Abstract
Background: Helicobacter pylori related-infections are common in developing countries, including Iran. However, little information is available on the antibiotic susceptibility of H. pylori in Yazd. Objectives: The aim of this study was to investigate the antibiotic resistance patterns of H. pylori isolates from gastric biopsy of patients in Yazd. Materials and method: In this descriptive-analytical study, 651 gastric biopsy specimens were taken from May 2012 to February 2013. Samples were cultured into selective Brucella agar media. After 3 to 10 days of incubation and identification of bacteria by using gram stain and biochemical tests, antibacterial susceptibility assay was performed by disk diffusion method. Results: All of 651 gastric biopsy specimens were cultured and 144 (22.12%) isolates of H. pylori were collected. In total, 76 (52.7%) of 144 H. pylori isolates were isolated from females and 68 (47.2%) from males. Rate of antibiotic resistance to metronidazole, tetracycline, clarithromycin, levofloxacin, ciprofloxacin and amoxicillin were 77.8%, 21.5%, 18.8%, 14.6%, 19.4% and 7.6%, respectively. No antibiotic resistance was found against furazolidone. There was no significant association between these isolates antibiotics resistance with sex, age and endoscopic diagnoses (P > 0.05). Conclusions: H. pylori isolates resistance was high to antibiotics, especially metronidazole. Therefore, determining resistance pattern of H. pylori isolates is recommended in all parts of the country.
Highlights
Helicobacter pylori related-infections are common in developing countries, including Iran
Antibiotic resistance of H. pylori to antibiotics varies in different geographical regions and depends on local use of antibiotics (5)
Similar to our study result, Milani (13) in Tabriz showed no significant association between metronidazole resistance and endoscopy diagnoses
Summary
Helicobacter pylori related-infections are common in developing countries, including Iran. Objectives: The aim of this study was to investigate the antibiotic resistance patterns of H. pylori isolates from gastric biopsy of patients in Yazd. Results: All of 651 gastric biopsy specimens were cultured and 144 (22.12%) isolates of H. pylori were collected. Rate of antibiotic resistance to metronidazole, tetracycline, clarithromycin, levofloxacin, ciprofloxacin and amoxicillin were 77.8%, 21.5%, 18.8%, 14.6%, 19.4% and 7.6%, respectively. H. pylori associated infections are treated with antibiotics such as metronidazole, clarithromycin, amoxicillin, tetracycline, and levofloxacin in addition to an acid secretion inhibitor drug (3). Drugs resistant to stomach acid such as metronidazole and clarithromycin with proton pump inhibitor (PPI) should be used in the treatment regimen (6). Antibiotic resistance to metronidazole, clarithromycin, tetracycline, amoxicillin and levofloxacin had been reported 26.7%, 17.2%, 5.9%, 16.2% and 11.2%, respectively until 2009 around the world. In Asia, resistance to these antibiotics had been 18.9%, 11.6%, 2.4%, 11.6% and 11.6%, respectively until 2009 (7)
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