Prevalence of Helicobacter pylori and Determination of Antibiotic Resistance in Patients with Gastritis Referred to Shahid Beheshti University of Medical Sciences Hospitals in Tehran Between 2010 and 2011

Abstract

Background:: Prevalence of Helicobacter pylori (H. pylori) differs among populations worldwide. H. pylori has been correlated with gastritis, peptic ulcer and cancer. Considering the treatment failure due to antibiotic resistance, proper treatment of H. pylori infection is of great importance. Objectives:: The aim of this study was to determine the prevalence of H. pylori infection based on age, sex and also to examine antibiotic resistance among patients referred to the endoscopy department of Shahid Beheshti University of Medical Sciences hospitals in Tehran from 2010 to 2011. Patients and Methods:: In this descriptive study, biopsies were taken from 192 patients with dyspepsia who underwent endoscopic evaluation. For diagnosis of H. pylori infection and histologic assessment, samples were stained by Giemsa and hematoxylin-eosin (H & E) staining. Based on the Sydney system for classification of gastritis, extent of H. pylori infection and severity of gastritis were measured. To determine antibiotic resistance after culturing on Brucella agar medium, antibiogram test was done using modified disk diffusion method on Mueller-Hinton agar considering standard conditions. Data analysis was done by the SPSS 16.0 software, using the chi-square and T-test methods. Results:: Overall prevalence of H. pylori was 83% among all patients and 90.3% among those with gastritis (CI 95% = 85.9% - 94.6%). There was no significant correlation between the extent of H. pylori infection and age (P = 0.182) and gender (P = 0.466). Yet, there was a significant correlation between H. pylori infection and severity of gastritis (P = 0.001). Rates of resistance to metronidazole, clarithromycin, amoxicillin, ciprofloxacin and tetracycline were 50%, 16.1%, 5.2%, 4.6% and 3.6%, respectively. Conclusions:: Prevalence of H. pylori infection in our patients was similar to that of developing countries. Severity of gastritis is correlated with the extent of H. pylori infection. Moreover, the antibiotic resistance rate observed in this study signifies the ever-growing importance of further antibiotic sensitivity studies to help with proper treatment regimens against H. pylori.