Abstract
Antimicrobial resistance is one of the major factors determining the efficacy of Helicobacter pylori eradication therapy. This study aimed to estimate the recent prevalence of multidrug resistance of H. pylori and its impact on eradication in Korea. A total of 174 patients were prospectively enrolled at Chung-Ang University Hospital from 2017 to 2019. H. pylori strains were isolated from the gastric body and antrum. The minimum inhibitory concentrations of antibiotics were determined by the serial twofold agar dilution method. Eradication results were reviewed and analyzed in connection with antibiotic resistance. The prevalence of H. pylori infection was 51.7% (90/174). The culture success rate was 77.8% (70/90). The resistance rates for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and moxifloxacin were 28.6% (20/70), 27.1% (19/70), 20.0% (14/70), 18.6% (13/70), 42.9% (30/70), and 42.9% (30/70), respectively. The multidrug resistance (resistance to two or more classes of antimicrobials) rate was 42.9% (30/70). Dual resistance to clarithromycin and metronidazole was confirmed in 8.6% (6/70). Eradication with a first-line treatment was successful in 75% (36/48), and those who received second-line treatment all achieved successful eradication. The rate of multidrug resistance is increasing, and standard triple therapy (STT) is no longer an acceptable first-line option for H. pylori eradication in Korea.
Highlights
Helicobacter pylori is a well-known risk factor for gastric cancer as well as various other gastrointestinal diseases [1]
Our study aimed to investigate the primary antibiotic resistance patterns of H. pylori and their impact on eradication in Seoul during 2017–2019, and to provide a basis for establishing an optimal strategy for the eradication therapy
Minimum inhibitory concentration (MIC) levels were evaluated in this group of 70 patients with successful H. pylori culture
Summary
Helicobacter pylori is a well-known risk factor for gastric cancer as well as various other gastrointestinal diseases [1]. Recent guidelines have shown attempts to expand the indications for testing and treatment of H. pylori infection [5,6]. In line with these trends, the Korean government insurance system expanded its coverage for eradication therapy to include. Regionally variable, H. pylori resistance rates to some key antibiotics are increasing in most parts of the world [7]. This antimicrobial resistance is becoming a major clinical problem undermining the efficacy of eradication regimens which had shown good effects in the past
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