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Herzlinger M, Dannheim K, Riaz M, Liu E, Bousvaros A, Bonilla S. Helicobacter pylori Antimicrobial Resistance in a Pediatric Population From the New England Region of the United States. Clin Gastroenterol Hepatol 2023; 21:3458-3460.e2. [PMID: 36871769 DOI: 10.1016/j.cgh.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Michael Herzlinger
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Warren Alpert Medical School of Brown University, and Hasbro Children's Hospital, Providence, Rhode Island
| | - Katelyn Dannheim
- Division of Pathology, The Warren Alpert Medical School of Brown University, and Hasbro Children's Hospital, Providence, Rhode Island
| | - Muhammad Riaz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Oklahoma, Oklahoma City, Oklahoma
| | - Enju Liu
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts
| | - Athos Bousvaros
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts
| | - Silvana Bonilla
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts.
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Monroy FP, Brown HE, Acevedo-Solis CM, Rodriguez-Galaviz A, Dholakia R, Pauli L, Harris RB. Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study. Microorganisms 2023; 11:2290. [PMID: 37764134 PMCID: PMC10536767 DOI: 10.3390/microorganisms11092290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a common bacterial infection linked to gastric malignancies. While H. pylori infection and gastric cancer rates are decreasing, antibiotic resistance varies greatly by community. Little is known about resistance rates among rural Indigenous populations in the United States. From 2018 to 2021, 396 endoscopy patients were recruited from a Northern Arizona clinic, where community H. pylori prevalence is near 60%. Gastric biopsy samples positive for H. pylori (n = 67) were sequenced for clarithromycin- and metronidazole-associated mutations, 23S ribosomal RNA (23S), and oxygen-insensitive NADPH nitroreductase (rdxA) regions. Medical record data were extracted for endoscopic findings and prior H. pylori history. Data analysis was restricted to individuals with no history of H. pylori infection. Of 49 individuals, representing 64 samples which amplified in the 23S region, a clarithromycin-associated mutation was present in 38.8%, with T2182C being the most common mutation at 90%. While the prevalence of metronidazole-resistance-associated mutations was higher at 93.9%, the mutations were more variable, with D95N being the most common followed by L62V. No statistically significant sex differences were observed for either antibiotic. Given the risk of treatment failure with antibiotic resistance, there is a need to consider resistance profile during treatment selection. The resistance rates in this population of American Indian patients undergoing endoscopy are similar to other high-risk populations. This is concerning given the high H. pylori prevalence and low rates of resistance testing in clinical settings. The mutations reported are associated with antibiotic resistance, but clinical resistance must be confirmed.
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Affiliation(s)
- Fernando P. Monroy
- Department of Biological Sciences, College of the Environment, Forestry and Natural Sciences, Northern Arizona University, 617 South Beaver Street, Flagstaff, AZ 86011, USA
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Heidi E. Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724, USA (R.B.H.)
| | - Claudia M. Acevedo-Solis
- Department of Biological Sciences, College of the Environment, Forestry and Natural Sciences, Northern Arizona University, 617 South Beaver Street, Flagstaff, AZ 86011, USA
| | - Andres Rodriguez-Galaviz
- Department of Biological Sciences, College of the Environment, Forestry and Natural Sciences, Northern Arizona University, 617 South Beaver Street, Flagstaff, AZ 86011, USA
| | - Rishi Dholakia
- Winslow Indian Health Care Center, 500 North Indiana Avenue, Winslow, AZ 86047, USA (L.P.)
| | - Laura Pauli
- Winslow Indian Health Care Center, 500 North Indiana Avenue, Winslow, AZ 86047, USA (L.P.)
| | - Robin B. Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, Tucson, AZ 85724, USA (R.B.H.)
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Gómez-Ruiz de Arbulo M, Tamayo E, Bujanda L, Mendibil L, Mendiola J, Cilla G, Montes M. Surveillance of Helicobacter pylori resistance over 22 Years (2000-2021) in Northern Spain. J Glob Antimicrob Resist 2023; 34:127-133. [PMID: 37433393 DOI: 10.1016/j.jgar.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES Helicobacter pylori gastritis is considered an infectious disease, regardless of symptoms and stage of disease. Most consensus documents recommend empirical therapy based on local antimicrobial susceptibility patterns. We aimed to provide clinically useful information about primary and secondary antimicrobial resistance to antimicrobials commonly prescribed for H. pylori. METHODS Overall, 31,406 gastroduodenal biopsies and 2,641 string tests from patients over 15 years of age were plated on selective media, isolating H. pylori in 36.7% of biopsies and 50.7% of string tests. Susceptibility testing could be performed in 96.6% (12,399/12,835) of H. pylori isolates. Polymerase chain reaction (PCR) was also used to detect H. pylori and its resistance to clarithromycin, providing susceptibility data for 112 patients with negative culture results. RESULTS Resistance to amoxicillin and tetracycline was unusual (0.6% and 0.2%, respectively). Rates of primary resistance to clarithromycin and metronidazole remained steady over the 22-year study period, at around 14% for clarithromycin and 30% for metronidazole, while primary resistance to levofloxacin tripled (from 7.6% in 2000 to 21.7% in 2021, P < 0.001) and increased with patient age. Notably, 1.8% of isolates were multiresistant to clarithromycin, metronidazole, and levofloxacin. Overall, secondary resistance rates were higher (P < 0.0001) than primary resistance rates for clarithromycin (42.5% vs 14.1%), metronidazole (40.9% vs 32%), and levofloxacin (21.5% vs 17.1%). CONCLUSION Determination of susceptibility for H. pylori by culture and/or PCR in patients undergoing endoscopy could facilitate the implementation of tailored therapy and guide the choice of empirical therapy when susceptibility testing cannot be performed, potentially helping limit the emergence of antimicrobial resistance.
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Affiliation(s)
- Marta Gómez-Ruiz de Arbulo
- Microbiology Department, Biodonostia Health Research Institute, Donostia University Hospital, Osakidetza Basque Health Service, San Sebastián, Gipuzkoa, Spain; Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Esther Tamayo
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Luis Bujanda
- Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute, Donostia University Hospital, CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Medicine, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Leire Mendibil
- Department of Liver and Gastrointestinal Diseases, Osakidetza Basque Health Service, Debabarrena Integrated Health Organization, Mendaro, Gipuzkoa, Spain
| | - Josune Mendiola
- Microbiology Department, Osakidetza Basque Health Service, Debabarrena Integrated Health Organization, Mendaro, Gipuzkoa, Spain
| | - Gustavo Cilla
- Microbiology Department, Infectious Diseases Area, Biodonostia Health Research Institute, Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, San Sebastián, Gipuzkoa, Spain
| | - Milagrosa Montes
- Microbiology Department, Biodonostia Health Research Institute, Donostia University Hospital, Osakidetza Basque Health Service, San Sebastián, Gipuzkoa, Spain.
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Mladenova I. Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review). Antibiotics (Basel) 2023; 12:1184. [PMID: 37508280 PMCID: PMC10376713 DOI: 10.3390/antibiotics12071184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide and one of the main etiological factors of chronic gastritis, peptic ulcer disease, and stomach neoplasms. The mass application of antibiotics without testing, especially during the last years of the pandemic of SARS-CoV-2, could lead to a dramatic increase in antibiotic resistance and reduced effectiveness of eradication regimens for H. pylori infection. The epidemiology of H. pylori resistance to antibiotics still has unclear mechanisms. Antibiotic policy should be intensified to optimize treatment, and regular monitoring of resistance of H. pylori in different geographical regions should be conducted. Individualized treatment according to susceptibility testing is strongly advisable, and the best treatment regimens should be selected. The mutations in the genes encoding the antibiotic target protein are significant risk factors for H. pylori resistance. Iatrogenic errors in diagnosis and prescribing treatment for the failure of H. pylori eradication are other important risk factors. The low level of awareness and compliance with the correct treatment influence the rate of H. pylori resistance. Epidemiological surveillance of antibiotic resistance and the adoption of new treatment strategies are needed. The discovery of an efficient vaccine against H. pylori could reduce the pressure of the world's growing antibiotic resistance.
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Affiliation(s)
- Irena Mladenova
- Department of Hygiene, Epidemiology, Microbiology, Parasitology and Infectious Diseases, Medical Faculty, Trakia University, 6000 Stara Zagora, Bulgaria
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Medakina I, Tsapkova L, Polyakova V, Nikolaev S, Yanova T, Dekhnich N, Khatkov I, Bordin D, Bodunova N. Helicobacter pylori Antibiotic Resistance: Molecular Basis and Diagnostic Methods. Int J Mol Sci 2023; 24:ijms24119433. [PMID: 37298385 DOI: 10.3390/ijms24119433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/10/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Helicobacter pylori is one of the most common cause of human infections. Infected patients develop chronic active gastritis in all cases, which can lead to peptic ulcer, atrophic gastritis, gastric cancer and gastric MALT-lymphoma. The prevalence of H. pylori infection in the population has regional characteristics and can reach 80%. Constantly increasing antibiotic resistance of H. pylori is a major cause of treatment failure and a major problem. According to the VI Maastricht Consensus, two main strategies for choosing eradication therapy are recommended: individualized based on evaluating sensitivity to antibacterial drugs (phenotypic or molecular genetic method) prior to their appointment, and empirical, which takes into account data on local H. pylori resistance to clarithromycin and monitoring effectiveness schemes in the region. Therefore, the determination of H. pylori resistance to antibiotics, especially clarithromycin, prior to choosing therapeutic strategy is extremely important for the implementation of these treatment regimens.
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Affiliation(s)
- Irina Medakina
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
| | - Larisa Tsapkova
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
| | - Vera Polyakova
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
| | - Sergey Nikolaev
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
| | - Tatyana Yanova
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
| | - Natalia Dekhnich
- FSBEI HE Smolensk State Medical University of the Ministry of Health of Russia, 214019 Smolensk, Russia
| | - Igor Khatkov
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
- Department of Propaedeutic of Internal Diseases and Gastroenterology, FSBEI HE Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
| | - Dmitry Bordin
- SBHI Moscow Clinical Scientific Center, 111123 Moscow, Russia
- Department of Propaedeutic of Internal Diseases and Gastroenterology, FSBEI HE Moscow State University of Medicine and Dentistry, 127473 Moscow, Russia
- Department of General Medical Practice and Family Medicine, FSBEI HE Tver State Medical University of the Ministry of Health of Russia, 170100 Tver, Russia
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Boyanova L, Hadzhiyski P, Gergova R, Markovska R. Evolution of Helicobacter pylori Resistance to Antibiotics: A Topic of Increasing Concern. Antibiotics (Basel) 2023; 12:antibiotics12020332. [PMID: 36830243 PMCID: PMC9952372 DOI: 10.3390/antibiotics12020332] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Antibiotic resistance among Helicobacter pylori strains is the major cause of eradication failure. Resistance prevalence is dynamic and can greatly vary among countries over the years. We revealed H. pylori resistance trends for five antibiotics in 14 countries through articles predominantly published in 2018-2022, since the latest data can best show the most recent trends in resistance evolution. Amoxicillin resistance generally exhibited no evolution, yet it increased in Bulgaria, Iran, China, and Vietnam. Metronidazole resistance exhibited different trends, including an increase, a decrease and no evolution in six, three, and five studies, respectively. Clarithromycin resistance increased in Australia, Belgium, Bulgaria, Italy, Iran, and Taiwan, but remained stable in France, Spain, Russia, China, Chile, and Colombia. Tetracycline resistance was low and stable except in Iran. Levofloxacin resistance increased in four European and six other countries/regions, without significant increases in France, Spain, and Chile. In Chile, triple resistance also increased. In countries such as France and Spain, resistance to most antibiotics was stabilized, while in Bulgaria, Belgium, Iran and Taiwan, resistance to three or more agents was reported. Use of non-recommended regimens, national antibiotic consumption, patient's compliance, host factors, strain virulence, migrations, and azithromycin overuse during the COVID-19 pandemic can influence resistance evolution. New drugs, eradication regimens and diagnostic methods, such as next-generation sequencing can improve H. pylori infection control.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Zdrave str. 2, 1431 Sofia, Bulgaria
- Correspondence: ; Tel.: +359-2-91-72-730
| | - Petyo Hadzhiyski
- Specialized Hospital for Active Pediatric Treatment, Medical University of Sofia, “Acad. Ivan Evstatiev Geshov” blvd., 1606 Sofia, Bulgaria
| | - Raina Gergova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Zdrave str. 2, 1431 Sofia, Bulgaria
| | - Rumyana Markovska
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Zdrave str. 2, 1431 Sofia, Bulgaria
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Rates of Antimicrobial Resistance in Helicobacter pylori Isolates From Clinical Trial Patients Across the US and Europe. Am J Gastroenterol 2023; 118:269-275. [PMID: 36191284 PMCID: PMC9889195 DOI: 10.14309/ajg.0000000000002045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Guidelines recommend that proton pump inhibitor-based triple regimens with clarithromycin not be used for Helicobacter pylori infection in areas where clarithromycin resistance is ≥15%, or in patients with prior macrolide use. Up-to-date information on local resistance patterns is limited, especially in the US. Here, we report resistance rates to antibiotics commonly used to treat H. pylori from a large study conducted in the US and Europe (pHalcon-HP). METHODS Gastric mucosal biopsies were collected from adult participants with H. pylori infection during screening. Minimum inhibitory concentrations were determined via agar dilution for clarithromycin, amoxicillin, and metronidazole, with breakpoints ≥1 μg/mL, >0.125 μg/mL, and >8 μg/mL, respectively. Resistance rates were obtained for the US and Europe, and also for US subregions and participating European countries. RESULTS Resistance rates were established in isolates from 907 participants. Overall, 22.2% were resistant to clarithromycin, 1.2% to amoxicillin, and 69.2% to metronidazole. Resistance in the US and Europe was similar; metronidazole resistance was the most prevalent (50%-79%) and amoxicillin the least (≤5%). In all subregions, ≥15% of isolates were resistant to clarithromycin, except the UK (0/8 isolates). Among clarithromycin-resistant isolates, 75% were also metronidazole-resistant. Two US isolates were resistant to clarithromycin and amoxicillin; one of these was also metronidazole-resistant. DISCUSSION The resistance rates observed in this study argue against the continued empiric use of proton pump inhibitor-based triple therapy containing clarithromycin, per treatment guidelines, and highlight the need for antibiotic resistance surveillance and novel treatment strategies for H. pylori infection in the US and Europe.
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Sholeh M, Khoshnood S, Azimi T, Mohamadi J, Kaviar VH, Hashemian M, Karamollahi S, Sadeghifard N, Heidarizadeh H, Heidary M, Saki M. The prevalence of clarithromycin-resistant Helicobacter pylori isolates: a systematic review and meta-analysis. PeerJ 2023; 11:e15121. [PMID: 37016679 PMCID: PMC10066884 DOI: 10.7717/peerj.15121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/03/2023] [Indexed: 04/06/2023] Open
Abstract
Background Knowledge of global clarithromycin (CLA)-resistant rates of Helicobacter pylori (H. pylori) is crucial for decision of the most appropriate eradication therapies with good clinical outcomes. Therefore, this review and meta-analysis aimed to evaluate the global prevalence of the CLA resistance in H. pylori to provide some guidance for selecting the first-line antibiotics. Method A comprehensive search was performed for relevant literature until April 2021 in PubMed, Embase, and Web of Science databases. Freeman-Tukey double arcsine transformation was performed to estimate the weighted pooled prevalence of resistance. Results The meta-analysis included 248 articles. The prevalence of CLA-resistant H. pylori was 27.53% (95% CI [25.41-29.69]). The heterogeneity between reports was significant (I2 = 97.80%, P < 0.01). The resistance rate increased from 24.28% in 2010-2017 to 32.14% in 2018-2021 (P < 0.01). Iran, with 38 articles, has the most report. Nevertheless, Switzerland, Portugal, and Israel had the highest resistance rates (67.16%, 48.11%, and 46.12%, respectively). The heterogeneity between the continents and the antimicrobial susceptibility methods also interpreted standard guidelines and breakpoints was insignificant (P > 0.05). Conclusion Overall CLA resistance rate was 27.53%, worldwide. The difference in CLA resistance rate among the included studies can be due to several reasons such as differences in antibiotic prescription rates in various geographic areas, use of different breakpoints or inaccurate criteria in performed studies, and the emergence of multidrug-resistant (MDR) strains.
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Affiliation(s)
- Mohammad Sholeh
- Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
| | - Saeed Khoshnood
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Taher Azimi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jasem Mohamadi
- Department of Pediatrics, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Vahab Hassan Kaviar
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Marzieh Hashemian
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Somayeh Karamollahi
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Nourkhoda Sadeghifard
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Hedayat Heidarizadeh
- Department of Pediatrics, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohsen Heidary
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Morteza Saki
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Helicobacter pylori Antibiotic Resistance in the United States Between 2011 and 2021: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2022; 117:1221-1230. [PMID: 35509128 DOI: 10.14309/ajg.0000000000001828] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/29/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Antimicrobial resistance among Helicobacter pylori strains has been rising globally, leading to declining eradication rates. We performed a systematic review and meta-analysis of the resistance patterns of H. pylori strains in the United States between 2011 and 2021. METHODS Ovid MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for manuscripts and conference abstracts published between 2011 and 2021 reporting H. pylori antibiotic resistance. A mixed-effects model estimated pooled rates of resistance to clarithromycin, amoxicillin, metronidazole, tetracycline, rifabutin, levofloxacin, or a combination of these, with 95% confidence intervals (CIs). RESULTS A total of 19 studies including 2,660 samples, met inclusion criteria. The pooled rate of resistance to metronidazole was 42.1% (95% CI 27.3%-58.6%), levofloxacin 37.6% (95% CI 26.3%-50.4%), clarithromycin 31.5% (95% CI 23.6%-40.6%), amoxicillin 2.6% (95% CI 1.4%-5.0%), tetracycline 0.87% (95% CI 0.2%-3.8%), rifabutin 0.17% (95% CI 0.00%-10.9%), and dual clarithromycin and metronidazole 11.7% (95% CI 0.1%-94.0%). Considerable data heterogeneity was evident for pooled resistance prevalence rates (I 2 > 50%), with the exception of rifabutin resistance. DISCUSSION Metronidazole, levofloxacin, and clarithromycin resistance rates each exceed 30%; thus, choosing an empiric antibiotic regimen without knowledge of the likely pattern of antibiotic resistance is not appropriate. Resistance to tetracycline, rifabutin, and amoxicillin remains low. Given the scarcity of available data with considerable heterogeneity among studies, continued surveillance, ideally with a more systematic approach to data collection, is an increasingly important goal in H. pylori management.
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Megraud F, Bruyndonckx R, Coenen S, Wittkop L, Huang TD, Hoebeke M, Bénéjat L, Lehours P, Goossens H, Glupczynski Y. Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut 2021; 70:1815-1822. [PMID: 33837118 DOI: 10.1136/gutjnl-2021-324032] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Our aim was to prospectively assess the antibiotic resistance rates in Helicobacter pylori strains in Europe in 2018 and to study the link between antibiotic consumption in the community and H. pylori resistance levels in the different countries. DESIGN The proportion of primary antibiotic resistance cases of H. pylori and their corresponding risk factors were investigated in 24 centres from 18 European countries according to a standardised protocol. Data on antibiotic consumption in the community were collected for the period 2008-2017. The link between antibiotic consumption and resistance data was assessed using generalised linear mixed models. The model with the best fit was selected by means of the Akaike Information Criterion. RESULTS H. pylori resistance rates for the 1211 adult patients included were 21.4% for clarithromycin, 15.8% for levofloxacin and 38.9% for metronidazole and were significantly higher in Central/Western and Southern than in the Northern European countries.The best model fit was obtained for the Poisson distribution using 2013 consumption data. A significant association was found between H. pylori clarithromycin resistance and consumption in the community of macrolides (p=0.0003) and intermediate-acting macrolides (p=0.005), and between levofloxacin resistance and consumption of quinolones (p=0.0002) and second-generation quinolones (p=0.0003). CONCLUSION This study confirms the positive correlation between macrolide and quinolone consumption in the community and corresponding H. pylori resistance in European countries. Hence, H. pylori treatment with clarithromycin and levofloxacin should not be started without susceptibility testing in most European countries.
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Affiliation(s)
- Francis Megraud
- UMR BaRITOn, INSERM U1053, University of Bordeaux, Bordeaux, France .,National Reference Centre for Helicobacters, Bacteriology Laboratory, Pellegrin University Hospital, Bordeaux, France
| | - Robin Bruyndonckx
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.,Data Science Institute (DSI), Hasselt University, Hasselt, Belgium
| | - Samuel Coenen
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | | | - Te-Din Huang
- Laboratory of Clinical Microbiology and National Reference Centre for Helicobacter pylori, CHU UCL Namur, Mont-Godinne, Belgium
| | - Martin Hoebeke
- Laboratory of Clinical Microbiology and National Reference Centre for Helicobacter pylori, CHU UCL Namur, Mont-Godinne, Belgium
| | - Lucie Bénéjat
- National Reference Centre for Helicobacters, Bacteriology Laboratory, Pellegrin University Hospital, Bordeaux, France
| | - Philippe Lehours
- UMR BaRITOn, INSERM U1053, University of Bordeaux, Bordeaux, France.,National Reference Centre for Helicobacters, Bacteriology Laboratory, Pellegrin University Hospital, Bordeaux, France
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Youri Glupczynski
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium .,Laboratory of Clinical Microbiology and National Reference Centre for Helicobacter pylori, CHU UCL Namur, Mont-Godinne, Belgium
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Climate Change and Enteric Infections in the Canadian Arctic: Do We Know What’s on the Horizon? GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Canadian Arctic has a long history with diarrheal disease, including outbreaks of campylobacteriosis, giardiasis, and salmonellosis. Due to climate change, the Canadian Arctic is experiencing rapid environmental transformation, which not only threatens the livelihood of local Indigenous Peoples, but also supports the spread, frequency, and intensity of enteric pathogen outbreaks. Advances in diagnostic testing and detection have brought to attention the current burden of disease due to Cryptosporidium, Campylobacter, and Helicobacter pylori. As climate change is known to influence pathogen transmission (e.g., food and water), Arctic communities need support in developing prevention and surveillance strategies that are culturally appropriate. This review aims to provide an overview of how climate change is currently and is expected to impact enteric pathogens in the Canadian Arctic.
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Nolen LD, Bressler S, Vindigni SM, Miller K, Nash S. Gastric Cancer in Alaska Native and American Indian People Living in Alaska, 1990-2017. Clin Transl Gastroenterol 2021; 12:e00374. [PMID: 34158461 PMCID: PMC8221803 DOI: 10.14309/ctg.0000000000000374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Alaska Native (AN) people experience a high burden of gastric cancer compared with other US Native and non-Native populations. Previous reports have suggested that gastric cancer in AN people occurs at a younger age and is a more aggressive pathologic type. We evaluated all cases of gastric cancer in AN people from 1990 to 2017 and compared the epidemiologic and pathologic characteristics with the gastric cancers that occurred in the same time in the US white (USW) population. METHODS Cancer data were collected by the Alaska Native Tumor Registry and National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were performed looking at the age and sex distribution of the affected AN and USW people, as well as the cancer characteristics, including the location, stage, and pathology. RESULTS The age distribution was significantly different between AN and USW patients (P < 0.001), with a greater proportion of AN people diagnosed younger than 40 years (11% vs 3%, P < 0.0001) and 40-59 years (37% vs 20%, P < 0.0001). In addition, a greater proportion of AN people were diagnosed with distant stage cancer (AN: 48% and USW: 35%, P < 0.0001). The age-adjusted rate of gastric cancer in the AN population was significantly higher than the USW population (20.8 vs 6.7 per 100,000 persons, P < 0.0001). Although there has been a significant decrease in the gastric cancer incidence rate in the USW population, no significant change in incidence was seen in the AN population. DISCUSSION This study highlights the disproportionate burden of gastric cancer in the AN population. Further work is needed to address and understand this disparity.
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Affiliation(s)
- Leisha D. Nolen
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Sara Bressler
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA
| | - Stephen M. Vindigni
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
- University of Washington, Seattle, Washington, USA
| | - Keri Miller
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Sarah Nash
- Department of Gastroenterology, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
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13
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Cerri G, Farina M, Brundu A, Gavini E, Salis A, Dathe W. Antibacterial activity of Zn-loaded Cuban zeolite against Helicobacter pylori in comparison to its Na-loaded and unmodified counterparts. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:2037-2048. [PMID: 33244649 PMCID: PMC8081705 DOI: 10.1007/s10653-020-00781-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/10/2020] [Indexed: 05/02/2023]
Abstract
Helicobacter pylori can be found in the stomach of about half of the humans, and a large population can be associated with serious diseases. To survive in the stomach H. pylori increases the pH locally by producing ammonia which binds to H+ becoming ammonium. This work investigated the effects on the in-vitro growth of H. pylori of a natural cation-exchanger mainly composed (≈70%) of clinoptilolite and mordenite. The zeolitized material from Cuba was evaluated in its original form (M), as well as in its Na- (M-Na) and Zn-exchanged (M-Zn) counterparts. In the preliminary agar cup diffusion test, H. pylori revealed susceptibility only to M-Zn, with a direct relationship between concentration and width of inhibition halo. Further experiments evidenced that bacterium replication increases when ammonium is supplied to the growth medium and decreases when zeolites subtract NH4+ via ion exchange. Due to the multi-cationic population of its zeolites M was not effective enough in removing ammonium and, in the Minimum Inhibitory Concentration (MIC) test, allowed bacterial growth even at a concentration of 50 mg/mL. Inhibition was achieved with M-Na because it contained sodium zeolites capable of maximizing NH4+ subtraction, although the MIC was high (30 mg/mL). M-Zn evidenced a more effective inhibitory capacity, with a MIC of 4 mg/mL. Zinc has antimicrobial properties and H. pylori growth was affected by Zn2+ released from clinoptilolite and mordenite. These zeolites, being more selective towards NH4+ than Zn2+, can also subtract ammonium to the bacterium, thus enhancing the efficacy of M-Zn.
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Affiliation(s)
- Guido Cerri
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy.
| | - Mauro Farina
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy
| | - Antonio Brundu
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy
| | - Elisabetta Gavini
- Department of Chemistry and Pharmacy, Sassari University, Via Muroni 23, 07100, Sassari, Italy
| | - Andrea Salis
- Department of Chemistry and Pharmacy, Sassari University, Via Muroni 23, 07100, Sassari, Italy
| | - Wilfried Dathe
- Heck Bio-Pharma GmbH, Gerberstraße 15, 73650, Winterbach, Germany
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14
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Simkin J, Nash SH, Barchuk A, O'Brien DK, Erickson AC, Hanley B, Hannah H, Corriveau A, Larsen IK, Skovlund CW, Larønningen S, Dummer TJB, Bruce MG, Ogilvie G. Stomach Cancer Incidence and Mortality Trends among Circumpolar Nations. Cancer Epidemiol Biomarkers Prev 2021; 30:845-856. [PMID: 33627381 DOI: 10.1158/1055-9965.epi-20-1618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/14/2021] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Stomach cancer incidence and mortality rates are declining across circumpolar nations, but the burden may not be distributed equally across subpopulations, including Indigenous peoples. Our objective was to examine stomach cancer incidence and mortality trends across circumpolar populations. METHODS Cancer incidence and mortality data from 1999-2016 were obtained from the Canadian Cancer Registry, Canadian Vital Statistics, CDC WONDER, NORDCAN, Northwestern Russian cancer registries, and National Cancer Reports. The direct method was used to calculate 10-year rolling age-standardized incidence and mortality rates to the world (WHO 2000-2025) and 2011 Canadian standard populations. Standardized incidence rate ratios (SRR) were calculated. Data were stratified by sex, year, and region. U.S. data were broken down by race [White; American Indian/Alaska Native (AIAN)]. Race data were not available from non-U.S. cancer registries. RESULTS Most populations showed declining incidence and mortality rates over time. Incidence rates among Greenland males and females, Alaska AIAN males and females, and Northern Canadian both sexes were elevated compared with regional counterparts and remained stable. The largest male SRR was observed among Alaska AIAN versus Alaska Whites [SRR = 3.82; 95% confidence interval (95% CI), 2.71-5.37]. The largest female SRR was observed among Alaska AIAN versus Alaska Whites (SRR = 4.10; 95% CI, 2.62-6.43). CONCLUSIONS Despite stomach cancer incidence and mortality rates declining overall, some northern and Indigenous populations experience elevated and stable incidence and mortality rates. IMPACT There is a need to address disparities observed among circumpolar subpopulations. Given similarities in incidence, mortality, and risk factor prevalence across circumpolar regions, addressing disparities could benefit from coordinated international action.
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Affiliation(s)
- Jonathan Simkin
- Cancer Control Research, BC Cancer, British Columbia, Canada. .,School of Population and Public Health, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Sarah H Nash
- Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Anton Barchuk
- European University at Saint Petersburg, Saint Petersburg, Russia.,NN Petrov National Cancer Research Medical Center of Oncology, Saint Petersburg, Russia
| | - David K O'Brien
- Alaska Cancer Registry, Health Analytics and Vital Records Section (HAVRS), Alaska Department of Health and Social Services, Anchorage, Alaska
| | - Anders C Erickson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Brendan Hanley
- Office of the Chief Medical Officer of Health, Department of Health and Social Services, Government of Yukon, Whitehorse, Yukon Territory, Canada
| | - Heather Hannah
- Department of Health and Social Services, Government of Northwest Territories, Yellowknife, Northwest Territories, Canada
| | - Andre Corriveau
- Department of Health and Social Services, Government of Northwest Territories, Yellowknife, Northwest Territories, Canada
| | | | | | | | - Trevor J B Dummer
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, British Columbia, Canada.,Centre of Excellence in Cancer Prevention, School of Population and Public Health, University of British Columbia, British Columbia, Canada
| | - Michael G Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Gina Ogilvie
- Cancer Control Research, BC Cancer, British Columbia, Canada.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, British Columbia, Canada.,Women's Health Research Institute, BC Women's Hospital + Health Centre, Vancouver, British Columbia, Canada
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Georgopoulos S, Papastergiou V. An update on current and advancing pharmacotherapy options for the treatment of H. pylori infection. Expert Opin Pharmacother 2020; 22:729-741. [PMID: 33131337 DOI: 10.1080/14656566.2020.1845649] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Eradication of Helicobacter pylori (H. pylori) becomes more challenging due to increasing antimicrobial resistance. Consequently, the performance of clarithromycin-containing triple therapies is now declining to unacceptable levels and should be abandoned unless a prior susceptibility test precludes clarithromycin resistance.Areas covered: This review summarizes updated evidence concerning new and advancing pharmacotherapy options for H. pylori eradication.Expert opinion: Due to the declining efficacy of legacy triple therapies, most guidelines recommend bismuth quadruple therapy as the best initial empiric treatment. Concomitant, sequential and hybrid therapies are remarkable bismuth-free quadruple options, provided that dual clarithromycin-metronidazole resistance is low. Levofloxacin-, rifabutin-, furazolidone- and sitafloxacin-containing regimens remain useful, particularly as salvage options. To eradicate H. pylori in line with the rules of antibiotic stewardship, susceptibility-guided treatment appears as the ideal approach. However, the feasibility and cost-effectiveness of universal pre-treatment susceptibility testing warrants further evaluation. Molecular testing methods promise convenient characterization of H. pylori antibiotic susceptibility. High-dose dual therapy (proton-pump-inhibitor plus amoxicillin) and vonoprazan, a more potent acid inhibitor that likely enhances the activity of amoxicillin, are promising alternatives that could decrease misuse of antibiotics. Addition of certain probiotics could somewhat increase the performance of H. pylori eradication regimens, while improving tolerability.
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Affiliation(s)
- Sotirios Georgopoulos
- Department of Gastroenterology, Athens Medical P. Faliron General Hospital, Athens, Greece
| | - Vasilios Papastergiou
- Department of Gastroenterology, "Konstantopoulion-Patision" General Hospital, Athens, Greece
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16
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Bair MJ, Chuang SL, Lei WY, Chen CL, Tian HW, Chiang TH, Su WWY, Lin CC, Chung Lo YT, Jou YY, Wu CY, Chia SL, Wu MS, Chen HH, Chu CH, Lee YC, Wang YW. Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer. J Gastroenterol Hepatol 2020; 35:609-616. [PMID: 31677184 DOI: 10.1111/jgh.14898] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/22/2019] [Accepted: 10/08/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM The aim of this study is to identify gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in Indigenous communities. METHODS First, we quantified the health disparities in gastric cancer in Indigenous peoples using data from the cancer registries during the period of 2006-2014. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy. RESULTS Gastric cancer incidence (24.4 vs 12.3 per 100 000 person-years) and mortality rates (15.8 vs 6.8 per 100 000 person-years) were higher in Indigenous than in non-Indigenous, with 2.19-fold (95% confidence interval [CI]: 2.06-2.33) and 2.47-fold (2.28-2.67) increased risk, respectively. In Indigenous communities, H. pylori infection was more prevalent in Indigenous than in non-Indigenous (59.4% vs 31.5%, P < 0.01). Regression analyses consistently showed that either the mountain or plain Indigenous had 1.89-fold (95% CI: 1.34-2.66) and 1.73-fold (95% CI: 1.24-2.41) increased risk for H. pylori infection, respectively, as compared with non-Indigenous, adjusting for other baseline characteristics. The high infection rates were similarly seen in young, middle-aged, and older adults. Program eradication rates using clarithromycin-based triple therapy were suboptimal (73.7%, 95% CI: 70.0-77.4%); the habits of smoking (1.70-fold, 95% CI: 1.01-2.39) and betel nut chewing (1.54-fold, 95% CI: 0.93-2.16) were associated with the higher risk of treatment failure. CONCLUSION Gastric cancer burden is higher in Indigenous Taiwanese peoples than in their non-Indigenous counterparts. Eliminating the prevalent risk factor of H. pylori infection is a top priority to reduce this health disparity.
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Affiliation(s)
- Ming-Jong Bair
- Division of Gastroenterology, Department of Internal Medicine, Taitung Mackey Memorial Hospital, Taitung, Taiwan.,Mackay Medical College, New Taipei City, Taiwan
| | - Shu-Lin Chuang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei-Yi Lei
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien County, Taiwan
| | - Chien-Lin Chen
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien County, Taiwan
| | - Hui-Wen Tian
- Shioulin District Public Health Center, Hualien County, Taiwan
| | - Tsung-Hsien Chiang
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan
| | - William Wang-Yu Su
- Division of Otolaryngology-Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chiu-Chu Lin
- Taitung Public Health Bureau, Taitung County, Taiwan
| | - Yuan-Ting Chung Lo
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Yann-Yuh Jou
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Chien-Yuan Wu
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Shu-Li Chia
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Yi-Chia Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ying-Wei Wang
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien County, Taiwan.,Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
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17
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Miernyk KM, Bruden D, Rudolph KM, Hurlburt DA, Sacco F, McMahon BJ, Bruce MG. Presence of cagPAI genes and characterization of vacA s, i and m regions in Helicobacter pylori isolated from Alaskans and their association with clinical pathologies. J Med Microbiol 2020; 69:218-227. [PMID: 32011229 PMCID: PMC10874806 DOI: 10.1099/jmm.0.001123] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction. Gastric cancer is a health disparity in the Alaska Native people. The incidence of Helicobacter pylori infection, a risk factor for non-cardia gastric adenocarcinoma, is also high. Gastric cancer is partially associated with the virulence of the infecting strain.Aim. To genotype the vacA s, m and i and cag pathogenicity island (cagPAI) genes in H. pylori from Alaskans and investigate associations with gastropathy.Methodology. We enrolled patients with gastritis, peptic ulcer disease (PUD) and intestinal metaplasia (IM) in 1998-2005 and patients with gastric cancer in 2011-2013. Gastric biopsies were collected and cultured and PCR was performed to detect the presence of the right and left ends of the cagPAI, the cagA, cagE, cagT and virD4 genes and to genotype the vacA s, m and i regions.Results. We recruited 263 people; 22 (8 %) had no/mild gastritis, 121 (46 %) had moderate gastritis, 40 (15%) had severe gastritis, 38 (14 %) had PUD, 30 (11 %) had IM and 12 (5 %) had gastric cancer. H. pylori isolates from 150 (57%) people had an intact cagPAI; those were associated with a more severe gastropathy (P≤0.02 for all comparisons). H. pylori isolates from 77 % of people had either the vacA s1/i1/m1 (40 %; 94/234) or s2/i2/m2 (37 %; 86/234) genotype. vacA s1/i1/m1 was associated with a more severe gastropathy (P≤0.03 for all comparisons).Conclusions. In this population with high rates of gastric cancer, we found that just over half of the H. pylori contained an intact cagPAI and 40 % had the vacA s1/i1/m1 genotype. Infection with these strains was associated with a more severe gastropathy.
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Affiliation(s)
- Karen M. Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Dana Bruden
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Karen M. Rudolph
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Debby A. Hurlburt
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Frank Sacco
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Michael G. Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA
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18
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Safarov T, Kiran B, Bagirova M, Allahverdiyev AM, Abamor ES. An overview of nanotechnology-based treatment approaches against Helicobacter Pylori. Expert Rev Anti Infect Ther 2019; 17:829-840. [PMID: 31591930 DOI: 10.1080/14787210.2019.1677464] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Tural Safarov
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Bukre Kiran
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Melahat Bagirova
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Adil M Allahverdiyev
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Emrah Sefik Abamor
- Department of Bioengineering, Faculty of Chemical and Metallurgical Engineering, Yildiz Technical University, Istanbul, Turkey
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19
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O'Connor A, Liou JM, Gisbert JP, O'Morain C. Review: Treatment of Helicobacter pylori Infection 2019. Helicobacter 2019; 24 Suppl 1:e12640. [PMID: 31486235 DOI: 10.1111/hel.12640] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
This review summarizes important studies regarding Helicobacter pylori therapy published from May 2018 to May 2019. The main themes that emerge involve studies assessing the efficacy of bismuth-based regimens. While in recent years the efficacy of bismuth-based quadruple therapy as a second-line therapy has been clearly established, there is now substantial evidence that it is the best performing first-line therapy. Antibiotic resistance was again intensely studied this year, and a clear and dramatic increase in resistance is noted for clarithromycin and levofloxacin; most notably, it may not be possible to support these therapies in most regions of the world much longer without testing. The utility of vonoprazan as an alternative to proton-pump inhibitor therapy, especially in resistant and difficult to treat groups, has also been considered in greater detail this year, as well as means of supporting and enhancing adherence to therapy. Several studies showed that the diversity of gut microbiota was significantly altered shortly after H pylori eradication. However, the diversity was restored to pre-treatment state after 2 months in patients treated with triple therapy. More studies are warranted to assess the long-term changes of gut microbiota after H pylori eradication.
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Affiliation(s)
- Anthony O'Connor
- Department Of Gastroenterology, Tallaght University Hospital/Trinity College, Dublin, Ireland
| | - Jyh-Ming Liou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Javier P Gisbert
- Gastroenterology Unit, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Universitario de La Princesa, Madrid, Spain
| | - Colm O'Morain
- Department Of Gastroenterology, Tallaght University Hospital/Trinity College, Dublin, Ireland
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Affiliation(s)
- Michael G Bruce
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention (CDC), Anchorage, Alaska
| | - Karen Miernyk
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention (CDC), Anchorage, Alaska
| | - Frank Sacco
- Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Timothy Thomas
- Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Brian McMahon
- Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Tom Hennessy
- Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention (CDC), Anchorage, Alaska
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