Abstract
SIRS, The purpose of testing for nitroimidazole resistance in Helicobacter pylori is that in vitro resistance is significantly related to reduced efficacy of nitroimidazole-containing eradication regimens1234 – these data have been obtained from microaerophilic incubation of samples. Furthermore, a recent study compared the effects of microaerophilic incubation with anaerobic incubation followed by microaerophilic incubation on the assessment of metronidazole resistance in 102 isolates and found little difference in the evaluation of resistance prevalence.5 In addition, alterations in the H. pylori gene rdxA have been identified as responsible for the vast majority of metronidazole resistance.6 Failure to produce the protein product of this gene can be assessed by immunoblotting with antisera to RdxA. This was confirmed in 25 out of 27 microaerophilically cultured metronidazole-resistant isolates7 supporting the currently recommended culture condition as being able to identify correctly metronidazole resistance in H. pylori. Current methods of sensitivity testing of H. pylori have been validated in the identification of resistance. Resistance to antimicrobials is a frequent cause of eradication failure. Specific resistance profiles of individual patients' samples will aid in the selection of effective and microbiologically sound eradication regimens.
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