Abstract
Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. A high frequency of H. pylori infection has been reported from resource-poor regions. H. pylori infection is curable with regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics. H. pylori isolates from gastric biopsies from outpatients > or = 18 years old affected by a gastro-duodenal ulcer were used in this study. Susceptibility testing was performed for amoxicillin, ciprofloxacin and metronidazole by using the Epsilometer test (E-test) method. H. pylori strains were isolated from 40 patients of whom 36 were diagnosed as having duodenal ulcer, two with gastric ulcer, and two with gastro-duodenal ulcer. Thirty-six (90%) of the isolates were resistant to metronidazole (MICs > or = 8 microg/l), whereas all isolates were susceptible to amoxicillin (MICs < or = 0.5 microg/ml) and ciprofloxacin (MICs < or = 1 microg/ml). These data suggest that metronidazole should not be used therapeutically among Senegalese patients in first-line therapy, while ciprofloxacin could be recommended in association with amoxicillin and a proton pump inhibitor in Senegal.
Highlights
The frequency of H. pylori infection is rising worldwide [1]
In this study, MICs of three antibiotics were determined for H. pylori isolates from Senegal
The study showed that all isolates were susceptible to amoxicillin and ciprofloxacin, whereas the metronidazole resistance rate was high (90% of the isolates)
Summary
The frequency of H. pylori infection is rising worldwide [1]. The problem is more acute in the resource-poor regions, in Africa [2]. The hospital prevalence rate of H. pylori infection in Senegal is as high as 82% [3]. The successful treatment for eradication of H. pylori infection requires a proton pump inhibitor (PPI) and a combination of two or more antibiotics, depending on the susceptibility of isolates to antibiotics [6]. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics, even considering that the resistance rates should be high [7]. A high frequency of H. pylori infection has been reported from resource-poor regions. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics. Conclusion: These data suggest that metronidazole should not be used therapeutically among Senegalese patients in first-line therapy, while ciprofloxacin could be recommended in association with amoxicillin and a proton pump inhibitor in Senegal
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