Abstract
AimTo determine the minimum inhibitory concentrations (MICs) of commonly used antibiotics against Helicobacter Pylori (H. pylori) in South China and compare their resistance rates by using EUCAST breakpoints and other breakpoints.MethodsPatients who had not previously received H. pylori treatment in clinical centers in South China were enrolled in this study from 2017 to 2020. Gastric biopsies were obtained for H. pylori culture. The MICs of amoxicillin (AMX), clarithromycin (CLA), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET) and furazolidone (FZD) were tested by broth microdilution method and assessed by two different breakpoints. ATCC43504 standard strain served as a control.ResultsA total of 208 H. pylori strains were isolated from patients’ biopsy samples. The MICs of AMX, CLA, MTZ, LEV, TET and FZD for H. pylori were 0.0156-256mg/L (MIC50 0.125mg/L, MIC90 4mg/L), 0.0156- >256 mg/L (MIC50 0.0312mg/L, MIC90 64mg/L), 0.0156- >256mg/L (MIC50 8mg/L, MIC90 256mg/L), 0.0156-256mg/L (MIC50 0.25mg/L, MIC90 16mg/L), 0.0156-256mg/L (MIC50 0.0625mg/L, MIC90 4mg/L), and 0.0156- >256mg/L (MIC50 0.0312mg/L, MIC90 2mg/L), respectively. The MICs of AMX, CLA, MTZ, LEV, TET and FZD for ATCC43504 strain were 0.25mg/L, 0.0625mg/L, 64mg/L, 0.5mg/L, 1mg/L and 0.25mg/L, respectively. The resistance rate of FZD was 11.05%. The overall resistance rates according to EUCAST breakpoints and other breakpoints were 57.21% and 14.90% for AMX (p<0.001), 38.94% and 38.94% for CLA (p = 1), 39.42% and 50.96% for MTZ (p<0.001), 12.98% and 10.58% for TET (p = 0.025), 35.10% and 35.10% for LEV (p = 1), respectively.ConclusionsOur results demonstrate that AMX, FZD, and TET, but not MTZ, CLR or LEV, showed good anti-H. pylori activity in vitro in South China. When different breakpoints were used, similar results were found with CLA, and LEV, but not with AMX, MTZ, or TET.
Highlights
Helicobacter pylori (H. pylori) is a spiral-shaped, gram-negative, and microaerophilic bacterium, which colonizes the gastric epithelia and infects approximately half of the population worldwide [1]
Our results demonstrate that AMX, FZD, and TET, but not MTZ, CLR or LEV, showed good anti-H. pylori activity in vitro in South China
Eradication of H. pylori has a preventive effect on gastric cancers [7] and has been proven to be efficient in treating nearly 75% of early mucosa-associated lymphoid tissue (MALT) lymphoma [8]
Summary
Helicobacter pylori (H. pylori) is a spiral-shaped, gram-negative, and microaerophilic bacterium, which colonizes the gastric epithelia and infects approximately half of the population worldwide [1]. The infection rate of H. pylori is higher in developing countries compared to developed countries [2]. H. pylori is an important etiology of global health problems because it can cause chronic gastritis, dyspepsia, peptic ulcers, gastric malignancies, and extragastric diseases [3, 4]. Eradication of H. pylori can effectively alleviate symptoms in functional dyspepsia, heal peptic ulcers, and improve atrophic gastritis and intestinal metaplasia [5]. Since 1994, H. pylori has been identified as a class-A carcinogen by the International Agency for Research on Cancer (IARC) [6]. Eradication of H. pylori has a preventive effect on gastric cancers [7] and has been proven to be efficient in treating nearly 75% of early mucosa-associated lymphoid tissue (MALT) lymphoma [8]. Early treatment of H. pylori is recommended for all symptomatic patients [9]
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