| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Frontiers in Microbiology | ||||
| Verlag: | FRONTIERS MEDIA SA | ||||
| Ort der Veröffentlichung: | LAUSANNE | ||||
| Band: | 13 | ||||
| Datum: | 2022 | ||||
| Institutionen: | Medizin > Lehrstuhl für Innere Medizin I | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | ANTIMICROBIAL RESISTANCE; SUSCEPTIBILITY; CLARITHROMYCIN; METAANALYSIS; MULTICENTER; INFECTION; EXPOSURE; CORPUS; ANTRUM; antibiotic resistance rate; antibiotic susceptibility testing; antibiotic stewardship; updated treatment strategies; Helicobacter pylori infection; chronic atrophic gastritis; intestinal metaplasia | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 57579 |
Web of ScienceZusammenfassung
BackgroundAntibiotic susceptibility of Helicobacter pylori to antibiotics may vary among different niches of the stomach. The progression of chronic H. pylori gastritis to atrophy changes intragastric physiology that may influence selection of resistant strains. AimTo study the antibiotic resistance of H. pylori taking the severity of atrophic gastritis in antrum and corpus into account. ...
Zusammenfassung
BackgroundAntibiotic susceptibility of Helicobacter pylori to antibiotics may vary among different niches of the stomach. The progression of chronic H. pylori gastritis to atrophy changes intragastric physiology that may influence selection of resistant strains. AimTo study the antibiotic resistance of H. pylori taking the severity of atrophic gastritis in antrum and corpus into account. MethodsHelicobacter pylori-positive patients (n = 110, m = 32, mean age 52.6 +/- 13.9 years) without prior H. pylori eradication undergoing upper gastrointestinal (GI) endoscopy for dyspeptic symptoms were included in a prospective study. Patients were stratified into three groups depending on the grade of atrophy: no atrophy (OLGA Stage 0), mild atrophy (OLGA Stage I-II) and moderate/severe atrophy (OLGA Stage III-IV). Two biopsies each from the antrum and the corpus and one from the angulus were taken and assessed according to the updated Sydney system. H. pylori strains were isolated from antrum and corpus biopsies and tested for antibiotic susceptibility (AST) for amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and rifampicin by the agar dilution methods. A Chi-square test of independence with a 95% confidence interval was used to detect differences in the proportion of patients with susceptible and resistant H. pylori strains. ResultsAmong 110 patients, primary clarithromycin resistance (R) was 30.0%, both in the antrum and corpus; metronidazole resistance accounted for 36.4 and 34.5% in the antrum and corpus; and levofloxacin was 19.1 and 22.7% in the antrum and corpus, respectively. Resistance rates to amoxicillin, tetracycline, and rifampicin were below 5%. Dual antibiotic resistance rate was 21.8%, and triple resistance rate was 9.1%. There was a significant difference in the resistance rate distribution in antrum (p < 0.0001) and corpus (p < 0.0001). With increasing severity of atrophy according to OLGA stages, there was a significant increase in clarithromycin-R and metronidazole-R. ConclusionIn treatment-naive patients, antibiotic resistance and heteroresistance were related to the severity of atrophy. The high clarithromycin resistance in atrophic gastritis suggests that H. pylori antibiotic susceptibility testing should always be performed in this condition before selecting the eradication regimen.
Metadaten zuletzt geändert: 29 Feb 2024 12:58
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