Antimicrobial susceptibility of clinical Helicobacter pylori isolates and its eradication by standard triple therapy: a study in west central region of Colombia

The aim of the present study was first to isolate from gastric biopsy specimens and to test their antibiotic susceptibility. Second, it was to evaluate the efficacy of the standard triple therapy from patients of the west central region of Colombia. positive patients received standard triple therapy...

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Published in:	Microbiology spectrum Vol. 12; no. 8; p. e0040124
Main Authors:	Alvarez-Aldana, Adalucy, Fernandez Uribe, Paula Andrea, Mejía Valencia, Tatiana, Guaca-Gonzalez, Yina Marcela, Santacruz-Ibarra, Jorge Javier, Arturo-Arias, Brenda Lucia, Castañeda-Chavez, Luis Javier, Pacheco-López, Robinson, Londoño-Giraldo, Lina María, Moncayo-Ortiz, José Ignacio
Format:	Journal Article
Language:	English
Published:	United States American Society for Microbiology 06-08-2024
Subjects:	Adult Aged Amoxicillin - pharmacology Amoxicillin - therapeutic use Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use antibiotics Clarithromycin - pharmacology Clarithromycin - therapeutic use Colombia Drug Resistance, Bacterial drug therapy Drug Therapy, Combination eradication Female Helicobacter Infections - drug therapy Helicobacter Infections - microbiology Helicobacter pylori Helicobacter pylori - drug effects Helicobacter pylori - genetics Helicobacter pylori - isolation & purification Humans Levofloxacin - pharmacology Levofloxacin - therapeutic use Male Metronidazole - pharmacology Metronidazole - therapeutic use Microbial Sensitivity Tests Middle Aged Proton Pump Inhibitors - therapeutic use Public Health Research Article resistance Treatment Outcome Young Adult Colombia Colombia drug therapy Helicobacter pylori antibiotics eradication resistance
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Summary:	The aim of the present study was first to isolate from gastric biopsy specimens and to test their antibiotic susceptibility. Second, it was to evaluate the efficacy of the standard triple therapy from patients of the west central region of Colombia. positive patients received standard triple therapy with proton pump inhibitor (PPI) (40 mg b.i.d.), clarithromycin (500 mg b.i.d.), and amoxicillin (1 g b.i.d.) for 14 days. Thereafter, antibiotic susceptibility of the isolates was assessed by E-Test. From 94 patients enrolled, 67 were positive for by histology or culture. Overall resistance to metronidazole, levofloxacin, rifampicin, clarithromycin, and amoxicillin was 81%, 26.2%, 23.9%, 19%, and 9.5%, respectively. No resistance was found for tetracycline. A total of 54 patients received standard triple therapy, 48 attended follow-ups testing, and of them, 30 had resistance test reports. Overall eradication rate was 81.2%. Second-line treatment was given to eight patients, four of whom were followed up with a 13C urea breath test (UBT) and remained positive for . Eradication was significantly higher in patients with clarithromycin susceptible than in resistant strains (95.6% vs 42.8% = 0.001). The updated percentages of resistance to clarithromycin in this geographical area had increased, so this value must be considered when choosing the treatment regimen.IMPORTANCEAntibiotic resistance in has increased worldwide, as has resistance to multiple antimicrobials (MDRs), which seriously hampers the successful eradication of the infection. The ideal success rate in eradicating infection (≥90%) was not achieved in this study (81.2%). This is the first time that MDR is reported (14.3%) in the region; the resistance to clarithromycin increased over time (3.8%-19%), and levofloxacin (26.2%) and rifampicin (23%) resistant isolates were detected for the first time. With these results, strain susceptibility testing is increasingly important, and the selection of treatment regimen should be based on local antibiotic resistance patterns.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The authors declare no conflict of interest.
ISSN:	2165-0497 2165-0497
DOI:	10.1128/spectrum.00401-24