Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain

Objectives Helicobacter pylori gastritis is considered an infectious disease, regardless of symptoms and stage of disease. Most consensus documents recommend empirical therapy based on local antimicrobial susceptibility patterns. We aimed to provide clinically useful information about primary and se...

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Authors: Gómez Ruiz de Arbulo, Marta, Tamayo Oya, Esther, Bujanda Fernández de Pierola, Luis, Mendibil, Leire, Mendiola, Josune, Cilla Eguiluz, Carlos Gustavo, Montes, Milagrosa
Format: article
Publication Date:2023
Country:España
Institution:Universidad del País Vasco
Repository:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/63418
Online Access:http://hdl.handle.net/10810/63418
Access Level:Open access
Keyword:Helicobacter pylori
resistance
Clarithromycin
Levofloxacin
Metronidazole
culture
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spelling Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern SpainGómez Ruiz de Arbulo, MartaTamayo Oya, EstherBujanda Fernández de Pierola, LuisMendibil, LeireMendiola, JosuneCilla Eguiluz, Carlos GustavoMontes, MilagrosaHelicobacter pyloriresistanceClarithromycinLevofloxacinMetronidazolecultureObjectives Helicobacter pylori gastritis is considered an infectious disease, regardless of symptoms and stage of disease. Most consensus documents recommend empirical therapy based on local antimicrobial susceptibility patterns. We aimed to provide clinically useful information about primary and secondary antimicrobial resistance to antimicrobials commonly prescribed for H. pylori. Methods Overall, 31,406 gastroduodenal biopsies and 2,641 string tests from patients over 15 years of age were plated on selective media, isolating H. pylori in 36.7% of biopsies and 50.7% of string tests. Susceptibility testing could be performed in 96.6% (12,399/12,835) of H. pylori isolates. Polymerase chain reaction (PCR) was also used to detect H. pylori and its resistance to clarithromycin, providing susceptibility data for 112 patients with negative culture results. Results Resistance to amoxicillin and tetracycline was unusual (0.6% and 0.2%, respectively). Rates of primary resistance to clarithromycin and metronidazole remained steady over the 22-year study period, at around 14% for clarithromycin and 30% for metronidazole, while primary resistance to levofloxacin tripled (from 7.6% in 2000 to 21.7% in 2021, P < 0.001) and increased with patient age. Notably, 1.8% of isolates were multiresistant to clarithromycin, metronidazole, and levofloxacin. Overall, secondary resistance rates were higher (P < 0.0001) than primary resistance rates for clarithromycin (42.5% vs 14.1%), metronidazole (40.9% vs 32%), and levofloxacin (21.5% vs 17.1%). Conclusion Determination of susceptibility for H. pylori by culture and/or PCR in patients undergoing endoscopy could facilitate the implementation of tailored therapy and guide the choice of empirical therapy when susceptibility testing cannot be performed, potentially helping limit the emergence of antimicrobial resistance.Elsevier202320232023info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10810/63418reponame:Addi. Archivo Digital para la Docencia y la Investigacióninstname:Universidad del País VascoIngléshttps://www.sciencedirect.com/science/article/pii/S2213716523001078info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-nd/3.0/es/© 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)Atribución-NoComercial-SinDerivadas 3.0 Españaoai:addi.ehu.eus:10810/634182026-06-18T09:23:17Z
dc.title.none.fl_str_mv Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
title Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
spellingShingle Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
Gómez Ruiz de Arbulo, Marta
Helicobacter pylori
resistance
Clarithromycin
Levofloxacin
Metronidazole
culture
title_short Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
title_full Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
title_fullStr Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
title_full_unstemmed Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
title_sort Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain
dc.creator.none.fl_str_mv Gómez Ruiz de Arbulo, Marta
Tamayo Oya, Esther
Bujanda Fernández de Pierola, Luis
Mendibil, Leire
Mendiola, Josune
Cilla Eguiluz, Carlos Gustavo
Montes, Milagrosa
author Gómez Ruiz de Arbulo, Marta
author_facet Gómez Ruiz de Arbulo, Marta
Tamayo Oya, Esther
Bujanda Fernández de Pierola, Luis
Mendibil, Leire
Mendiola, Josune
Cilla Eguiluz, Carlos Gustavo
Montes, Milagrosa
author_role author
author2 Tamayo Oya, Esther
Bujanda Fernández de Pierola, Luis
Mendibil, Leire
Mendiola, Josune
Cilla Eguiluz, Carlos Gustavo
Montes, Milagrosa
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Helicobacter pylori
resistance
Clarithromycin
Levofloxacin
Metronidazole
culture
topic Helicobacter pylori
resistance
Clarithromycin
Levofloxacin
Metronidazole
culture
description Objectives Helicobacter pylori gastritis is considered an infectious disease, regardless of symptoms and stage of disease. Most consensus documents recommend empirical therapy based on local antimicrobial susceptibility patterns. We aimed to provide clinically useful information about primary and secondary antimicrobial resistance to antimicrobials commonly prescribed for H. pylori. Methods Overall, 31,406 gastroduodenal biopsies and 2,641 string tests from patients over 15 years of age were plated on selective media, isolating H. pylori in 36.7% of biopsies and 50.7% of string tests. Susceptibility testing could be performed in 96.6% (12,399/12,835) of H. pylori isolates. Polymerase chain reaction (PCR) was also used to detect H. pylori and its resistance to clarithromycin, providing susceptibility data for 112 patients with negative culture results. Results Resistance to amoxicillin and tetracycline was unusual (0.6% and 0.2%, respectively). Rates of primary resistance to clarithromycin and metronidazole remained steady over the 22-year study period, at around 14% for clarithromycin and 30% for metronidazole, while primary resistance to levofloxacin tripled (from 7.6% in 2000 to 21.7% in 2021, P < 0.001) and increased with patient age. Notably, 1.8% of isolates were multiresistant to clarithromycin, metronidazole, and levofloxacin. Overall, secondary resistance rates were higher (P < 0.0001) than primary resistance rates for clarithromycin (42.5% vs 14.1%), metronidazole (40.9% vs 32%), and levofloxacin (21.5% vs 17.1%). Conclusion Determination of susceptibility for H. pylori by culture and/or PCR in patients undergoing endoscopy could facilitate the implementation of tailored therapy and guide the choice of empirical therapy when susceptibility testing cannot be performed, potentially helping limit the emergence of antimicrobial resistance.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10810/63418
url http://hdl.handle.net/10810/63418
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://www.sciencedirect.com/science/article/pii/S2213716523001078
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
Atribución-NoComercial-SinDerivadas 3.0 España
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/3.0/es/
Atribución-NoComercial-SinDerivadas 3.0 España
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Addi. Archivo Digital para la Docencia y la Investigación
instname:Universidad del País Vasco
instname_str Universidad del País Vasco
reponame_str Addi. Archivo Digital para la Docencia y la Investigación
collection Addi. Archivo Digital para la Docencia y la Investigación
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869406231786946560
score 15,301603

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