1887

Abstract

The aim of this study was to evaluate the primary, combined and post-treatment antibacterial resistance rates in 1205 strains from non-treated (786 adults, 282 children) and treated (109 adults, 28 children) patients in Bulgaria. Susceptibility was tested by the limited agar dilution method. Overall primary resistance rates to metronidazole, clarithromycin, amoxicillin, tetracycline and both metronidazole and clarithromycin were respectively 15·0, 12·5, 1·5, 3·4 and 4·7 % in children and 25·6, 12·6, 0·8, 5·2 and 4·9 % in adults. Primary metronidazole resistance in adults was more common than in children, but the differences for other agents tested were not significant. Primary resistance rates were in the range of those reported worldwide. There was no significant increase in primary resistance rates from 1996/1999 to 2003/2004; however, clarithromycin resistance rates exhibited a slight tendency to increase. Post-treatment resistance to amoxicillin was detected in 1·6 % of 63 strains. Post-treatment resistance to metronidazole was common (81·6 %) and that to clarithromycin was considerable (36 %). Alarming emergence of strains with triple resistance to amoxicillin, metronidazole and clarithromycin was found in two non-treated and three treated patients. The results motivate a larger and continuing surveillance of resistance in Bulgaria and worldwide.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.46208-0
2006-01-01
2024-04-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/55/1/65.html?itemId=/content/journal/jmm/10.1099/jmm.0.46208-0&mimeType=html&fmt=ahah

References

  1. Bontems P., Devaster J. M., Corvaglia L., Dezsofi A., Van Den Borre C., Goutier S., Butzler J. P., Cadranel S. 2001; Twelve year observation of primary and secondary antibiotic-resistant Helicobacter pylori strains in children. Pediatr Infect Dis J 20:1033–1038 [CrossRef]
    [Google Scholar]
  2. Cantón R., Martín de Argila C., de Rafael L., Baquero F. 2001; Antimicrobial resistance in Helicobacter pylori . Rev Med Microbiol 12:47–61 [CrossRef]
    [Google Scholar]
  3. DeLoney C. R., Schiller N. L. 2000; Characterization of an in vitro-selected amoxicillin-resistant strain of Helicobacter pylori . Antimicrob Agents Chemother 44:3368–3373 [CrossRef]
    [Google Scholar]
  4. Kalach N., Bergeret M., Benhamou P. H., Dupont C., Raymond J. 2001; High levels of resistance to metronidazole and clarithromycin in Helicobacter pylori strains in children. J Clin Microbiol 39:394–397 [CrossRef]
    [Google Scholar]
  5. Kwon D. H., Dore M. P., Kim J. J., Kato M., Lee M., Wu J. Y., Graham D. Y. 2003; High-level β -lactam resistance associated with acquired multidrug resistance in Helicobacter pylori . Antimicrob Agents Chemother 47:2169–2178 [CrossRef]
    [Google Scholar]
  6. Lopez-Brea M., Martinez M. J., Domingo D., Alarcon T. 2001; A 9 year study of clarithromycin and metronidazole resistance in Helicobacter pylori from Spanish children. J Antimicrob Chemother 48:295–297 [CrossRef]
    [Google Scholar]
  7. Megraud F. 2004; H. pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut 53:1374–1384 [CrossRef]
    [Google Scholar]
  8. Megraud F., Lehn N., Lind T. & 7 other authors; 1999; Antimicrobial susceptibility testing of Helicobacter pylori in a large multicenter trial: the MACH 2 study. Antimicrob Agents Chemother 43:2747–2752
    [Google Scholar]
  9. Meyer J. M., Silliman N. P., Wang W. & 7 other authors; 2002; Risk factors for Helicobacter pylori resistance in the United States: the surveillance of H. pylori antimicrobial resistance partnership (SHARP) study, 1993–1999. Ann Intern Med 136:13–24 [CrossRef]
    [Google Scholar]
  10. NCCLS 2000 Performance standards for antimicrobial susceptibility testing. Tenth informational supplement . Approved Standard M100-S10 (M7 Wayne, PA: NCCLS;
    [Google Scholar]
  11. Peitz U., Sulliga M., Wolle K. & 7 other authors; 2002; High rate of post-therapeutic resistance after failure of macrolide-nitroimidazole triple therapy to cure Helicobacter pylori infection: impact of two second-line therapies in a randomized study. Aliment Pharmacol Ther 16:315–324 [CrossRef]
    [Google Scholar]
  12. Watanabe K., Tanaka A., Imase K., Tokunaga K., Sugano H., Kai A., Ishida H., Itoh T., Takahashi S. 2005; Amoxicillin resistance in Helicobacter pylori : studies from Tokyo, Japan from 1985 to 2003. Helicobacter 10:4–11 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.46208-0
Loading
/content/journal/jmm/10.1099/jmm.0.46208-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error