titoli, abstracts, parole chiave >>>
High rate of levofloxacin resistance in a background of clarithromycin-and metronidazole-resistant Helicobacter pylori in Vietnam

Phan, Trung Nam and Santona, Antonella and Tran, Van Huy and Tran, Thi Nhu Hoa and An Le, Van and Cappuccinelli, Pietro Antonio and Rubino, Salvatore and Paglietti, Bianca (2015) High rate of levofloxacin resistance in a background of clarithromycin-and metronidazole-resistant Helicobacter pylori in Vietnam. International Journal of Antimicrobial Agents, Vol. 45 (3), p. 244-248. ISSN 0924-8579. eISSN 1872-7913. Article.

Full text not available from this repository.

DOI: 10.1016/j.ijantimicag.2014.10.019

Abstract

Antimicrobial resistance in Helicobacter pylori has increased worldwide and has become a major causeof treatment failure in many countries, including Vietnam. It is advisable to perform an antibiogram toprovide optimal regimens for H. pylori eradication. This study evaluated the rate of antibiotic resistance to the four commonly used antibiotics against H. pylori at a tertiary care hospital in Central Vietnam andanalysed point mutations in genes related to clarithromycin (CLA) and levofloxacin (LFX) resistance. Atotal of 92 H. pylori strains from gastric biopsy specimens were tested; 42.4% were resistant to CLA (primary, 34.2%; secondary, 73.7%), 41.3% to LFX (primary, 35.6%; secondary, 63.2%), 76.1% to metronidazole(MTZ) and 1.1% to amoxicillin. Multidrug resistance was observed in 56.5% (primary, 50.7%; secondary,78.9%) of isolates (P < 0.05). The rate of resistance to LFX was significantly higher in females than males(P < 0.05). Most of the CLA- and LFX-resistant strains harboured resistance-associated mutations, withcommon positions at A2143G and T2182C in the 23S rRNA gene and at Asn-87 or Asp-91 in GyrA. Minimum inhibitory concentrations (MICs) increased in strains carrying quadruple mutations in their23S rRNA gene and in strains with Asn-87 GyrA mutation (P < 0.05). One high-level LFX-resistant strain(MIC = 32 mg/L) had new mutations with a combination of N87A, A88N and V65I. High resistance rates toCLA, MTZ and LFX discourage standard and LFX-based triple therapies as first-line treatment in Vietnam.

Item Type:Article
ID Code:10628
Status:Published
Refereed:Yes
Uncontrolled Keywords:Helicobacter pylori, primary antibiotic, resistance, secondary antibiotic resistance, 23S rRNA gene, gyrA, mutations
Subjects:Area 06 - Scienze mediche > MED/07 Microbiologia e microbiologia clinica
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
Publisher:Elsevier
ISSN:0924-8579
eISSN:1872-7913
Deposited On:11 May 2015 11:27

I documenti depositati in UnissResearch sono protetti dalle leggi che regolano il diritto d'autore

Repository Staff Only: item control page