EVALUATION OF HELICOBACTER PYLORI RESISTANCE TO CLARITHROMYCIN AND LEVOFLOXACIN BY EPSILOMETER TEST IN DONG NAI PROVINCE, 2013

Abstract

Background: Regimens with Clarithromycin-based and Levofloxacin-based triple were standard treatments for H.pylori eradication, but the increased prevalence of H.pylori strains resistant to Clarithromycin (CLA) and Levofloxacin (LEV) had became the main factor for treatment failure. Aims: to determine the rate of H. pylori isolates in culture and antibiogram using Epsilometer (Etest) with CLA and LEV done successfully in patients who have positive CLO test; to determine the prevalence of primary and secondary resistance of H. pylori to CLA and LEV. Materials and methods: 60 patients who presenting with gastroduodenal diseases at Thong Nhat-Dong Nai Hospital, from 11/2013 to 12/2013, with CLO test positive, were recruited to the study. H.pylori isolates were cultured with PYL medium, then antibiogram against CLA and LEV done by Epsilometer test (Etest) method with Muller Hinton Agar. Results: the rate of successful culture of H.pylori isolates was 91.7%; the mean time for H.pylori growth was 4.0±1.2 days (3-10 days), of these, 81.8% growing in 3-4 days; the successful rate of antibiograms was 89,1%; the rate of primary and secondary resistance to CLA and LEV were 64.1-100% and 29.2-100% respectively; sensitivity rate and resistance rate to both kinds of antibiotics were 20.4% and 22.4%. Conclusions: We should not choose the CLA-based and LEV-based triple therapies in treatment for patients infected with H.pylori in Dong Nai province, except when having sensitive evidence; rather, we should choose Bismuth-based quadruple therapy or use CLA with a different usage such as sequential or concomitant therapy. Key words: H.pylori, antibiotic resistance, primary culture, antibiogram