Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea

Byoungrak An, Byung Soo Moon, Heejung Kim, Hyun Chul Lim, Yong Chan Lee, Gyusang Lee, Sa Hyun Kim, Min Park, Jong Bae Kim

Research output: Contribution to journalArticle

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Abstract

Background: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. Methods: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. Results: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0% (5/71), 2.8% (2/71), 0% (0/71), 45.1% (32/71), and 26.8% (19/71), respectively, and for the 2011-2012 isolates were 16.0% (15/94), 2.1% (2/94), 0% (0/94), 56.3% (53/94), and 22.3% (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9% (12/71) in the 2009-2010 isolates to 23.4% (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8%) and failed in 4 of 7 patients (57.1%) in a clarithromycin-resistant and amoxicillin-susceptible group. Conclusions: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.

Original languageEnglish
Pages (from-to)415-419
Number of pages5
JournalAnnals of laboratory medicine
Volume33
Issue number6
DOIs
Publication statusPublished - 2013 Dec 4

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Clarithromycin
Korea
Microbial Drug Resistance
Helicobacter pylori
Amoxicillin
Anti-Bacterial Agents
Levofloxacin
Metronidazole
Tetracycline
Multiple Drug Resistance
Pharmaceutical Preparations
Dilution
Agar
Monitoring
Testing

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

An, Byoungrak ; Moon, Byung Soo ; Kim, Heejung ; Lim, Hyun Chul ; Lee, Yong Chan ; Lee, Gyusang ; Kim, Sa Hyun ; Park, Min ; Kim, Jong Bae. / Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea. In: Annals of laboratory medicine. 2013 ; Vol. 33, No. 6. pp. 415-419.
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title = "Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea",
abstract = "Background: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. Methods: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. Results: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0{\%} (5/71), 2.8{\%} (2/71), 0{\%} (0/71), 45.1{\%} (32/71), and 26.8{\%} (19/71), respectively, and for the 2011-2012 isolates were 16.0{\%} (15/94), 2.1{\%} (2/94), 0{\%} (0/94), 56.3{\%} (53/94), and 22.3{\%} (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9{\%} (12/71) in the 2009-2010 isolates to 23.4{\%} (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8{\%}) and failed in 4 of 7 patients (57.1{\%}) in a clarithromycin-resistant and amoxicillin-susceptible group. Conclusions: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.",
author = "Byoungrak An and Moon, {Byung Soo} and Heejung Kim and Lim, {Hyun Chul} and Lee, {Yong Chan} and Gyusang Lee and Kim, {Sa Hyun} and Min Park and Kim, {Jong Bae}",
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Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea. / An, Byoungrak; Moon, Byung Soo; Kim, Heejung; Lim, Hyun Chul; Lee, Yong Chan; Lee, Gyusang; Kim, Sa Hyun; Park, Min; Kim, Jong Bae.

In: Annals of laboratory medicine, Vol. 33, No. 6, 04.12.2013, p. 415-419.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Antibiotic resistance in Helicobacter pylori strains and its effect on H. pylori eradication rates in a single center in Korea

AU - An, Byoungrak

AU - Moon, Byung Soo

AU - Kim, Heejung

AU - Lim, Hyun Chul

AU - Lee, Yong Chan

AU - Lee, Gyusang

AU - Kim, Sa Hyun

AU - Park, Min

AU - Kim, Jong Bae

PY - 2013/12/4

Y1 - 2013/12/4

N2 - Background: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. Methods: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. Results: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0% (5/71), 2.8% (2/71), 0% (0/71), 45.1% (32/71), and 26.8% (19/71), respectively, and for the 2011-2012 isolates were 16.0% (15/94), 2.1% (2/94), 0% (0/94), 56.3% (53/94), and 22.3% (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9% (12/71) in the 2009-2010 isolates to 23.4% (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8%) and failed in 4 of 7 patients (57.1%) in a clarithromycin-resistant and amoxicillin-susceptible group. Conclusions: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.

AB - Background: Clarithromycin, amoxicillin, metronidazole, tetracycline, and levofloxacin have been commonly used for the eradication of Helicobacter pylori. We compared the change in antibiotic resistance of H. pylori strains during two separate periods and investigated the effect of antibiotic resistance on H. pylori eradication. Methods: H. pylori strains were isolated from 71 patients between 2009 and 2010 and from 94 patients between 2011 and 2012. The distribution of minimal inhibitory concentration (MIC) of 5 antibiotics was assessed using the agar dilution method, and H. pylori eradication based on the antimicrobial susceptibility of the isolates was investigated retrospectively. Results: Antibiotic resistance rate against clarithromycin, amoxicillin, tetracycline, metronidazole, and levofloxacin for the 2009-2010 isolates were 7.0% (5/71), 2.8% (2/71), 0% (0/71), 45.1% (32/71), and 26.8% (19/71), respectively, and for the 2011-2012 isolates were 16.0% (15/94), 2.1% (2/94), 0% (0/94), 56.3% (53/94), and 22.3% (21/94), respectively. Multi-drug resistance for 2 or more antibiotics increased slightly from 16.9% (12/71) in the 2009-2010 isolates to 23.4% (22/94) in the 2011-2012 isolates. In follow-up testing of 66 patients, first-line treatment successfully eradicated H. pylori in 50 patients (75.8%) and failed in 4 of 7 patients (57.1%) in a clarithromycin-resistant and amoxicillin-susceptible group. Conclusions: We observed an increase in resistance to clarithromycin and an overall increase in multi-drug resistance during the 2 study periods. The effectiveness of the eradication regimen was low with combinations of clarithromycin and amoxicillin, particularly in the clarithromycin-resistant group. Thus, eradication of H. pylori depends upon periodic monitoring of antimicrobial susceptibility.

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