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Loghmari MH, Aissaoui F, Guediche A, Bouhlel W, Zakhama M, Chaabene NB, Rehaiem A, Ben Abdeljalil N, Njima M, Zakhama A, Kadri Y, Mastouri M, Safer L. Treatment of Helicobacter pylori infection 14-day concomitant quadruple therapy versus triple therapy: A parallel double-blind randomized controlled trial. Health Sci Rep 2023; 6:e1593. [PMID: 37808931 PMCID: PMC10551283 DOI: 10.1002/hsr2.1593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/14/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background and Aims Successful Helicobacter pylori (Hp) eradication with the traditional 7-day course of proton pump inhibitor triple therapy is declining. Prolonging therapy to 14 days is associated with better eradication rates. Most learned societies recommend concomitant quadruple therapy (QC) as a first-line alternative therapy for this bacterial infection. The aim of this study is to compare the efficacy and safety of triple therapy (TT) and QC for the eradication of Hp infection. Methods A parallel double-blind randomized controlled trial was conducted. The diagnosis of Hp infection was made by pathological examination of gastric biopsies. Patients were randomly assigned to two treatment groups: either QC (esomeprazole 80 mg, amoxicillin 2000 mg, clarithromycin 1000 mg, and metronidazole 1000 mg daily) or triple therapy (esomeprazole 80 mg, amoxicillin 2000 mg, and clarithromycin 1000 mg daily in divided doses) for 14 days. The efficacy of the treatment is defined by Hp eradication attested by a negative breath test performed 6 weeks after the completion of treatment. Treatment outcomes were compared using the chi-square test, while binary logistic regression identified predictors of treatment failure. Results Ninety-two patients were included. Forty-two patients belonged to the QC group and 50 to the TT group. No significant difference was noted between the two groups concerning the rate of Hp eradication either by intention to treat (81% vs. 72% respectively, p = 0.31) or per protocol (81.6% vs. 76.1% respectively, p = 0.54). Likewise, there was no difference between the two groups in terms of tolerance to treatment (59.5% for QC vs. 58% for TT, p = 0.88). No factor has been associated with treatment failure. Conclusion There was no significant difference in the rate of HP eradication between the QC and the 14-day triple therapy. Neither regimen should be used topically because of their low eradication rates.
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Affiliation(s)
| | - Firas Aissaoui
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Arwa Guediche
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Wided Bouhlel
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Mejda Zakhama
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Nabil B. Chaabene
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Amel Rehaiem
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
| | - Nouha Ben Abdeljalil
- Department of Pathological AnatomyFattouma Bourguiba University HospitalMonastirTunisia
| | - Manel Njima
- Department of Pathological AnatomyFattouma Bourguiba University HospitalMonastirTunisia
| | - Abdelfetteh Zakhama
- Department of Pathological AnatomyFattouma Bourguiba University HospitalMonastirTunisia
| | - Yosr Kadri
- Microbiology LaboratoryFattouma Bourguiba University HospitalMonastirTunisia
| | - Maha Mastouri
- Microbiology LaboratoryFattouma Bourguiba University HospitalMonastirTunisia
| | - Leila Safer
- Department of Hepato‐GastroenterologyFattouma Bourguiba University HospitalMonastirTunisia
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Chtourou L, Moalla M, Mnif B, Smaoui H, Gdoura H, Boudabous M, Mnif L, Amouri A, Hammami A, Tahri N. Prevalence of Helicobacter pylori resistance to clarithromycin in Tunisia. J Med Microbiol 2022; 71. [PMID: 36006691 DOI: 10.1099/jmm.0.001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Helicobacter pylori (H. pylori) resistance to clarithromycin is increasing worldwide. Data on the prevalence of H. pylori resistance are limited in Tunisia.Gap statement. Given that H. pylori resistance to clarithromycin has not been studied in Tunisia since 2010, there was a need to determinate its prevalence and the principal mutations implicated in this resistance.Aim. The aims were to define the prevalence of H. pylori infection among symptomatic patients and to determinate the level of clarithromycin resistance among these patients and the main mutations conferring this resistance.Methods. We conducted a cross-sectional study from March 2017 to February 2020 in the Hepato-Gastroenterology Department of Hedi Chaker University Hospital in Sfax that included 124 Tunisian patients who underwent gastroduodenal endoscopy with biopsies. Mutations conferring resistance to clarithromycin were detected using the Allplex H. pylori and ClariR PCR Assay.Results. Out of 124 biopsies, 101 (81.5 2 %) were PCR-positive for H. pylori. Mutations conferring resistance to clarithromycin were detected in 30/95 (31.6 %) of patients. The rate of primary resistance was 25.3 % and of secondary resistance 62.5 %. The most frequently detected mutation was A2143G (86, 90%) followed by A2142G (11, 36%). Seven patients had a double mutation A2143G-A2142G. The factors independently associated with resistance to clarithromycin were diabetes, high blood pressure, the presence of a bulbar ulcer on endoscopy and the presence of gastric atrophy on histology.Conclusion. Detection of more than 25 % of strains with clarithromycin resistance mutations makes the H. pylori first-line treatment with clarithromycin questionable in our setting, and a review of empirical treatment of H. pylori is urgently needed.
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Affiliation(s)
- Lassaad Chtourou
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Manel Moalla
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Basma Mnif
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hend Smaoui
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Hela Gdoura
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mona Boudabous
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Leila Mnif
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Ali Amouri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nabil Tahri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
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Dabbebi H, Elloumi H, Kechiche C, Hammemi E, Cheikh I, Jmaa A. Effect of Helicobacter pylori eradication therapy on the response of MALT-Gastric lymphoma. LA TUNISIE MEDICALE 2022; 100:37-43. [PMID: 35822330 PMCID: PMC8996311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The link between gastric mucosa-associated lymphoid tissue lymphoma (LG-MALT) and chronic Helicobacter Pylori (HP) infection had led to a real revolution in the management of the disease. AIMS To study the results of the HP eradication therapy and to clarify its place in the tumor response. METHODS A descriptive retrospective bicentric study, between January 2007 and December 2016, including patients with LG-MALT treated in the gastroenterology departments of Sahloul hospital in Sousse and Habib Bougtafa hospital in Bizerte, and having received treatment for eradication of HP. RESULTS Sixty-three patients were included. The male/female sex ratio was 1.42. The average age was 58 years. The symptomatology was dominated by epigastric pain (96.8%). On digestive endoscopy, the most frequent location and appearance were gastric antrum (39.6%) and ulcerations (89%). The lymphoma was classified as stage IE and IIE1 in 81% and 19% of cases, respectively. The HP status was positive in all patients. The HP eradication rate was 82.5% after three anti-HP treatment courses. Complete remission of lymphoma was obtained in 81% of patients at 18 months. Non-response to HP eradication therapy was observed in 19% of patients. Non-responder patients had a longer diagnostic delay (p=0.02), more diffuse endoscopic involvement (p=0.001) and a more frequent appearance of large gastric folds (p=0.001). CONCLUSION The course of LG-MALT is determined by the treatment for the eradication of HP. Its success promotes remission of lymphoma.
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Zhang Y, Meng F, Jin J, Wang J, Gu BB, Peng JB, Ye LP. Ninety-four thousand-case retrospective study on antibacterial drug resistance of Helicobacter pylori. World J Clin Cases 2021; 9:10838-10849. [PMID: 35047595 PMCID: PMC8678885 DOI: 10.12998/wjcc.v9.i35.10838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The resistance rate to antibacterial drugs is the key inhibitor of Helicobacter pylori (H. pylori) eradication treatment.
AIM To evaluate the prevalence and drug resistance of H. pylori based on big data.
METHODS Gastric mucosal specimens were collected from naive patients undergoing upper gastrointestinal endoscopy for H. pylori culture and antimicrobial susceptibility testing (AST), including clarithromycin, levofloxacin, metronidazole and amoxicillin. Every 10 years of age was grouped as an age group. The H. pylori infection and resistance were explored based on the age group and gender.
RESULTS The number of H. pylori-positive specimen was 94509 in 283823 gastric mucosal specimens, with an infection rate of 33.30%. The infection rate increased with age, and males had a higher infection rate than females. The average resistance rate of H. pylori to amoxicillin and metronidazole was 0.21% and 93.72%, which remained stable. The average resistance rate to clarithromycin was 23.99% with an increasing trend from 14.43% to 38.24%. The average resistance rate to levofloxacin was 30.29%, which increased from 17.07% to 39.42% and mostly stabilized after 2017. The resistance rate of H. pylori increased with age, except amoxicillin. H. pylori in females are at higher risk of resistance to metronidazole, but not to amoxicillin, regardless of the age group. Meanwhile, H. pylori in females are at higher risk of resistance to levofloxacin and clarithromycin in the 21-50 age group. The single, dual, triple and quadruple-drug resistance rate was 54.59%, 29.03%, 11.71% and 0.11%, respectively.
CONCLUSION The resistance of H. pylori in Taizhou city is serious. Guided by the consensus report, individualized treatment based on AST is recommended.
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Affiliation(s)
- Yu Zhang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
| | - Fei Meng
- Department of Research Service, Zhiyuan Medical Inspection Institute CO., LTD, Hangzhou 310030, Zhejiang Province, China
| | - Jie Jin
- Department of Research Service, Zhiyuan Medical Inspection Institute CO., LTD, Hangzhou 310030, Zhejiang Province, China
| | - Jun Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
| | - Bin-Bin Gu
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
| | - Jin-Bang Peng
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
| | - Li-Ping Ye
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Linhai 318000, Zhejiang Province, China
- Department of Gastroenterology, Taizhou Hospital Affiliated to Wenzhou Medical University, Taizhou 318000, Zhejiang Province, China
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Khiddi F, Abdellahi MVM, Horma MA, Billoet A, Collobert G, Amar AM, Nech HDM, Vadel EHM, Houmeida A, Raymond J, Dauga C, Gastli N. Characteristics of Helicobacter pylori strains isolated from Mauritanian patients. Helicobacter 2020; 25:e12726. [PMID: 32686319 DOI: 10.1111/hel.12726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Helicobacter pylori (H pylori) is responsible for various diseases including cancer It co-evolved with humans, and human migrations shaped the expansion and the diversity of strains around the world. The risk of developing a disease depends on virulence factors, mainly the cytotoxin-associated gene A protein (CagA). The aim of this study was to determine the cagA status in H pylori strains from Mauritanian patients and to search for a relationship with endoscopic and histologic findings. MATERIAL AND METHODS H pylori was searched in gastric biopsies taken during endoscopy in patients with gastro-duodenal symptoms. RT-PCR was used for the diagnosis and resistance to clarithromycin. The cagA status was determined with PCR and the EPIYA-cagA polymorphism with sequencing. RESULTS At all, 76/78 (97.4%) biopsies were positive. The rate of clarithromycin resistance was 4/76 (5.26%) due to the A2143G mutation, with a mixed population in 2 cases. The cagA gene was present in 23/76 (30.26%) biopsies, and the EPIYA motif was ABC in 21 (91.3%). High bacterial load and inflammation were significantly associated with cagA-positive status (P < .01). Phylogenetic analysis of the glmM and hspA genes highlighted a mixture of African and European genes in strains of H pylori isolated from patients of Moor origin. CONCLUSION We report a high prevalence of H pylori infection in Mauritanian patients, a low rate of clarithromycin resistance (5.26%) and high bacterial load and inflammation associated with cagA-positive status. The phylogenetic analysis highlights the mix of different populations leading to the Moor ethnicity.
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Affiliation(s)
- Fatimetou Khiddi
- Unit of Epidemiology and Diversity of Microorganisms, Nouakchott, Mauritania
| | | | | | - Annick Billoet
- Centre, Université de Paris, France Bacteriology Laboratory, Cochin Hospital, AP-HP, Paris, France
| | - Ghislaine Collobert
- Centre, Université de Paris, France Bacteriology Laboratory, Cochin Hospital, AP-HP, Paris, France
| | - Ahmed Mohamed Amar
- Gastroenterology Department, Cheikh Zayid hospital, Nouakchott, Mauritania
| | | | | | - Ahmed Houmeida
- Anatomo-pathology Department, Chiva Clinic, Nouakchott, Mauritania
| | - Josette Raymond
- Centre, Université de Paris, France Bacteriology Laboratory, Cochin Hospital, AP-HP, Paris, France.,Université Paris Saclay, Bacteriology Laboratory, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Catherine Dauga
- Department of Computational Biology, Institut Pasteur, Paris, France
| | - Nabil Gastli
- Centre, Université de Paris, France Bacteriology Laboratory, Cochin Hospital, AP-HP, Paris, France
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Boyanova L, Markovska R, Medeiros J, Gergova G, Mitov I. Delafloxacin against Helicobacter pylori, a potential option for improving eradication success? Diagn Microbiol Infect Dis 2020; 96:114980. [DOI: 10.1016/j.diagmicrobio.2019.114980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/23/2019] [Accepted: 12/26/2019] [Indexed: 02/07/2023]
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Murata M, Sugimoto M, Mizuno H, Kanno T, Satoh K. Clarithromycin Versus Metronidazole in First-Line Helicobacter Pylori Triple Eradication Therapy Based on Resistance to Antimicrobial Agents: Meta-Analysis. J Clin Med 2020; 9:jcm9020543. [PMID: 32079208 PMCID: PMC7073899 DOI: 10.3390/jcm9020543] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/09/2020] [Accepted: 02/12/2020] [Indexed: 02/08/2023] Open
Abstract
Background: International treatment guidelines for Helicobacter pylori infection recommend a proton pump inhibitor (PPI)/amoxicillin/clarithromycin (CAM) regimen (PAC) or PPI/amoxicillin/metronidazole (MNZ) regimen (PAM) as first-line therapy based on culture and sensitivity testing. As incidence rates of antimicrobial agent-resistant strains are changing year by year, it is important to reevaluate the efficacy of eradication regimens. We performed a meta-analysis to evaluate the efficacy and safety of PAC and PAM based on different locations categorized by the reported incidence of CAM- and MNZ-resistant strains. Methods: Randomized control trials (RCTs) comparing eradication rates between PAC and PAM first-line treatment up to December 2018 were included. We divided RCTs into four groups based on resistance to CAM (< 15% or ≥ 15%) and MNZ (< 15% or ≥ 15%). Results: A total of 27 studies (4825 patients) were included. Overall eradication rates between PAC and PAM were similar (74.8% and 72.5%, relative risk (RR): 1.13, 95% confidence interval (CI): 0.91–1.39, P = 0.27) in the intention-to-treat analysis. In areas with low MNZ- and high CAM-resistance rates, PAM had a significantly higher eradication rate than PAC (92.5% vs. 70.8%, RR: 0.29, 95% CI: 0.13–0.68). In areas with high MNZ- and low CAM-resistance rates, the eradication rate with PAC was only 72.9%. Conclusions: Overall eradication rates with PAC and PAM were equivalent worldwide. In low MNZ-resistance areas, PAM may be recommended as first-line therapy. However, the efficacy of PAC may be insufficient, irrespective of susceptibility to CAM.
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Affiliation(s)
- Masaki Murata
- Department of Gastroenterology, Shiga University of Medical Science Hospital, Otsu, Shiga 520-2192, Japan;
- Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Fushimi, Kyoto 612-8555, Japan
| | - Mitsushige Sugimoto
- Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Otsu, Shiga 520-2192, Japan
- Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan
- Correspondence: ; Tel.: +81-3-3342-6111; Fax: +81-3-3345-5359
| | - Hitomi Mizuno
- Toyoda Aoba Clinic, Iwata, Shizuoka 438-0821, Japan;
| | - Takeshi Kanno
- Division of Gastroenterology, Tohoku University Hospital, Sendai, Miyagi 980-8578, Japan;
| | - Kiichi Satoh
- Department of Gastroenterology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi 329-2763, Japan;
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Sharifi A, Azizi M, Moradi-Choghakabodi P, Aghaei S, Azizi A. In vitro anti-Helicobacter pylori activity of aqueous extract from Persian Oak testa. CHINESE HERBAL MEDICINES 2019. [DOI: 10.1016/j.chmed.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Smith S, Fowora M, Pellicano R. Infections with Helicobacter pylori and challenges encountered in Africa. World J Gastroenterol 2019; 25:3183-3195. [PMID: 31333310 PMCID: PMC6626727 DOI: 10.3748/wjg.v25.i25.3183] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/02/2019] [Accepted: 06/01/2019] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is the causative agent of gastritis, peptic ulcer disease, mucosa associated lymphoid tissue lymphoma and gastric cancer (GC). While this bacterium infects 50% of the world’s population, in Africa its prevalence reach as high as 80% as the infection is acquired during childhood. Risk factors for H. pylori acquisition have been reported to be mainly due to overcrowding, to have infected siblings or parent and to unsafe water sources. Despite this high H. pylori prevalence there still does not exist an African guideline, equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection. In this continent, although there is a paucity of epidemiologic data, a contrast between the high prevalence of H. pylori infection and the low incidence of GC has been reported. This phenomenon is the so-called “African Enigma” and it has been hypothesized that it could be explained by environmental, dietary and genetic factors. A heterogeneity of data both on diagnosis and on therapy have been published. In this context, it is evident that in several African countries the increasing rate of bacterial resistance, mainly to metronidazole and clarithromycin, requires continental guidelines to recommend the appropriate management of H. pylori. The aim of this manuscript is to review current literature on H. pylori infection in Africa, in terms of prevalence, risk factors, impact on human health, treatment and challenges encountered so as to proffer possible solutions to reduce H. pylori transmission in this continent.
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Affiliation(s)
- Stella Smith
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos PMB 2013, Nigeria
| | - Muinah Fowora
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Lagos PMB 2013, Nigeria
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Melese A, Genet C, Zeleke B, Andualem T. Helicobacter pylori infections in Ethiopia; prevalence and associated factors: a systematic review and meta-analysis. BMC Gastroenterol 2019; 19:8. [PMID: 30630433 PMCID: PMC6327617 DOI: 10.1186/s12876-018-0927-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/26/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Helicobacter pylori (H.pylori) infections are prevalent and recognized as major cause of gastrointestinal diseases in Ethiopia. However, Studies conducted on the prevalence, risk factors and other clinical forms of H.pylori on different population and geographical areas are reporting conflicting results. Therefore, this review was conducted to estimate the pooled prevalence of H.pylori infections and associated factors in Ethiopia. METHODS PubMed, Embase, Google scholar, and Ethiopian Universities' repositories were searched following the Preferred Items for Systematic review and Meta-analysis (PRISMA) guideline. The quality of included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics based on the random effects model. Comprehensive meta-analysis (CMA 2.0) and Review Manager (RevMan 5.3) were employed to compute the pooled prevalence and summary odds ratios of factors associated with of H.pylori infection. RESULTS Thirty seven studies with a total of 18,890 participants were eligible and included in the analysis. The overall pooled prevalence of H.pylori infection was 52.2% (95% CI: 45.8-58.6). In the subgroup analysis by region, the highest prevalence was found in Somalia (71%; 95% CI: 32.5-92.6) and the lowest prevalence was reported in Oromia (39.9%; 95% CI: 17.3-67.7). Absence of hand washing after toilet (OR = 1.8, 95% CI; 1.19-2.72), alcohol consumption (OR = 1.34, 95% CI; 1.03-1.74) and gastrointestinal (GI) symptoms (OR = 2.23, 95% CI; 1.59-3.14) were associated with H.pylori infection. The trend of H.pylori infection showed a decreasing pattern overtime from 1990 to 2017 in the meta-regression analysis. CONCLUSION The prevalence of H.pylori infection remains high; more than half of Ethiopians were infected. Although the trend of infection showed a decreasing pattern; appropriate use of eradication therapy, health education primarily to improve knowledge and awareness on the transmission dynamics of the bacteria, behavioral changes, adequate sanitation, population screening and diagnosis using multiple tests are required to reduce H.pylori infections. Recognizing the bacteria as a priority issue and designing gastric cancer screening policies are also recommended.
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Affiliation(s)
- Addisu Melese
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Chalachew Genet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Balew Zeleke
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tesfaye Andualem
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debra Tabor, Ethiopia
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11
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Genotyping and antimicrobial resistance patterns of Helicobacter pylori in human and dogs associated with A2142G and A2143G point mutations in clarithromycin resistance. Microb Pathog 2018; 123:330-338. [DOI: 10.1016/j.micpath.2018.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023]
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Bachir M, Allem R, Benejat L, Tifrit A, Medjekane M, Drici AEM, Megraud F, Douidi KT. Molecular detection of mutations involved in Helicobacter pylori antibiotic resistance in Algeria. J Antimicrob Chemother 2018; 73:2034-2038. [DOI: 10.1093/jac/dky167] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/14/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Meryem Bachir
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef, Chlef, Algeria
| | - Rachida Allem
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef, Chlef, Algeria
| | - Lucie Benejat
- French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France
| | - Abedelkarim Tifrit
- Laboratory of Molecular Microbiology, Proteomics and Health, Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University, Sidi Bel Abbes, Algeria
| | - Meriem Medjekane
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef, Chlef, Algeria
| | - Amine El-Mokhtar Drici
- Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University, Sidi Bel Abbes, Algeria
| | - Francis Megraud
- French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France
| | - Kara Turki Douidi
- Department of Gastroenterology, University Hospital of Sidi Bel Abbes, Sidi Bel Abbes, Algeria
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Jaka H, Rhee JA, Östlundh L, Smart L, Peck R, Mueller A, Kasang C, Mshana SE. The magnitude of antibiotic resistance to Helicobacter pylori in Africa and identified mutations which confer resistance to antibiotics: systematic review and meta-analysis. BMC Infect Dis 2018; 18:193. [PMID: 29699490 PMCID: PMC5921563 DOI: 10.1186/s12879-018-3099-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/17/2018] [Indexed: 12/19/2022] Open
Abstract
Background Worldwide Helicobacter pylori (H.pylori) treatment is of great challenge due to increased antibiotic resistance. The burden of H. pylori antibiotic resistance in Africa is high with unclear information regarding the real magnitude. This systematic review and meta-analysis was conducted to investigate the magnitude of H.pylori antibiotic resistance in Africa to gain insight of the extent of the problem among H.pylori naïve treatment patients. Method The search was performed in the academic databases, Embase, PubMed, Web of Science and Africa Wide Information. ProQuest Dissertation and Theses, Scopus, Ethos, Africa Index Medicus (WHO), BioMed Central Proceedings, BASE, British Library, Open grey, Library of Congress and the New York Academy of Grey Literature Report were additionally searched for grey literature. Published articles from Africa on H.pylori antibiotic resistance between 1986 and June 2017 were systematically reviewed to estimate the H. pylori extent of resistance to macrolides, quinolones, amoxicillin, tetracycline and metronidazole. Results In 26 articles a total of 2085 isolates were tested for metronidazole, 1530 for amoxicillin, 1277 for tetracycline, 1752 for clarithromycin and 823 for quinolones.The overall pooled proportion of H.pylori resistance to quinolones, clarithromycin, tetracycline, metronidazole and amoxicillin were: (17.4%, 95%CI 12.8 - 21.9), (29.2%, 95%CI:26.7-31.8), (48.7%, 95%CI: 44.5-52.9), (75.8%, 95% CI: 74.1-.77.4) and (72.6%, 95% CI: 68.6-76.6), respectively. The commonest mutation detected were A2143G (49/97) for clarithromycin, RdxA (41/56) for metronidazole and D87I (16/40) for quinolones. Conclusion Prevalence of metronidazole, clarithromycin, and amoxicillin resistance is high in developing world including Africa. This could impair the first line triple therapy of the H.pylori infection. There is a need of conducting surveillance of H.pylori susceptibility pattern in Africa for dual and triple resistance which can be used for the empirical treatment. Electronic supplementary material The online version of this article (10.1186/s12879-018-3099-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyasinta Jaka
- Gastroenterology and Hepatology Unit, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences and Bugando Hospital Mwanza, P.O. BOX 1464, Mwanza, Tanzania.
| | | | - Linda Östlundh
- National Medical Library, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Luke Smart
- Cincinnati Children's Hospital Medical Centre, Cincinnati, Ohio, USA
| | - Robert Peck
- Gastroenterology and Hepatology Unit, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences and Bugando Hospital Mwanza, P.O. BOX 1464, Mwanza, Tanzania.,Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | | | | | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Heath and Allied Sciences Mwanza, Mwanza, Tanzania
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14
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Wang YH, Li Z, Wang L, Zhu-Ge LY, Zhao RL, Wu S, Wang Y, An Y, Xie Y. A systematic review and meta-analysis of genotypic methods for detecting antibiotic resistance in Helicobacter pylori. Helicobacter 2018; 23:e12467. [PMID: 29405526 DOI: 10.1111/hel.12467] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Antibiotic susceptibility testing is essential for tailored treatments to cure Helicobacter pylori (H. pylori) infection. However, phenotypic methods have some limitations. OBJECTIVES To evaluate the feasibility of genotypic detection methods compared with phenotypic detection methods using samples taken from H. pylori-infected patients. METHODS Literature searches were conducted in the following databases (from January 2000 to November 2016): PubMed, Embase, the Cochrane Library, and Web of Science. A meta-analysis and systematic review was performed for studies that compared genotypic methods with phenotypic methods for the detection of H. pylori antibiotic susceptibility. RESULTS This meta-analysis showed that the pooled sensitivity, specificity, and diagnostic odds ratio (DOR) for the A2142G/C and/or A2143G combination for the detection of clarithromycin resistance in the strain samples were 0.97 (95% CI: 0.94-0.99), 1.00 (95% CI: 0.99-1.00), and 13 742 (95% CI: 1708-110 554), respectively. The pooled sensitivity, specificity, and DOR for the A2142G/C and/or A2143G combination for the detection of clarithromycin resistance in biopsy samples were 0.96 (95% CI: 0.90-0.99), 0.96 (95% CI: 0.91-0.99), and 722 (95% CI: 117-4443), respectively. The summarized sensitivity, specificity, and DOR value for the ability of the genotypic methods to detect quinolone resistance in biopsy specimens were 0.97 (95% CI: 0.87-0.99), 0.99 (95% CI: 0.92-1.00), and 6042 (95% CI: 486-75 143), respectively. CONCLUSION The genotypic detection methods were reliable for the diagnosis of clarithromycin and quinolone resistance in the strain and biopsy specimens. The A2142G/C and/or A2143G combination had the best sensitivity and specificity for the detection of clarithromycin resistance.
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Affiliation(s)
- You-Hua Wang
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Zhen Li
- Department of Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Le Wang
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.,Jiangxi Provincial Key Laboratory of Translational Medicine and Oncology, Jiangxi Cancer Hospital, Nanchang, Jiangxi Province, China
| | - Li-Ya Zhu-Ge
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Ru-Lin Zhao
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.,Department of Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Shuang Wu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Ya Wang
- Department of Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Ying An
- Department of Medical College, Nanchang University, Nanchang, Jiangxi Province, China
| | - Yong Xie
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
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15
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Pourakbari B, Mahmoudi S, Parhiz J, Sadeghi RH, Monajemzadeh M, Mamishi S. High frequency of metronidazole and clarithromycin-resistantHelicobacter pyloriin formalin-fixed, paraffin-embedded gastric biopsies. Br J Biomed Sci 2018; 75:61-65. [DOI: 10.1080/09674845.2017.1391466] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- B Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - S Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - J Parhiz
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - RH Sadeghi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - M Monajemzadeh
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S Mamishi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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16
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Bachir M, Allem R, Tifrit A, Medjekane M, Drici AEM, Diaf M, Douidi KT. Primary antibiotic resistance and its relationship with cagA and vacA genes in Helicobacter pylori isolates from Algerian patients. Braz J Microbiol 2018; 49:544-551. [PMID: 29452847 PMCID: PMC6066781 DOI: 10.1016/j.bjm.2017.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 11/04/2017] [Accepted: 11/27/2017] [Indexed: 01/06/2023] Open
Abstract
The epidemiology of Helicobacter pylori resistance to antibiotics is poorly documented in Africa and especially in Algeria. The aim of our study was to determine the antibiotic resistance rates, as well as its possible relationship with VacA and CagA virulence markers of isolates from Algerian patients. One hundred and fifty one H. pylori isolate were obtained between 2012 and 2015 from 200 patients with upper abdominal pain. Antimicrobial susceptibility testing was performed for amoxicillin, clarithromycin, metronidazole, ciprofloxacin, rifampicin and tetracycline. Molecular identification of H. pylori and the detection of vacA and cagA genes were performed using specific primers. We found that H. pylori was present in 83.5% of collected biopsies, 54.9% of the samples were cagA positive, 49.67% were vacA s1m1, 18.30% were vacA s1m2 and 25.49% were vacA s2m2. Isolates were characterized by no resistance to amoxicillin (0%), tetracycline (0%), rifampicin (0%), a high rate of resistance to metronidazole (61.1%) and a lower rate of resistance to clarithromycin (22.8%) and ciprofloxacin (16.8%). No statically significant relationship was found between vagA and cagA genotypes and antibiotic resistance results (p > 0.5) except for the metronidazole, which had relation with the presence of cagA genotype (p = 0.001).
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Affiliation(s)
- Meryem Bachir
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef (UHBC), Chlef, Algeria.
| | - Rachida Allem
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef (UHBC), Chlef, Algeria
| | - Abedelkarim Tifrit
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef (UHBC), Chlef, Algeria
| | - Meriem Medjekane
- Bioresources Laboratory, Department of Biology, Faculty of Natural and Life Sciences, Hassiba Ben Bouali University of Chlef (UHBC), Chlef, Algeria
| | - Amine El-Mokhtar Drici
- Laboratory of Molecular Microbiology, Proteomics and Health, Department of Biology, Faculty of Natural and Life Sciences, University of Djillali Liabes (UDL), Sidi-Bel-Abbes, Algeria
| | - Mustafa Diaf
- Laboratory of Molecular Microbiology, Proteomics and Health, Department of Biology, Faculty of Natural and Life Sciences, University of Djillali Liabes (UDL), Sidi-Bel-Abbes, Algeria
| | - Kara Turki Douidi
- Department of Gastroenterology, University Hospital Hassani Abedelkader, Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria
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17
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Bouihat N, Burucoa C, Benkirane A, Seddik H, Sentissi S, Al Bouzidi A, Elouennas M, Benouda A. Helicobacter pylori Primary Antibiotic Resistance in 2015 in Morocco: A Phenotypic and Genotypic Prospective and Multicenter Study. Microb Drug Resist 2016; 23:727-732. [PMID: 27996373 DOI: 10.1089/mdr.2016.0264] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Knowledge of local antibiotic resistance is crucial to adaption of the choice of effective empirical first-line treatment for Helicobacter pylori infection. The aim of this study was to evaluate, for the first time in Morocco, the prevalence of the primary resistance of H. pylori to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and rifamycin. We conducted a 1-year prospective study (2015), including 255 Moroccan patients referred for gastro-duodenal endoscopy to two hospitals of Rabat (Morocco) and never previously treated for H. pylori infection. Three gastric biopsies were collected: one for histology, one for culture, and one for molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin. Antimicrobial susceptibility testing was performed on isolated strains by Etest and disk diffusion methods. One hundred seventy-seven patients were infected (69.4%). The prevalence of primary resistances of H. pylori to clarithromycin was 29%, 40% to metronidazole, 0% to amoxicillin, tetracycline, and rifamycin, and 11% to levofloxacin. Only four isolates (2%) were resistant to both clarithromycin and metronidazole. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Moroccan population leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Morocco and to prefer a concomitant quadruple therapy.
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Affiliation(s)
- Najat Bouihat
- 1 Laboratoire de Microbiologie, Université Mohammed V, Hôpital Universitaire Cheick-Zaid , Faculté de Médecine de Rabat, Rabat, Morocco
| | - Christophe Burucoa
- 2 EA 4331 LITEC, Université de Poitiers , CHU de Poitiers, Laboratoire de Bactériologie-Hygiène, Poitiers, France
| | - Ahmed Benkirane
- 3 Departement de Gastroentérologie II, Hôpital Militaire d'Instruction Mohammed V , Rabat, Morocco
| | - Hassan Seddik
- 3 Departement de Gastroentérologie II, Hôpital Militaire d'Instruction Mohammed V , Rabat, Morocco
| | - Sara Sentissi
- 3 Departement de Gastroentérologie II, Hôpital Militaire d'Instruction Mohammed V , Rabat, Morocco
| | - Abderrahmane Al Bouzidi
- 4 Pôle des laboratoires, Hôpital Militaire d'Instruction Mohamed V, équipe de recherche en pathologie tumorale, Faculté de Médecine de Rabat , Rabat, Morocco
| | - Mustapha Elouennas
- 5 Laboratoire de Microbiologie, Hôpital Militaire d'Instruction Mohammed V , Rabat, Morocco
| | - Amina Benouda
- 6 Laboratoire de Microbiologie, Hôpital Universitaire Cheick-Zaid, Université Abulcasis des Sciences de la Santé , Rabat, Morocco
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18
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Tajbakhsh S, Falahi J, Motamed N, Tabib SM, Bahador A, Gharibi S. Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran. ACTA ACUST UNITED AC 2016. [DOI: 10.17795/ajcmi-36521] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Saeed Tajbakhsh
- Department of Microbiology and Parasitology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, IR Iran
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, IR Iran
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Goudarzi H, Seyedjavadi SS, Fazeli M, Azad M, Goudarzi M. Genotyping of Peroxisome Proliferator-Activated Receptor gamma in Iranian Patients with Helicobacter pylori Infection. Asian Pac J Cancer Prev 2016. [PMID: 26225656 DOI: 10.7314/apjcp.2015.16.13.5219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Helicobacter pylori (H. pylori) infection as a serious problem in both adults and children can induce chronic gastritis, peptic ulcer disease (PUD), and possibly gastric cancer. The aim of the current study was to survey antibiotic resistance and also to determine influence of PPARγ polymorphism in patients with H. pylori infection. During an 11-month-period, 98 H. pylori isolates were collected from 104 biopsy specimens. In vitro susceptibility of H. pylori isolates to 4 antimicrobial agents metronidazole, clarithromycin, amoxicillin and tetracycline were assessed by quantitative method according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guideline. PPARγ polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism assay. The frequency of H. pylori infection in our study was 94.2%. In vitro susceptibility data showed that highest level of resistance was related to metronidazole (66.3%), and the majority of H. pylori isolates were highly susceptible to amoxicillin and tetracycline (94.9% and 96.9%, respectively). Genotypic frequencies were 25.5% for CC (Pro12Pro), 40.8% for GC (Pro12Ala) and 33.7% for GG (Ala12Ala). In our study, CG genotype had highest distributions among infected patients with H. pylori. The study suggests that the PPAR-γ Pro12Ala polymorphism could be evaluated as a potential genetic marker for susceptibility to gastric cancer in the presence of H. pylori infection.
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Affiliation(s)
- Hossein Goudarzi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran E-mail :
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20
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Talebi Bezmin Abadi A. Vaccine against Helicobacter pylori: Inevitable approach. World J Gastroenterol 2016; 22:3150-3157. [PMID: 27003991 PMCID: PMC4789989 DOI: 10.3748/wjg.v22.i11.3150] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/05/2016] [Accepted: 01/30/2016] [Indexed: 02/06/2023] Open
Abstract
Over three decades have passed since the discovery of Helicobacter pylori (H. pylori), and yet many questions about its treatment remain unanswered. For example, there is no certainty regarding continued use of current antibiotic therapy against H. pylori. The bad news is that even combined regimens are also unable to eradicate bacterial colonization. The worst problem with H. pylori chemotherapy is that even if we identify the most successful regimen, it cannot eliminate the risk of re-infection. This problem is further complicated by the fact that clinicians have no information as to whether probiotics are useful or not. Moreover, to date, we have no large scale produced vaccine effective against H. pylori. Due to the relatively rapid and abundant dissemination of guidelines globally reported concerning management of gastric cancer prevention and therapeutic regimens, clinicians may choose a vaccine as better effective weapon against H. pylori. Therefore, a radical shift in adopted strategies is needed to guide ultimate decisions regarding H. pylori management. In light of failures in vaccine projects, we should identify better vaccine design targeting conserved/essential genes. The unique character and persistence of H. pylori pose obstacles to making an effective vaccine. Preferably, in developing countries, the best reasonable and logical approach is to recommend prophylactic H. pylori vaccine among children as an obligatory national program to limit primary colonization. Trying to produce a therapeutic vaccine would be postponed until later. In reality, we should not forget to prescribe narrow spectrum antibiotics. In the current review, I draw a route to define the best adopted strategy against this rogue bacterium.
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21
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Xuan SH, Wu LP, Zhou YG, Xiao MB. Detection of clarithromycin-resistant Helicobacter pylori in clinical specimens by molecular methods: A review. J Glob Antimicrob Resist 2016; 4:35-41. [PMID: 27436390 DOI: 10.1016/j.jgar.2016.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 12/17/2022] Open
Abstract
Various molecular methods have been developed to rapidly detect clarithromycin (CLR) resistance in Helicobacter pylori isolates in clinical specimens. All of these assays for detecting CLR resistance in H. pylori are based on detection of mutations in the 23S rRNA gene. In this article, we summarise current knowledge regarding the detection of H. pylori CLR resistance in clinical specimens by molecular tests. The available data showed that restriction fragment length polymorphism (RFLP), 3'-mismatch PCR, DNA sequencing, the PCR line probe assay (PCR-LiPA) and fluorescence in situ hybridisation assay (FISH) are able to detect CLR-resistant H. pylori in clinical specimens with excellent specificity and sensitivity. However, several factors limit their clinical application, including fastidious, time-consuming preparation and low-throughput as well as carrying a risk of contamination. Furthermore, as an invasive method, FISH is not suitable for children or the elderly. Among the molecular methods, one that is most promising for the future is real-time PCR probe hybridisation technology using fluorescence resonance energy transfer (FRET) probes, which can rapidly detect CLR resistance with high sensitivity and specificity in biopsies and stool specimens, even though mixed infections are present in clinical specimens. Moreover, due to the advantages that this method is simple, rapid and economical, real-time PCR is technically feasible for clinical application in small- and medium-sized hospitals in developing countries. Second, with high sensitivity, specificity and throughput, DNA chips will also be a valuable tool for detecting resistant H. pylori isolates from cultures and clinical specimens.
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Affiliation(s)
- Shi-Hai Xuan
- Department of Clinical Laboratory, The Affiliated Dongtai Hospital of Nantong University, Dongtai 224200, China
| | - Li-Pei Wu
- Department of Clinical Laboratory, The Affiliated Dongtai Hospital of Nantong University, Dongtai 224200, China
| | - Yu-Gui Zhou
- Department of Clinical Laboratory, The Affiliated Dongtai Hospital of Nantong University, Dongtai 224200, China
| | - Ming-Bing Xiao
- Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong 226001, China.
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Ben Mansour K, Fendri C, Battikh H, Garnier M, Zribi M, Jlizi A, Burucoa C. Multiple and mixed Helicobacter pylori infections: Comparison of two epidemiological situations in Tunisia and France. INFECTION GENETICS AND EVOLUTION 2016; 37:43-8. [DOI: 10.1016/j.meegid.2015.10.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/16/2015] [Accepted: 10/26/2015] [Indexed: 02/07/2023]
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Djennane-Hadibi F, Bachtarzi M, Layaida K, Ali Arous N, Nakmouche M, Saadi B, Tazir M, Ramdani-Bouguessa N, Burucoa C. High-Level Primary Clarithromycin Resistance of Helicobacter pylori in Algiers, Algeria: A Prospective Multicenter Molecular Study. Microb Drug Resist 2015; 22:223-6. [PMID: 26554340 DOI: 10.1089/mdr.2015.0209] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Knowledge of local antibiotic resistance is crucial to adaptation for the choice of the optimal first-line treatment for Helicobacter pylori infection. Clarithromycin is a key component of the standard triple therapy largely used worldwide and, more particularly, in Algeria. Clarithromycin resistance is the main risk factor for treatment failure. The aim of this study was to evaluate, for the first time in Algeria, the prevalence of the primary resistance of H. pylori to clarithromycin. We conducted a prospective study (2008-2014) that included 195 Algerian patients referred for gastroduodenal endoscopy to two University Hospitals, one General Hospital, and several private gastroenterologists in Algiers (Algeria). One gastric biopsy was collected for the molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin with a quadruplex real-time PCR using Scorpion primers. The Scorpion PCR detected H. pylori DNA in 91 biopsies (47%). A mutation conferring resistance to clarithromycin was detected in 32 of the 91 positive patients (35%) and in 29 of the 88 positive patients never previously treated for an H. pylori infection (33%). The prevalence of primary resistance of H. pylori to clarithromycin was 33% in the Algerian population being studied. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Algerian population that we report leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Algeria.
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Affiliation(s)
| | - Mohamed Bachtarzi
- 1 Laboratoire de Microbiologie Médicale, CHU Mustapha Bacha , Algiers, Algeria
| | - Karim Layaida
- 2 Service de Gastroentérologie, CHU Mustapha Bacha , Algiers, Algeria
| | | | - Mhamed Nakmouche
- 4 Service de Gastroentérologie, CHU Bab El Oued , Algiers, Algeria
| | - Berkane Saadi
- 2 Service de Gastroentérologie, CHU Mustapha Bacha , Algiers, Algeria
| | - Mohamed Tazir
- 1 Laboratoire de Microbiologie Médicale, CHU Mustapha Bacha , Algiers, Algeria
| | | | - Christophe Burucoa
- 5 EA 4331 LITEC, Université de Poitiers , CHU de Poitiers, Laboratoire de Bactériologie-Hygiène, Poitiers, France
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Boyanova L, Gergova G, Evstatiev I, Spassova Z, Kandilarov N, Yaneva P, Markovska R, Mitov I. Helicobacter pyloriresistance to six antibiotics by two breakpoint systems and resistance evolution in Bulgaria. Infect Dis (Lond) 2015; 48:56-62. [DOI: 10.3109/23744235.2015.1082035] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Ghotaslou R, Leylabadlo HE, Asl YM. Prevalence of antibiotic resistance in Helicobacter pylori: A recent literature review. World J Methodol 2015; 5:164-174. [PMID: 26413490 PMCID: PMC4572030 DOI: 10.5662/wjm.v5.i3.164] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/06/2015] [Accepted: 08/21/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To review previous studies (the last 6 years) about the Helicobacter pylori (H. pylori) antibiotic resistance in order to evaluate the trend in antibiotic resistance.
METHODS: In this study, the PubMed, MEDLINE, Science Direct, Google Scholar and Scielo manuscripts were reviewed from 2009 to 2014.
RESULTS: On the whole rates of H. pylori antibiotic resistance were 47.22% (30.5%-75.02%) for metronidazole, 19.74% (5.46%-30.8%) for clarithromycin, 18.94% (14.19%-25.28%) for levofloxacin, and 14.67% (2%-40.87%) for amoxicillin, 11.70% (0%-50%) for tetracycline, 11.5% (0%-23%) for furazolidon and 6.75% (1%-12.45%) for rifabutin. The frequency of tetracycline, metronidazole and amoxicillin resistance was higher in Africa, while clarithromycin and levofloxacin resistance was higher in North America and Asian, respectively.
CONCLUSION: The most sensitive drug is rifabutin and the lowest sensitive drug is metronidazole in the world. The worldwide H. pylori antibiotic resistance to clarithromycin and levofloxacin has increased during the last 6 years. The present systematic review show alarming results and a novel plan is needed for eradication therapy of H. pylori infections.
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Picoli SU, Mazzoleni LE, Fernández H, De Bona LR, Neuhauss E, Longo L, Prolla JC. Resistance to amoxicillin, clarithromycin and ciprofloxacin of Helicobacter pylori isolated from Southern Brazil patients. Rev Inst Med Trop Sao Paulo 2014; 56:197-200. [PMID: 24878996 PMCID: PMC4085860 DOI: 10.1590/s0036-46652014000300003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/17/2013] [Indexed: 01/14/2023] Open
Abstract
Introduction:Helicobacter pylori is a bacteria which infects half the world
population and is an important cause of gastric cancer. The eradication therapy is
not always effective because resistance to antimicrobials may occur. The aim of this
study was to determine the susceptibility profile of H. pylori to
amoxicillin, clarithromycin and ciprofloxacin in the population of Southern
Brazil. Material and methods: Fifty four samples of H. pylori
were evaluated. The antibiotics susceptibility was determined according to the
guidelines of the British Society for Antimicrobial Chemotherapy and the Comité de
l'Antibiogramme de la Société Française de Microbiologie. Results: Six (11.1%) H. pylori isolates were resistant
to clarithromycin, one (1.9%) to amoxicillin and three (5.5%) to ciprofloxacin. These
indices of resistance are considered satisfactory and show that all of these
antibiotics can be used in the empirical therapy. Conclusion: The antibiotics amoxicillin and clarithromycin are still a
good option for first line anti-H. pylori treatment in the
population of Southern Brazil.
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Affiliation(s)
| | | | - Heriberto Fernández
- Institute of Clinical Microbiology, School of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - Laura Renata De Bona
- Hospital de Clínicas de Porto Alegre, Service of Gastroenterology, Porto Alegre, RS, Brazil
| | - Erli Neuhauss
- Centro Universitário Metodista, Porto Alegre, RS, Brazil
| | - Larisse Longo
- Hospital de Clínicas de Porto Alegre, Service of Gastroenterology, Porto Alegre, RS, Brazil
| | - João Carlos Prolla
- Programa de Pós-Graduação em Gastroenterologia e Hepatologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Yue JY, Yue J, Wang MY, Song WC, Gao XZ. CagA status & genetic characterization of metronidazole resistant strains of H. pylori from: A region at high risk of gastric cancer. Pak J Med Sci 2014; 30:804-8. [PMID: 25097521 PMCID: PMC4121702 DOI: 10.12669/pjms.304.4840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/02/2014] [Accepted: 04/15/2014] [Indexed: 12/31/2022] Open
Abstract
Objective: The aim of study was to determine relationship between cagA and genetic characterization of metronidazole (MTZ) resistant H. pylori strains from a region at high risk of gastric cancer. Methods: 172 H. pylori strains were isolated from the patients with dyspeptic symptoms, and antimicrobial susceptibility testing for MTZ was assessed by E-test. rdxA and frxA genes were amplified using PCR among the MTZ resistant isolates. The status of the plasmid and classes 1~3 integrons were investigated in all isolates. Results: MTZ was detected in 88 isolates (51.16%). Variations in the rdxA gene leading to alterations of amino acids in RdxA proteins were identified in all MTZ resistant strains. FrxA contained missense alterations in 55 MTZ resistant isolates, while the premature truncation of FrxA was caused by frameshift mutations in 9 MTZ resistant strains. Plasmid was found in one MTZ sensitive strain (0.58%), and none of Class 1~3 integrases gene was detected in the studied isolates. The conservative cagA fragment was obtained from all clinical isolates of H. pylori. The sequence of cagA 3' variable region in 164 strains were obtained, including East Asian-type (122, 74.39%) and Western-type (42, 25.61%). Prevalence of Western-type cagA 3' variable region was significantly higher in MTZ resistant (33.73%, 28/83) than those of MTZ-sensitive strains (17.28%, 14/81) (p=0.02). Conclusion: A high prevalence of MTZ resistance was found in the region, and bacterial chromosome mutations in the rdxA and frxA gene still contribute to the high-level MTZ resistance. H. pylori strains characterized with West-type cagA 3’ variable region tend to acquire MTZ resistance in the region.
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Affiliation(s)
- Jin-Yong Yue
- Jin-Yong Yue, Department of Gastroenterology, Weihai Municipal Hospital affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Jing Yue
- Jing Yue, Department of Gastroenterology, Weihai Municipal Hospital affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Ming-Yi Wang
- Ming-Yi Wang, Department of Clinical Lab, Weihai Municipal Hospital affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Wen-Chong Song
- Wen-chong Song, Department of Gastroenterology, Weihai Municipal Hospital affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
| | - Xiao-Zhong Gao
- Xiao-Zhong Gao, Department of Gastroenterology, Weihai Municipal Hospital affiliated to Dalian Medical University, Weihai, Shandong, 264200, PR China
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Virulence factors and antibiotic resistance in children with Helicobacter pylori gastritis. J Pediatr Gastroenterol Nutr 2014; 58:608-12. [PMID: 24792628 DOI: 10.1097/mpg.0000000000000273] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES There are limited data regarding the pattern of Helicobacter pylori (Hp) antibiotic resistance and virulence factors in children. Evaluation of prevalence of drug resistance and virulence-factor genotype in children with Hp gastritis and to investigate whether there is any relation between drug resistance and genotype were our aims in this study. METHODS Ninety-eight children with polymerase chain reaction-positive Hp gastritis were included. Antimicrobial susceptibility was tested by disc diffusion method and polymerase chain reaction assays were used for the determination of virulence factors. RESULTS The resistance rates to clarithromycin, metronidazole, and amoxicillin were 23.5%, 11.7%, and 3.9%, respectively. All strains carried vacA genotype, and 51%, 70.4%, 49%, 34.7%, and 25.5% were cagA-, cagE-, babA2-, iceA1-, and iceA2-positive, respectively. Of those 98 specimens, 81.6%, 19.4%, 38.8%, and 63.3% carried vacAs1, vacAs2, vacAm1, and vacAm2, respectively. Dominant vacA type was s1am2 (32.7%), followed by s1am1 (14.3%) and s2m2 (12.2%). Significant rates of clarithromycin resistance were observed in cagE-, iceA1-, babA2-, and vacAs1c-positive groups. In those with metronidazole resistance, vacAs1 and vacAs1c were more common (P < 0.05). CONCLUSIONS The cagE-positive and vacA s1a/m2 genotypes, which are correlated with increased antibiotic resistance, were predominant in our population. In countries where Hp infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality.
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Prevalence of Resistance of Helicobacter pylori Strains to Selected Antibiotics in Isfahan, Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.6342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Xiong LJ, Tong Y, Wang Z, Mao M. Detection of clarithromycin-resistant Helicobacter pylori by stool PCR in children: a comprehensive review of literature. Helicobacter 2013; 18:89-101. [PMID: 23067446 DOI: 10.1111/hel.12016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Helicobacter pylori infection is acquired mainly during childhood. To eradicate H. pylori, clarithromycin-based triple therapy has been recommended in children and adults by the latest Maastricht Consensus. However, the prevalence of clarithromycin-resistant H. pylori was higher in children than that in adults. Therefore, rapid, reliable and noninvasive methods for detecting clarithromycin-resistant H. pylori strains should be developed for children. MATERIALS AND METHODS Studies on evaluating stool PCR in detecting clarithromycin-resistant H. pylori and epidemiological surveys of the prevalence of clarithromycin-resistant H. pylori in children were searched in PubMed (from 1966 to December, 2011) for reviewing. RESULTS The average rates of primary clarithromycin-resistant H. pylori ranged from less than 10% to more than 40% in different regions. The rates of secondary resistance to clarithromycin were higher than primary resistance in the same population. In H. pylori isolated from children, the frequent point mutations that are responsible for the clarithromycin resistance included A2143G, A2142G, A2142C and A2144G, and they varied geographically. Comparing with culture-based susceptibility tests, stool PCR performed excellently for their rapidity, independence of bacterial growth, reproducibility and easy standardization. However, stool PCR showed lower sensitivity but perfect specificity in detection of clarithromycin-resistant H. pylori in children. Methodology and mixed infections of resistant H. pylori strains might contribute to the considerable discrepancies of stool PCR results. CONCLUSION Detection of clarithromycin-resistant H. pylori by stool PCR for children are reliable, rapid, noninvasive methods that are worthy of further clinical promotion. However, more evaluations of stool PCR in detection of clarithromycin-resistant H. pylori in children need to be conducted.
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Affiliation(s)
- Li Jing Xiong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
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Seck A, Burucoa C, Dia D, Mbengue M, Onambele M, Raymond J, Breurec S. Primary antibiotic resistance and associated mechanisms in Helicobacter pylori isolates from Senegalese patients. Ann Clin Microbiol Antimicrob 2013; 12:3. [PMID: 23298145 PMCID: PMC3552979 DOI: 10.1186/1476-0711-12-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 01/05/2013] [Indexed: 12/13/2022] Open
Abstract
Background Antibiotic combination therapy for Helicobacter pylori eradication must be adapted to local resistance patterns, but the epidemiology of H. pylori resistance to antibiotics is poorly documented in Africa. The aim was to determine the antibiotic resistance rates, as well as the associated molecular mechanisms, of strains isolated in Dakar, Senegal. Methods One hundred and eight H. pylori strains were isolated between 2007 and 2009 from 108 patients presenting with upper abdominal pain to the Gastroenterology Department of Le Dantec Hospital. Antimicrobial susceptibility testing was performed for amoxicillin, clarithromycin, metronidazole, levofloxacin and tetracyclin using the E-test method. Mutations in the 23S rRNA gene of clarithromycin-resistant strains and in gyrA and gyrB of levofloxacin-resistant strains were investigated. Results Isolates were characterized by no resistance to amoxicillin (0%), tetracycline (0%), and very low rate of resistance to clarithromycin (1%), but a high rate of resistance to metronidazole (85%). The clarithromycin-resistant strain displayed the A2143G mutation. A worrying rate of levofloxacin resistance was detected (15%). N87I and D91N were the most common mutations in the quinolone-resistance-determining region of gyrA. Conclusions The first-line empirical regimen for H. pylori eradication in Senegal should include clarithromycin. Increasing rates of fluoroquinolone resistance detected should discourage the use of levofloxacin-containing regimens without prior antimicrobial susceptibility testing.
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Affiliation(s)
- Abdoulaye Seck
- Institut Pasteur, Unité de Biologie Médicale et Environnementale, 36 avenue pasteur, Dakar, Senegal
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Antimicrobial susceptibility and resistance patterns among Helicobacter pylori strains from The Gambia, West Africa. Antimicrob Agents Chemother 2012; 57:1231-7. [PMID: 23263004 DOI: 10.1128/aac.00517-12] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori is a globally important and genetically diverse gastric pathogen that infects most people in developing countries. Eradication efforts are complicated by antibiotic resistance, which varies in frequency geographically. There are very few data on resistance in African strains. Sixty-four Gambian H. pylori strains were tested for antibiotic susceptibility. The role of rdxA in metronidazole (Mtz) susceptibility was tested by DNA transformation and sequencing; RdxA protein variants were interpreted in terms of RdxA structure. Forty-four strains (69%) were resistant to at least 8 μg of Mtz/ml. All six strains from infants, but only 24% of strains from adults, were sensitive (P = 0.0031). Representative Mtz-resistant (Mtz(r)) strains were rendered Mtz susceptible (Mtz(s)) by transformation with a functional rdxA gene; conversely, Mtz(s) strains were rendered Mtz(r) by rdxA inactivation. Many mutations were found by Gambian H. pylori rdxA sequencing; mutations that probably inactivated rdxA in Mtz(r) strains were identified and explained using RdxA protein's structure. All of the strains were sensitive to clarithromycin and erythromycin. Amoxicillin and tetracycline resistance was rare. Sequence analysis indicated that most tetracycline resistance, when found, was not due to 16S rRNA gene mutations. These data suggest caution in the use of Mtz-based therapies in The Gambia. The increasing use of macrolides against respiratory infections in The Gambia calls for continued antibiotic susceptibility monitoring. The rich variety of rdxA mutations that we found will be useful in further structure-function studies of RdxA, the enzyme responsible for Mtz susceptibility in this important pathogen.
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Najafipour R, Farivar TN, Pahlevan AA, Johari P, Safdarian F, Asefzadeh M. Agreement rate of rapid urease test, conventional PCR, and scorpion real-time PCR in detecting helicobacter pylori from tonsillar samples of patients with chronic tonsillitis. J Glob Infect Dis 2012; 4:106-9. [PMID: 22754245 PMCID: PMC3385199 DOI: 10.4103/0974-777x.96773] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Helicobacter pylori is capable of inducing systemic inflammatory reactions through immunological processes. There are several methods to identify the presence of H. pylori in clinical samples including rapid urease test (RUT), conventional polymerase chain reaction (PCR), and the Scorpion real-time PCR. Aim: The aim of the present study is to compare the agreement rate of these tests in identifying H. pylori in tonsillar biopsy specimens collected from patients with chronic tonsillitis. Materials and Methods: A total of 103 tonsil biopsy samples from patients with clinical signs of chronic tonsillitis were examined with RUT, PCR, and Scorpion real-time PCR. The degree of agreement between the three tests was later calculated. Results: There was a poor degree of agreement between RUT and PCR and also RUT and Scorpion real-time PCR (Kappa=0.269 and 0.249, respectively). In contrast with RUT, there was a strong degree of agreement between PCR and Scorpion real-time PCR (Kappa=0.970). Conclusion: The presence of a strong agreement between the Scorpion real-time PCR and PCR as well as its technical advantage over the conventional PCR assay, made the Scorpion real-time PCR an appropriate laboratory test to investigate the presence of H. pylori in tonsillar biopsy specimens in patients suffering from chronic tonsillitis.
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Affiliation(s)
- Reza Najafipour
- Cell and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Detection of four clarithromycin resistance point mutations in Helicobacter pylori: comparison of real-time PCR and PCR-RFLP methods. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s00580-012-1519-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kargar M, Ghorbani-Dalini S, Doosti A, Souod N. Real-time PCR for Helicobacter pylori quantification and detection of clarithromycin resistance in gastric tissue from patients with gastrointestinal disorders. Res Microbiol 2012; 163:109-13. [DOI: 10.1016/j.resmic.2011.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 11/16/2011] [Indexed: 12/21/2022]
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Liu G, Xu X, He L, Ding Z, Gu Y, Zhang J, Zhou L. Primary antibiotic resistance of Helicobacter pylori isolated from Beijing children. Helicobacter 2011; 16:356-62. [PMID: 21923681 DOI: 10.1111/j.1523-5378.2011.00856.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The antimicrobials resistance of Helicobacter pylori (H. pylori) was able to sharply decline the eradication rate of H. pylori both in adults and children, but there are limited studies about the primary antibiotic resistance and the related gene mutations, specifically in China. MATERIALS AND METHODS The primary resistance to 9 antibiotics of 73 H. pylori strains isolated from gastric biopsies of children recruited at Beijing Children's Hospital was assessed, and the mutations in 23S rRNA gene of 65 macrolide-resistant strains and in gyrA and gyrB of 12 quinolone-resistant strains were investigated. RESULTS The resistance rate to clarithromycin, azithromycin, metronidazole, levofloxacin, moxifloxacin, and rifampicin was 84.9%, 87.7%, 61.6%, 13.7%, 15.1%, and 6.8%, respectively. No resistance to amoxicillin, gentamicin, and tetracycline was observed. Dual, triple, and quadruple antibacterial resistant percentage was 46.6% (34/73), 15.1% (11/73), and 2.7% (2/73), respectively. The gene mutation rate of A2142C, A2142G, and A2143G in 23S rRNA gene was 1.5% (1/65), 6.2% (4/65), and 84.6% (55/65), respectively. The detection rate of mutations of Asn87, Asp91, and Met191 in GyrA was 41.7% (5/12), 25% (3/12), and 25% (3/12), respectively. CONCLUSION The high prevalence of primary antibiotic resistance was out of expectation in H. pylori strains isolated from the children in Beijing. Antibiotic susceptibility should be made clear before the antibiotic was used in the anti-H. pylori therapy in this population. The A2143G was the most populated mutation in macrolide-resistant strains, and Asn87 and Asp91 of GyrA were the most common mutation points in quinolone resistance strains.
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Affiliation(s)
- Guodong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Abstract
This article reviewed the important publications on Helicobacter pylori research with children between April 2010 and March 2011. The most interesting studies in the last year lend further weight to the evidence for vertical transmission of H. pylori. The discovery of a potential role for jhp0562, the gene which encodes for the cell envelope protein glycosyltransferase, in the progression to peptic ulcer disease is also very interesting as it may provide a novel way to distinguish children at risk of peptic ulcer disease from those who are not, and so determine those who requires treatment to eradicate H. pylori. The rise in non-H. pylori-associated ulcers and erosions continues to be reported with no apparent risk factors for these ulcers identified to date. High levels of treatment failure continue to be reported, and there remains an urgent need for more effective treatment regimes for children.
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Affiliation(s)
- Josef Sýkora
- Department of Paediatrics, Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Pilsen, Czech Republic.
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Choli-Papadopoulou T, Kottakis F, Papadopoulos G, Pendas S. Helicobacter pylori neutrophil activating protein as target for new drugs against H. pylori inflammation. World J Gastroenterol 2011; 17:2585-91. [PMID: 21677824 PMCID: PMC3110918 DOI: 10.3748/wjg.v17.i21.2585] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 02/15/2011] [Accepted: 02/22/2011] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is among the most common human infections and the major risk factor for peptic ulcer disease and gastric cancer. Within this work we present the implication of C-terminal region of H. pylori neutrophil activating protein in the stimulation of neutrophil activation as well as the evidence that the C-terminal region of H. pylori activating protein is indispensable for neutrophil adhesion to endothelial cells, a step necessary to H. pylori inflammation. In addition we show that arabino galactan proteins derived from chios mastic gum, the natural resin of the plant Pistacia lentiscus var. Chia inhibit neutrophil activation in vitro.
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