Increasing antimicrobial resistance of Helicobacter pylori infection among Saudi patients undergoing upper gastrointestinal endoscopy

Abstract

There is growing concern about <em>Helicobacter pylori</em> (<em>H. pylori</em>) resistance strains being the main agent contributing to eradication failure. In this study we evaluated the prevalence and antimicrobial susceptibility trends of <em>H. pylori</em> over a period of time. Over a period of seven years a total of 384 biopsy specimens were sent to the microbiology department and evaluated for culturing <em>H. pylori</em> and assess its susceptibility. Biopsy specimens that cultured and where bacterial susceptibility was determined were regarded as <em>H. pylori</em> positive, and specimens that failed to culture were considered <em>H. pylori</em> negative. A total of 221 patients with <em>H. pylori</em> positive were assessed and antimicrobial susceptibility was determined. The overall prevalence of <em>H. pylori</em> infections among Saudis undergoing upper gastrointestinal endoscopy, with indicated specimens, was 57.6%. Antimicrobial susceptibility was evaluated; overall clarithromycin resistance was found to be 4.5% and metronidazole resistance 52.5%. The number of clarithromycin resistant strains has increased significantly from 2.5% in 2008 to 10% in 2014 (PH. pylori infection is very common among Saudi patients with peptic ulcer disease. Resistance of <em>H. pylori</em> against clarithromycin and metronidazole has increased significantly over the seven-year period. This suggests a need to monitor the annual antimicrobial susceptibility pattern.