Antimicrobial Resistance Profile of Helicobacter pylori Clinical Isolates in Duhok City, Kurdistan Region/Iraq

Abstract

Studies have been referred to the increasing the numbers of H. pylori isolates against antibiotics in the world and account for recurrent and unresponsiveness of many cases of infections. In Iraq, particularly Kurdistan region there are no data regarding the antibiotic resistance profile of H. pylori isolated from clinical cases.The purpose of this work was to investigate the antimicrobial resistance profile of H. pylori isolates from clinical cases against clarithromycin, levofloxacin, amoxicillin, metronidazole, ciprofloxacin and tetracycline. In this study 150 antral biopsies were sampled from patients referred to the Duhokhepatology and gastroenterology center, Azadi Teaching Hospital, Duhok, Kurdistan Region, Iraq for endoscopy examination between March and May, 2014. H. pylori was isolated from 30 (20%) out of 150 patients and their antimicrobial susceptibility were checked by disc diffusion assay. All isolates were susceptible to levofloxacin but with variable resistance patterns to metronidazole, tetracycline, ciprofloxacin, clarithromycin and amoxicillin which were 53.3%, 16.6%, 13.4%, 10% and 6.7% respectively. The patterns of resistance were differed from resistance to 4 combined antimicrobial agents to 2 combined antimicrobial agents. Conclusions: A high percentage of resistance to metronidazole was detected and it should be considered when prescribing drugs to the patients by the clinicians. Periodic evaluation the antimicrobial resistance profile of H. pylori clinical isolates against commonly prescribed drugs in order to prevent generation of resistant strains and to choose the most effective therapeutic strategy in the area.