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Losurdo G, Mezzapesa M, Ditonno I, Piazzolla M, Pricci M, Girardi B, Celiberto F, Galeano G, Riezzo G, Russo F, Iannone A, Ierardi E, Di Leo A. Helicobacter pylori Secondary Antibiotic Resistance after One or More Eradication Failure: A Genotypic Stool Analysis Study. Antibiotics (Basel) 2024; 13:336. [PMID: 38667013 PMCID: PMC11047300 DOI: 10.3390/antibiotics13040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
Helicobacter pylori (H. pylori) antibiotic resistance is the leading cause for unsuccessful eradication therapy. After one or more failures, the chance of encountering secondary antibiotic resistance increases. The aim of this study was to characterize genotypic secondary resistance in a cohort of southern Italian H. pylori patients with at least one previous failure. Such patients collected stool samples using a dedicated kit (THD fecal testTM), and bacterial DNA was extracted and amplified using RT-PCR. Resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline was assessed using a high-resolution melting curve. We enrolled 50 patients. A total of 72% of patients failed one previous antibiotic course, 16% failed two, 10% failed three, and 2% failed four. The rate of secondary antibiotic resistance was 16% for clarithromycin, 18% for metronidazole, 14% for amoxicillin, 14% for levofloxacin, and 2% for tetracycline. Among the eight clarithromycin-resistant patients, five (62.5%) previously received a clarithromycin-based regimen. The same rate was 33.3% (3/9) for metronidazole. The only tetracycline-resistant patient had received Pylera. In conclusion, our data seem to show that, even though secondary resistance is not very high, resistance to clarithromycin could be very likely related to previous exposure to this antibiotic.
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Affiliation(s)
- Giuseppe Losurdo
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Martino Mezzapesa
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Ilaria Ditonno
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Mariapaola Piazzolla
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | | | | | - Francesca Celiberto
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
- Ph.D. Course in Organs and Tissues Transplantation and Cellular Therapies, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Grazia Galeano
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy
| | - Andrea Iannone
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Enzo Ierardi
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
| | - Alfredo Di Leo
- Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy
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Sousa C, Ferreira R, Santos SB, Azevedo NF, Melo LDR. Advances on diagnosis of Helicobacter pylori infections. Crit Rev Microbiol 2023; 49:671-692. [PMID: 36264672 DOI: 10.1080/1040841x.2022.2125287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
The association of Helicobacter pylori to several gastric diseases, such as chronic gastritis, peptic ulcer disease, and gastric cancer, and its high prevalence worldwide, raised the necessity to use methods for a proper and fast diagnosis and monitoring the pathogen eradication. Available diagnostic methods can be classified as invasive or non-invasive, and the selection of the best relies on the clinical condition of the patient, as well as on the sensitivity, specificity, and accessibility of the diagnostic test. This review summarises all diagnostic methods currently available, including the invasive methods: endoscopy, histology, culture, and molecular methods, and the rapid urease test (RUT), as well as the non-invasive methods urea breath test (UBT), serological assays, biosensors, and microfluidic devices and the stool antigen test (SAT). Moreover, it lists the diagnostic advantages and limitations, as well as the main advances for each methodology. In the end, research on the development of new diagnostic methods, such as bacteriophage-based H. pylori diagnostic tools, is also discussed.
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Affiliation(s)
- Cláudia Sousa
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS - Associate Laboratory, Braga/Guimarães, Portugal
| | - Rute Ferreira
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS - Associate Laboratory, Braga/Guimarães, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - Sílvio B Santos
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS - Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno F Azevedo
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Luís D R Melo
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS - Associate Laboratory, Braga/Guimarães, Portugal
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Sampath G, Govarthanan M, K S, N P, Rameshkumar N, Krishnan M, Nagarajan K. Isolation and identification of metronidazole resistance Helicobacter pylori from gastric patients in the southeastern region of India and its advanced antibacterial treatment using biological silver oxide nanoparticles. Biochem Eng J 2022. [DOI: 10.1016/j.bej.2022.108445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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El Shahawy MS, Shady ZM, Gaafar A. Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection. Arab J Gastroenterol 2021; 22:209-214. [PMID: 34521593 DOI: 10.1016/j.ajg.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 06/07/2021] [Accepted: 08/28/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND STUDY AIMS The successful eradication rates with standard clarithromycin-based triple therapy are declining concerning the high antibiotic resistance rate and adverse drug reactions. This study aims to evaluate the effect of adding 1,25-hydroxyvitamin D3 on the eradication rates of the standard clarithromycin-based triple therapy for Helicobacter pylori infection. PATIENTS AND METHODS This is a randomized prospective comparative study of 150 patients diagnosed with H. pylori gastritis using magnifying narrow-band imaging endoscopy and supported by a stool antigen test. Patients were divided into two groups: group A (n = 75) treated with amoxicillin, clarithromycin, and esomeprazole for 2 weeks; group B (n = 75) treated with 1,25-hydroxyvitamin D3 for 1 month plus amoxicillin, clarithromycin, and esomeprazole for 2 weeks. The H. pylori eradication rates were assessed using stool antigen test conducted 4 weeks after the end of therapy. Furthermore, the H. pylori eradication rates were assessed with per-protocol (PP) and intention-to-treat (ITT) analyses. RESULTS The current results showed that H. pylori eradication was achieved in 46 of 62 (74.19%) and 46 of 75 (61.33%) patients via PP and ITT analyses, respectively, in group A. However, eradication was achieved in 60 of 68 (88.23%) and 60 of 75 (80%) patients via PP and ITT analyses, respectively, in group B. Therefore, the H. pylori eradication rates in the group where vitamin D3 was added to the clarithromycin-based triple therapy were significantly higher than in the other groups (p = 0.012 and p = 0.029 in ITT and PP analyses, respectively). CONCLUSIONS Adding vitamin D3 to the standard clarithromycin-based triple therapy could provide an additional advantage to achieve significantly higher eradication rates for H. pylori infection.
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Affiliation(s)
- Mohamed S El Shahawy
- Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, AL-Azhar University, Cairo, Egypt.
| | - Zakarya M Shady
- Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, AL-Azhar University, Cairo, Egypt.
| | - Abdullah Gaafar
- Department of Clinical Pathology, Faculty of Medicine, AL-Azhar University, Cairo, Egypt.
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Egli K, Wagner K, Keller PM, Risch L, Risch M, Bodmer T. Comparison of the Diagnostic Performance of qPCR, Sanger Sequencing, and Whole-Genome Sequencing in Determining Clarithromycin and Levofloxacin Resistance in Helicobacter pylori. Front Cell Infect Microbiol 2020; 10:596371. [PMID: 33392106 PMCID: PMC7773895 DOI: 10.3389/fcimb.2020.596371] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/17/2020] [Indexed: 12/21/2022] Open
Abstract
Helicobacter pylori antibiotic resistance is increasing worldwide, emphasizing the urgent need for more rapid resistance detection prior to the administration of H. pylori eradication regimens. Macrolides and fluoroquinolones are widely used to treat H. pylori. In this study, we aimed to compare the diagnostic performance of A) 23SrDNA qPCR (with melting curve analysis) and an in-house developed gyrA qPCR followed by Sanger sequencing with a commercial IVD-marked hybridization probe assay (for 23SrDNA and gyrA) using 142 gastric biopsies (skipping culturing) and B) the same two qPCR for 23SrDNA and gyrA (including Sanger sequencing) with whole-genome sequencing (WGS) and phenotypic characterization of clarithromycin and levofloxacin resistance using 76 cultured isolates. The sensitivity of both qPCRs was 100% compared to that of the commercial IVD-marked hybridization probe assay for the detection of H. pylori in gastric biopsies (without resistance testing). The specificity of the qPCR gyrA followed by Sanger sequencing was 100%, indicating that the best sequence identity was always H. pylori. The results show good agreement between molecular tests, especially between qPCR (inclusive Sanger sequencing) and WGS. Discrepancies (concerning mutated or wild type of positive H. pylori gastric biopsies) were observed between Sanger sequencing of the gyrA gene and the corresponding commercial hybridization probe assay, mostly because the high sequence diversity of the gyrA gene even at positions adjacent to the relevant codons of 87 and 91 interfered with obtaining correct results from the hybridization probe assay. Interestingly, we found several mixed sequences, indicating mixed populations in the gastric biopsies (direct detection without culturing). There was a high percentage of both levofloxacin and clarithromycin resistance in gastric biopsies (both between 22% and 29%, direct detection in gastric biopsies). Therefore, we recommend analyzing both targets in parallel. We confirmed that phenotypic resistance is highly correlated with the associated mutations. We concluded that the two qPCR followed by Sanger sequencing of the gyrA gene is a fast, cost-effective and comprehensive method for resistance testing of H. pylori directly in gastric biopsies.
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Affiliation(s)
- Konrad Egli
- Labormedizinisches zentrum Dr Risch, Buchs, Switzerland
| | - Karoline Wagner
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.,Laboratory Medicine, University Hospital of Basel, Basel, Switzerland
| | - Peter M Keller
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Lorenz Risch
- Labormedizinisches zentrum Dr Risch, Buchs, Switzerland.,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Martin Risch
- Labormedizinisches zentrum Dr Risch, Buchs, Switzerland
| | - Thomas Bodmer
- Labormedizinisches zentrum Dr Risch, Buchs, Switzerland
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Pohl D, Keller PM, Bordier V, Wagner K. Review of current diagnostic methods and advances in Helicobacter pylori diagnostics in the era of next generation sequencing. World J Gastroenterol 2019; 25:4629-4660. [PMID: 31528091 PMCID: PMC6718044 DOI: 10.3748/wjg.v25.i32.4629] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/25/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is highly prevalent in the human population and may lead to severe gastrointestinal pathology including gastric and duodenal ulcers, mucosa associated tissue lymphoma and gastric adenocarcinoma. In recent years, an alarming increase in antimicrobial resistance and subsequently failing empiric H. pylori eradication therapies have been noted worldwide, also in many European countries. Therefore, rapid and accurate determination of H. pylori’s antibiotic susceptibility prior to the administration of eradication regimens becomes ever more important. Traditionally, detection of H. pylori and its antimicrobial resistance is done by culture and phenotypic drug susceptibility testing that are cumbersome with a long turn-around-time. Recent advances in diagnostics provide new tools, like real-time polymerase chain reaction (PCR) and line probe assays, to diagnose H. pylori infection and antimicrobial resistance to certain antibiotics, directly from clinical specimens. Moreover, high-throughput whole genome sequencing technologies allow the rapid analysis of the pathogen’s genome, thereby allowing identification of resistance mutations and associated antibiotic resistance. In the first part of this review, we will give an overview on currently available diagnostic methods for detection of H. pylori and its drug resistance and their implementation in H. pylori management. The second part of the review focusses on the use of next generation sequencing technology in H. pylori research. To this end, we conducted a literature search for original research articles in English using the terms “Helicobacter”, “transcriptomic”, “transcriptome”, “next generation sequencing” and “whole genome sequencing”. This review is aimed to bridge the gap between current diagnostic practice (histology, rapid urease test, H. pylori culture, PCR and line probe assays) and new sequencing technologies and their potential implementation in diagnostic laboratory settings in order to complement the currently recommended H. pylori management guidelines and subsequently improve public health.
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Affiliation(s)
- Daniel Pohl
- Division of Gastroenterology, University Hospital of Zurich, Zurich 8006, Switzerland
| | - Peter M Keller
- Institute for Infectious Diseases, University of Bern, Bern 3010, Switzerland
| | - Valentine Bordier
- Division of Gastroenterology, University Hospital of Zurich, Zurich 8006, Switzerland
| | - Karoline Wagner
- Institute of Medical Microbiology, University of Zurich, Zurich 8006, Switzerland
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7
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Tonkic A, Vukovic J, Vrebalov Cindro P, Pesutic Pisac V, Tonkic M. Diagnosis of Helicobacter pylori infection : A short review. Wien Klin Wochenschr 2018; 130:530-4. [PMID: 29959527 DOI: 10.1007/s00508-018-1356-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 06/15/2018] [Indexed: 12/21/2022]
Abstract
Helicobacter pylori infections represent an important factor in the pathogenesis of chronic gastritis, peptic ulcer, MALT lymphoma and gastric adenocarcinoma. The recently published Maastricht V/Florence consensus report indicated that the urea breath test using 13 C urea still remains the best non-invasive test to diagnose H. pylori infections with high sensitivity and specificity. Among the stool antigen tests, the ELISA monoclonal antibody test is a rational option. Effective therapy should be based only on susceptibility testing in regions with documented high clarithromycin resistance (>15%). Advanced high-resolution endoscopic technologies enable increased diagnostic accuracy for detection of H. pylori infections.
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Shaikh RU, Dawane AA, Pawar RP, Gond DS, Meshram RJ, Gacche RN. Inhibition of Helicobacter pylori
and Its Associate Urease by Labdane Diterpenoids Isolated from Andrographis paniculata. Phytother Res 2015; 30:412-7. [DOI: 10.1002/ptr.5542] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 01/26/2023]
Affiliation(s)
- Rafik U. Shaikh
- Department of Botany; Poona College; Camp Pune 411 001 MS India
| | - Ashwini A. Dawane
- School of Life Sciences; Swami Ramanand Teerth Marathwada University; Nanded 431 606 MS India
| | - Rajendra P. Pawar
- Department of Chemistry; Deogiri College; Aurangabad 431 005 MS India
| | - Dhananjay S. Gond
- Department of Microbiology; Savitribai Phule Pune University; Pune 411 007 MS India
| | - Rohan J. Meshram
- School of Life Sciences; Swami Ramanand Teerth Marathwada University; Nanded 431 606 MS India
| | - Rajesh N. Gacche
- School of Life Sciences; Swami Ramanand Teerth Marathwada University; Nanded 431 606 MS India
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9
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Gong YN, Li YM, Yang NM, Li HZ, Guo F, Lin L, Wang QY, Zhang JK, Ji ZZ, Mao JB, Mao JL, Shi ZC, Tang WH, Zhu XJ, Shao W, Zhang XF, Wang XH, Tong YF, Jiang MZ, Chen GL, Wang ZY, Tu HM, Jiang GF, Wu JS, Chen XP, Ding QL, Ouyang H, Jin FZ, Xu YL, Zhang JZ. Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences. World J Gastroenterol 2015; 21:944-952. [PMID: 25624729 PMCID: PMC4299348 DOI: 10.3748/wjg.v21.i3.944] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/11/2014] [Accepted: 09/19/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy of centralized culture and possible influencing factors.
METHODS: From January 2010 to July 2012, 66452 patients with suspected Helicobacter pylori (H. pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy. Gastric mucosal biopsies were taken from the antrum for culture. These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time: 5, 24 and 48 h. The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test. An additional 5736 biopsies from H. pylori-positive patients (5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.
RESULTS: The positive culture rate was 31.66% (21036/66452) for the patient samples and 71.72% (4114/5736) for the H. pylori-positive quality control specimens. In the 5 h transport group, the positive culture rate was 30.99% (3865/12471), and 32.84% (14960/45553) in the 24 h transport group. In contrast, the positive culture rate declined significantly in the 48 h transport group (26.25%; P < 0.001). During transportation, the average natural temperature increased from 4.67 to 29.14 °C, while the positive culture rate declined from 36.67% (1462/3987) to 24.12% (1799/7459). When the temperature exceeded 24 °C, the positive culture rate decreased significantly, especially in the 48 h transport group (23.17%).
CONCLUSION: Transportation of specimens within 24 h and below 24 °C is reasonable and acceptable for centralized culture of multicenter H. pylori samples.
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Cellini L, Di Campli E, Di Bartolomeo S, Bessa LJ, Baffoni M, Di Giulio M. New transport medium for cultural recovery of Helicobacter pylori. J Clin Microbiol. 2014;52:4325-4329. [PMID: 25320229 DOI: 10.1128/jcm.02850-14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We developed a new transport medium (GESA--Helicobacter pylori transport medium [publication no. WO/2014/019696, patent pending no. PCT/EP2013/002292; Liofilchem s.r.l., Roseto degli Abruzzi, Teramo, Italy]) for recovery of Helicobacter pylori from gastric biopsy samples. GESA transport medium, in a semisolid state, provides the optimal conditions for maintaining the viability of the microorganism over time. The efficacy of the transport medium was assessed through in vitro and ex vivo experiments. We were able to recover different suspensions of H. pylori ATCC 43629 and H. pylori 13 A in GESA transport medium stored at 4 °C for up to 10 days. In particular, with a starting inoculum of ∼ 10(5) CFU, after 7 days of storage, 150 ± 25 CFU and 40 ± 7 CFU of the reference and clinical strains were detected, respectively. H. pylori colonies were isolated from gastric specimens taken from both the antrum and the fundus in 68 (90.66%) of 75 urea breath test (UBT)-positive patients. Moreover, GESA transport medium allowed the recovery and isolation of H. pylori colonies from additional biopsy samples from 13 of the 75 detected subjects at up to 10 days of biopsy sample storage at 4 °C. Finally, GESA transport medium preserved its characteristics when stored at 4°C for 1 year from its preparation, thus allowing good recovery of H. pylori. GESA transport medium can be considered a standardized transport medium with high performance that optimizes the recovery rate of H. pylori grown by culture.
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Vega AE, Silva HJ, Cortiñas TI. Evaluation of a serum-free transport medium supplemented with cyanobacterial extract, for the optimal survival of Helicobacter pylori from biopsy samples and strains. Eur J Clin Microbiol Infect Dis 2011; 31:135-9. [PMID: 21559765 DOI: 10.1007/s10096-011-1285-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Accepted: 04/19/2011] [Indexed: 01/06/2023]
Abstract
The purpose of this work was to evaluate the use of an alternative transport medium supplemented with a cyanobacterial extract (CE), free of animal derivatives, to preserve the viability of Helicobacter pylori strains during long-term transportation and allow its recovery from biopsy samples. The transport media evaluated were Mueller-Hinton broth 0.3% agar (MH) and 0.3% of CE (MH-CE). MH broth 5% fetal calf serum (FCS) was used as the reference medium (MH-FCS). Biopsy samples from 134 patients, H. pylori NCTC 11638 and six clinical isolates were studied. A higher recovery (p ≤ 0.001) at 4°C was obtained in MH-CE than in MH-FCS after 96 h of storage. Only MH-CE allowed recovery after 120 h. The H. pylori recovery at room temperature after 96 h was higher (p ≤ 0.005) in MH-CE than in MH-FCS. Similar survival rates were observed in biopsy samples conserved in MH-CE and MH-FCS at 4°C. The recovery after 48 h at room temperature in MH-CE was higher (p ≤ 0.05) than MH-FCS and was the only medium allowing recovery after 72 h. The MH-CE medium is a simple, inexpensive and animal derivatives-free transport medium that can be used to preserve H. pylori viability and its recovery from biopsy samples.
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Affiliation(s)
- A E Vega
- Área Microbiología, Departamento de Bioquímica y Ciencias Biológicas, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, Bloque I, Primer Piso, Avda. Ejército de los Andes 950, 5700 San Luis, Argentina
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Abstract
Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Primary H. pylori susceptibility patterns, however, are becoming less predictable. Currently, high (> or =20%) clarithromycin resistance rates have been observed in the USA and in developed countries in Europe and Asia, while the highest (> or =80%) metronidazole-resistance rates have been reported in Africa, Asia and South America. Primary quinolone-resistance rates of 10% or more have already been reported in developed countries in Europe and Asia. Primary amoxicillin resistance has been low (0 to <2%) in Europe but higher (6-59%) in Africa, Asia and South America. Similarly, tetracycline resistance has been absent or low (<5%) in most countries and higher (9-27%) in Asia and South America. The increasing clarithromycin and quinolone resistance, and multidrug resistance detected in 0 to less than 5% in Europe and more often (14.2%) in Brazil are worrying. Growing resistance often parallels national antibiotic consumption and may vary within patient groups according to the geographic region, patient's age and sex, type of disease, birthplace, other infections and other factors. The geographic map and evolution of primary H. pylori resistance are clinically important, should be considered when choosing eradication regimens, and should be monitored constantly at national and global levels in an attempt to reach the recently recommended goal of eradication of more than 95%.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Zdrave street 2, 1431 Sofia, Bulgaria.
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Ndip RN, Malange Takang AE, Ojongokpoko JEA, Luma HN, Malongue A, Akoachere JFTK, Ndip LM, MacMillan M, Weaver LT. Helicobacter pylori isolates recovered from gastric biopsies of patients with gastro-duodenal pathologies in Cameroon: current status of antibiogram. Trop Med Int Health 2008; 13:848-54. [PMID: 18384477 DOI: 10.1111/j.1365-3156.2008.02062.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the prevalence of Helicobacter pylori in patients with gastro-duodenal pathologies and the susceptibility patterns of isolates to the currently recommended antibiotic treatment regimen used in Cameroon. METHODS Consecutive dyspeptic patients referred to Douala General Hospital, Cameroon for endoscopy were recruited in the study. Gastric biopsies were collected from the patients and H. pylori isolated and identified following standard microbiology and biochemical techniques. Antibiotic susceptibility was determined by disk diffusion and agar dilution methods against clarithromycin, tetracycline, amoxicillin and metronidazole. Data were analysed using chi-square test and significance considered at P < 0.05. RESULTS Seventy-one (92.2%) of the 77 patients (mean age 44.5 +/- 15.7, range 15-77 years) were positive for H. pylori. The antibiotic susceptibility rates were 56% for tetracycline, 55.3% for clarithromycin, 14.4% for amoxicillin and 6.8% for metronidazole. The prevalence of clarithromycin resistance in males vs. females was 42.1%vs. 46.7%, while for metronidazole it was 89.5%vs. 94.7% (P > 0.05). Antimicrobial susceptibility results also revealed 12 antibiotypes based on resistance to the antimicrobial agents investigated. The resistance pattern, amoxicillin and metronidazole (AMR(R) MET(R)) was the most common (23.7%) amongst the isolates. More than 60% of the isolates exhibited multi-drug resistance to three or four antibiotics. CONCLUSION Multi-drug resistance is common against the current treatment regimen in Cameroon and, therefore, calls for urgent studies involving newer and broad spectrum antibiotics to address the problem.
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Affiliation(s)
- Roland N Ndip
- Department of Biochemistry and Microbiology, Faculty of Science, University of Buea, Buea, Cameroon.
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Morosini MI, Loza E, Gutiérrez O, Almaraz F, Baquero F, Cantón R. Evaluation of 4 swab transport systems for the recovery of ATCC and clinical strains with characterized resistance mechanisms. Diagn Microbiol Infect Dis 2006; 56:19-24. [PMID: 16822635 DOI: 10.1016/j.diagmicrobio.2006.02.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Revised: 02/27/2006] [Accepted: 02/27/2006] [Indexed: 11/21/2022]
Abstract
Despite limitations of swab transport systems (STS), many clinical samples and bacterial isolates are sent on these devices. We evaluated the performance of 4 commercial STS: M40 Transystem (S1, Copan Italia, Bovezzo, Italy), UNI-TER (S2, MEUS, Piove di Sacco, Italy), Euromed (S3, LAB SERVICE, Surbo, Italy), and Eurotubo (S4, Deltalab, Rubí, Spain). Survival of ATCC and clinical strains with characterized resistance mechanisms, stored at room temperature and using the roll-plate method (NCCLS M40-A) after holding times of 0, 6, 24, 48, and 72 h, and 7 days, was assessed. After 24 h, only S1 was able to maintain Streptococcus pneumoniae (ATCC 6305), Haemophilus influenzae (10211), and Neisseria meningitidis (13090) viability with a percentage range of recovery with respect to the baseline count at zero time of 104-184%. Neisseria gonorrhoeae (43069) was uncultivable after 6 h with all STS except S1 (46% recovery). Eighteen percent recovery after 24 h and 7% after 6 h was observed for Fusobacterium nucleatum (25586) and Peptostreptococcus anaerobius (27337), respectively, but only with S1. Resistance mechanisms in clinical isolates do not affect survival with any of the STS.
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Affiliation(s)
- María-Isabel Morosini
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
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