Abstract
This study was conducted to estimate the evolution of antimicrobial susceptibilities of <i>H. pylori</i> strains isolated in Cameroon from 2014 to 2016 in relation to sociodemographic factors and clinical outcomes. A total of 278 <i>H. pylori</i> strains were isolated from patients with gastroduodenal disorders and tested for their susceptibility to nine antibiotics using the disc diffusion method. With time, a significant decreased of resistance was observed against clarithromycin (31.11 to 3.20%, p<0.0001), erythromycin (66.69 to 9.6%, p<0.0001) and metronidazole (86.67 to 69.6%, p<0.0001). Resistance to tetracycline (0 to 2.4%) and doxycycline (0 to 1.6%) slightly increase with time. Resistance to amoxicillin (95.5 to 94.4%), ciprofloxacin (4.44 to 4%) and levofloxacin (0 to 0.8%) was relatively constant. No resistance was detected against rifampicin with the time. A significant decrease of resistance was detected against metronidazole / clarithromycin (22.22 to 1.6%, p<0.0001) and amoxicillin / clarithromycin (26.67 to 3.2%, p<0.0001). Among the tested isolates, 0.92 and 2.4% elicited triple resistance to metronidazole / tetracycline / amoxicillin in 2015 and 2016, and 0.8% quadruple resistance to metronidazole / tetracycline / clarithromycin / amoxicillin in 2016. Higher resistance rate was noticed as age increase and among female compared to men. Our data showed evolution in the antimicrobial susceptibilities of <i>H pylori</i> strains circulating in our milieu with time. This finding highlights the need of monitoring periodically <i>H. pylori</i> resistance profile to antibiotics in order to determine the adapted treatment for this infection.
Highlights
Peptic ulcer disease is a major public health problem because of its high prevalence, its complications and its cost
Tripletherapy regimen consists of proton pump inhibitor and two antibiotics: amoxicillin and clarithromycin, or metronidazole and clarithromycin while quadruple therapy consists of proton pump inhibitor, bismuth and two antibiotics: amoxicillin plus clarithromycin, or metronidazole plus tetracycline [4, 5]
We evaluated the evolution of antimicrobial susceptibilities of 278 H. pylori clinical isolates from Cameroon during a 3-years period (2014 to 2016)
Summary
Peptic ulcer disease is a major public health problem because of its high prevalence, its complications and its cost. Since the discovery of Helicobacter pylori by Warren and Marshall in 1982 [1], peptic ulcer disease is mostly curable with a week's course of antibiotics and antisecretory drugs [2, 3]. Regimen used in H. pylori eradication are triple and quadruple therapy [4, 5]. Other treatments have been proposed, including metronidazole, as well as tetracycline, fluoroquinolones, and rifamycins [4, 5]. These treatments, mainly because of resistance have become less effective.
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