) and ciprofloxacin (CIP; 15.38%) by a few isolates in our study. These data suggest that metronidazole should be used among Pakistani patients in first-line therapy with caution and ciprofloxacin in association. The clinician must know their area's resistance patterns when selecting an empiric antibiotic regimen for H. pylori.

Downloads

Download data is not yet available.

References

Abbas, Z., Fareed, R., Baig, M., Khan, T., and Shah, M. (2001). Prevalence of histological reflux oesophagitis in H. pylori positive patients: effect of density of H. pylori and activity of inflammation. JPMA. The Journal of the Pakistan Medical Association 51, 36-41.

Adamek, R., Suerbaum, S., Pfaffenbach, B., and Opferkuch, W. (1998). Primary and acquired Helicobacter pylori resistance to clarithromycin, metronidazole, and amoxicillin—influence on treatment outcome. The American journal of gastroenterology 93, 386-389.

Al-Qurashi, A. R., El-Morsy, F., and Al-Quorain, A.-A. (2001). Evolution of metronidazole and tetracycline susceptibility pattern in Helicobacter pylori at a hospital in Saudi Arabia. International journal of antimicrobial agents 17, 233-236.

Blaser, M. J., and Atherton, J. C. (2004). Helicobacter pylori persistence: biology and disease. The Journal of clinical investigation 113, 321-333.

Boyanova, L., Mentis, A., Gubina, M., Rozynek, E., Gosciniak, G., Kalenic, S., Göral, V., Kupcinskas, L., Kantarçeken, B., and Aydin, A. (2002). The status of antimicrobial resistance of Helicobacter pylori in eastern Europe. Clinical Microbiology and Infection 8, 388-396.

Corral, J. E., Mera, R., Dye, C. W., and Morgan, D. R. (2017). Helicobacter pylori recurrence after eradication in Latin America: Implications for gastric cancer prevention. World journal of gastrointestinal oncology 9, 184.

Falsafi, T., Mobasheri, F., Nariman, F., and Najafi, M. (2004). Susceptibilities to different antibiotics of Helicobacter pylori strains isolated from patients at the pediatric medical center of Tehran, Iran. Journal of clinical microbiology 42, 387-389.

Gerrits, M. M., Godoy, A. P., Kuipers, E. J., Ribeiro, M. L., Stoof, J., Mendonça, S., Van Vliet, A. H., Pedrazzoli Jr, J., and Kusters, J. G. (2006). Multiple mutations in or adjacent to the conserved penicillin‐binding protein motifs of the penicillin‐binding protein 1A confer amoxicillin resistance to Helicobacter pylori. Helicobacter 11, 181-187.

Gisbert, J. P., and Pajares, J. M. (2001). Helicobacter pylori therapy: first-line options and rescue regimen. Digestive Diseases 19, 134-143.

Glupczynski, Y., Megraud, F., Lopez-Brea, M., and Andersen, L. (2001). European multicentre survey of in vitro antimicrobial resistance in Helicobacter pylori. European journal of clinical microbiology & infectious diseases 20, 820-823.

Goodwin, A., Kersulyte, D., Sisson, G., Veldhuyzen van Zanten, S. J., Berg, D. E., and Hoffman, P. S. (1998). Metronidazole resistance in Helicobacter pylori is due to null mutations in a gene (rdxA) that encodes an oxygen‐insensitive NADPH nitroreductase. Molecular microbiology 28, 383-393.

Graham, D. Y. (1998). Antibiotic resistance in Helicobacter pylori: implications for therapy. Gastroenterology 115, 1272-1277.

Jeong, J.-Y., Mukhopadhyay, A. K., Dailidiene, D., Wang, Y., Velapatiño, B., Gilman, R. H., Parkinson, A. J., Nair, G. B., Wong, B. C., and Lam, S. K. (2000). Sequential inactivation of rdxA (HP0954) and frxA (HP0642) nitroreductase genes causes moderate and high-level metronidazole resistance in Helicobacter pylori. Journal of bacteriology 182, 5082-5090.

Khokhar, N. (2002). One-week therapy with omeprazole, clarithromycin and amoxicillin for eradication of Helicobacter pylori infection. JOURNAL-COLLEGE OF PHYSICIANS AND SURGEONS OF PAKISTAN 12, 338-340.

Kim, J. J., Reddy, R., Lee, M., Kim, J. G., El-Zaatari, F. A., Osato, M. S., Graham, D. Y., and Kwon, D. H. (2001). Analysis of metronidazole, clarithromycin and tetracycline resistance of Helicobacter pylori isolates from Korea. Journal of Antimicrobial Chemotherapy 47, 459-461.

Kuipers, E. (1997). Helicobacter pylori and the risk and management of associated diseases: gastritis, ulcer disease, atrophic gastritis and gastric cancer. Alimentary pharmacology & therapeutics 11, 71-88.

Kusters, J. G., Van Vliet, A. H., and Kuipers, E. J. (2006). Pathogenesis of Helicobacter pylori infection. Clinical microbiology reviews 19, 449-490.

Malfertheiner, P., Megraud, F., O'morain, C., Hungin, A., Jones, R., Axon, A., Graham, D., Tytgat, G., and Group, E. H. P. S. (2002). Current concepts in the management of Helicobacter pylori infection—The Maastricht 2‐2000 Consensus Report. Alimentary pharmacology & therapeutics 16, 167-180.

Malfertheiner, P., Sipponen, P., Naumann, M., Moayyedi, P., Mégraud, F., Xiao, S.-D., Sugano, K., and Nyrén, O. (2005). Helicobacter pylori eradication has the potential to prevent gastric cancer: a state-of-the-art critique. Official journal of the American College of Gastroenterology| ACG 100, 2100-2115.

Megraud, F. (2004). H pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut 53, 1374-1384.

Misra, R., Bhagat, M., and Ahmed, N. (2006). Helicobacter pylori in Dyspepsia–Antibiotic sensitivity and virulence patterns. Medical Journal Armed Forces India 62, 22-26.

NIH, C. C. (1994). Helicobacter pylori in peptic ulcer disease: NIH consensus development panel. JAMA 272, 65-69.

Paul, R., Postius, S., Melchers, K., and Schäfer, K. P. (2001). Mutations of the Helicobacter pylori genes rdxA and pbp1 cause resistance against metronidazole and amoxicillin. Antimicrobial agents and chemotherapy 45, 962-965.

Perez‐Perez, G. I., Rothenbacher, D., and Brenner, H. (2004). Epidemiology of Helicobacter pylori infection. Helicobacter 9, 1-6.

Ribeiro, M. L., Vitiello, L., Miranda, M. C., Benvengo, Y. H., Godoy, A. P., Mendonca, S., and Pedrazzoli, J. (2003). Mutations in the 23S rRNA gene are associated with clarithromycin resistance in Helicobacter pylori isolates in Brazil. Annals of Clinical Microbiology and Antimicrobials 2, 1-4.

Schrauwen, R., Janssen, M., and De Boer, W. (2009). Seven-day PPI-triple therapy with levofloxacin is very effective for Helicobacter pylori eradication.

Sengupta, S., Saraswathi, K., Varaiya, A., De, A., and Gogate, A. (2002). HELICOBACTER IN DUODENAL ULCER DISEASE AND ITS ERADICATION. Indian Journal of Medical Microbiology 20, 163-164.

Sipponen, P. (1994). Gastric cancer—a long-term consequence of Helicobacter pylori infection? Scandinavian Journal of Gastroenterology 29, 24-27.

Storskrubb, T., Aro, P., Ronkainen, J., Wreiber, K., Nyhlin, H., Bolling‐Sternevald, E., Talley, N. J., Engstrand, L., and Agréus, L. (2006). Antimicrobial susceptibility of Helicobacter pylori strains in a random adult Swedish population. Helicobacter 11, 224-230.

Thyagarajan, S., Ray, P., Das, B. K., Ayyagari, A., Khan, A. A., Dharmalingam, S., Rao, U. A., Rajasambandam, P., Ramathilagam, B., and Bhasin, D. (2003). Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study. Journal of gastroenterology and hepatology 18, 1373-1378.

Torres, J., Camorlinga-Ponce, M., Pérez-Pérez, G., Madrazo-De la Garza, A., Dehesa, M., González-Valencia, G., and Muñoz, O. (2001). Increasing multidrug resistance in Helicobacter pylori strains isolated from children and adults in Mexico. Journal of Clinical Microbiology 39, 2677-2680.

Versalovic, J., Shortridge, D., Kibler, K., Griffy, M. V., Beyer, J., Flamm, R. K., Tanaka, S. K., Graham, D. Y., and Go, M. F. (1996). Mutations in 23S rRNA are associated with clarithromycin resistance in Helicobacter pylori. Antimicrobial agents and chemotherapy 40, 477-480.

Wang, Wong, Mukhopadhyay, Berg, Cho, Lai, Fung, Hui, and Lam (2000). High prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kong. Alimentary pharmacology & therapeutics 14, 901-910.

Wayne, P. (2010). Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing: 20th informational supplement. CLSI document M100-S20.

Yakoob, J., Jafri, N., Jafri, W., Zaman, S., Bian, L. C., Islam, M., Hussainy, A. S., and Zaman, V. (2004). Polymerase chain reaction in the detection of Helicobacter pylori infection. Journal of the College of Physicians and Surgeons--pakistan: JCPSP 14, 153-156.