1887

Abstract

Treatment failure with standard eradication regimes may require the use of ‘rescue’ therapies containing fluoroquinolones or rifamycins. The susceptibilities of in the UK to such antimicrobials are unknown; therefore, this study aimed to determine the frequencies and molecular markers of resistance. Ciprofloxacin and rifampicin susceptibilities were determined by Etest and/or disc diffusion for 255 isolates of , including 171 isolates from adult dyspeptic patients with refractive infections. Mutations in known resistance-determining regions of and were determined. The ciprofloxacin resistance rate was 7.5 %, and mutations, predominantly at codon position 91, were identified in most resistant isolates. One isolate (<1 %) had an unequivocal rifampicin-resistant phenotype by Etest yet had no associated mutations in the gene. As resistance rates were low in isolates, including those from patients with refractive infections, it was concluded that fluoroquinolones or rifamycins might be considered in the UK for inclusion in ‘rescue’ therapies.

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2009-10-01
2019-10-13
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References

  1. Bogaerts, P., Berhin, C., Nizet, H. & Glupczynski, Y. ( 2006; ). Prevalence and mechanisms of resistance to fluoroquinolones in Helicobacter pylori strains from patients living in Belgium. Helicobacter 11, 441–445.[CrossRef]
    [Google Scholar]
  2. Boyanova, L., Gergova, G., Knikolov, R., Davidkov, L., Kamburov, V., Jelev, C. & Mitov, I. ( 2008; ). Prevalence and evolution of Helicobacter pylori resistance to 6 antimicrobial agents over 12 years and correlation between susceptibility testing methods. Diagn Microbiol Infect Dis 60, 409–415.[CrossRef]
    [Google Scholar]
  3. Branca, G., Spanu, T., Cammarota, G., Schito, A. M., Gasparini, A., Gasparini, G. B. & Fadda, G. ( 2004; ). High levels of dual resistance to clarithromycin and metronidazole and in vitro activity of levofloxacin against Helicobacter pylori isolates from patients after failure of therapy. Int J Antimicrob Agents 24, 433–438.[CrossRef]
    [Google Scholar]
  4. Cabrita, J., Oleastro, M., Matos, R., Manhente, A., Cabral, J., Barros, R., Lopes, A. I., Ramalho, P., Neves, B. C. & Gurreiro, A. S. ( 2000; ). Features and trends in Helicobacter pylori antibiotic resistance in Lisbon area, Portugal (1990–1999). J Antimicrob Chemother 46, 1029–1031.[CrossRef]
    [Google Scholar]
  5. Carothers, J. J., Bruce, M. G., Hennessy, T. W., Bensler, M., Morris, J. M., Reasonover, A. L., Hurlburt, D. A., Parkinson, A. M., Coleman, J. M. & McMahon, B. J. ( 2007; ). The relationship between previous fluoroquinone use and levofloxacin resistance in Helicobacter pylori infection. Clin Infect Dis 44, e5–e8.[CrossRef]
    [Google Scholar]
  6. Cattoir, V., Nectoux, J., Lascols, C., Deforges, L., Delchier, J. C., Megraud, F., Soussy, C. J. & Cambau, E. ( 2007; ). Update on fluoroquinolone resistance in Helicobacter pylori: new mutations leading to resistance and first description of a gyrA polymorphism associated with hypersusceptibility. Int J Antimicrob Agents 29, 389–396.[CrossRef]
    [Google Scholar]
  7. Chisholm, S. A. & Owen, R. J. ( 2008; ). Application of polymerase chain reaction based assays for rapid identification and antibiotic resistance screening of Helicobacter pylori in gastric biopsies. Diagn Microbiol Infect Dis 61, 67–71.[CrossRef]
    [Google Scholar]
  8. Chisholm, S. A., Teare, E. L., Davies, K. & Owen, R. J. ( 2007; ). Surveillance of primary antibiotic resistance of Helicobacter pylori at centres in England (mid-Essex) and Wales (Gwynedd) over a six-year period (2000–2005). Euro Surveill 12, E3–E4.
    [Google Scholar]
  9. Dore, M. P., Leandro, G., Realdi, G., Sepulveda, A. R. & Graham, D. Y. ( 2000; ). Effect of pretreatment antibiotic resistance to metronidazole and clarithromycin on outcome of Helicobacter pylori therapy: a meta-analytical approach. Dig Dis Sci 45, 68–76.[CrossRef]
    [Google Scholar]
  10. Elviss, N. C., Owen, R. J., Xerry, J., Walker, A. M. & Davies, K. ( 2004; ). Helicobacter pylori resistance patterns and genotypes in adult dyspeptic patients from a regional population in North Wales. J Antimicrob Chemother 54, 435–440.[CrossRef]
    [Google Scholar]
  11. Elviss, N. C., Owen, R. J., Breathnach, A., Palmer, C. & Shetty, N. ( 2005; ). Helicobacter pylori antibiotic-resistance patterns and risk factors in adult dyspeptic patients from ethnically diverse populations in central and south London during 2000. J Med Microbiol 54, 567–574.[CrossRef]
    [Google Scholar]
  12. Falsafi, T., Mobasheri, F., Nariman, F. & Najafi, M. ( 2004; ). Susceptibilities to different antibiotics of Helicobacter pylori strains isolated from patients at the pediatric medical center of Tehran, Iran. J Clin Microbiol 42, 387–389.[CrossRef]
    [Google Scholar]
  13. Fujimura, S., Kato, S., Kawamura, T. & Watanabe, A. ( 2002; ). In vitro activity of rifampicin against Helicobacter pylori isolated from children and adults. J Antimicrob Chemother 49, 541–543.[CrossRef]
    [Google Scholar]
  14. Fujimura, S., Kato, S., Iinuma, K. & Watanabe, A. ( 2004; ). In vitro activity of fluoroquinolone and the gyrA gene mutation in Helicobacter pylori strains isolated from children. J Med Microbiol 53, 1019–1022.[CrossRef]
    [Google Scholar]
  15. Gisbert, J. P. & Pajares, J. M. ( 2005; ). Helicobacter pylori “rescue” therapy after failure of two eradication treatments. Helicobacter 10, 363–372.[CrossRef]
    [Google Scholar]
  16. Gisbert, J. P., Calvet, X., Bujanda, L., Marcos, S., Gisbert, J. L. & Pajares, J. M. ( 2003; ). ‘Rescue’ therapy with rifabutin after multiple Helicobacter pylori treatment failures. Helicobacter 8, 90–94.[CrossRef]
    [Google Scholar]
  17. Glocker, E. & Kist, M. ( 2004; ). Rapid detection of point mutations in the gyrA gene of Helicobacter pylori conferring resistance to ciprofloxacin by a fluorescence resonance energy transfer-based real-time PCR approach. J Clin Microbiol 42, 2241–2246.[CrossRef]
    [Google Scholar]
  18. Glocker, E., Bogdan, C. & Kist, M. ( 2007a; ). Characterization of rifampicin-resistant clinical Helicobacter pylori isolates from Germany. J Antimicrob Chemother 59, 874–879.[CrossRef]
    [Google Scholar]
  19. Glocker, E., Stueger, H. P. & Kist, M. ( 2007b; ). Quinolone resistance in Helicobacter pylori isolates in Germany. Antimicrob Agents Chemother 51, 346–349.[CrossRef]
    [Google Scholar]
  20. Go, M. F. ( 2002; ). Review article: natural history and epidemiology of Helicobacter pylori infection. Aliment Pharmacol Ther 16 (Suppl. 1), 3–15.
    [Google Scholar]
  21. Heep, M., Beck, D., Bayerdorffer, E. & Lehn, N. ( 1999; ). Rifampin and rifabutin resistance mechanism in Helicobacter pylori. Antimicrob Agents Chemother 43, 1497–1499.
    [Google Scholar]
  22. Heep, M., Kist, M., Strobel, S., Beck, D. & Lehn, N. ( 2000a; ). Secondary resistance among 554 isolates of Helicobacter pylori after failure of therapy. Eur J Clin Microbiol Infect Dis 19, 538–541.[CrossRef]
    [Google Scholar]
  23. Heep, M., Rieger, U., Beck, D. & Lehn, N. ( 2000b; ). Mutations in the beginning of the rpoB gene can induce resistance to rifamycins in both Helicobacter pylori and Mycobacterium tuberculosis. Antimicrob Agents Chemother 44, 1075–1077.[CrossRef]
    [Google Scholar]
  24. Heep, M., Lehn, N., Brandstatter, B., Rieger, U., Senzenberger, S. & Wehrl, W. ( 2002; ). Detection of rifabutin resistance and association of rpoB mutations with resistance to four rifamycin derivatives in Helicobacter pylori. Eur J Clin Microbiol Infect Dis 21, 143–145.[CrossRef]
    [Google Scholar]
  25. Jenks, P. J. ( 2002; ). Causes of failure of eradication of Helicobacter pylori. BMJ 325, 3–4.[CrossRef]
    [Google Scholar]
  26. Kim, J. M., Kim, J. S., Jung, H. C., Kim, N., Kim, Y. J. & Song, I. S. ( 2004; ). Distribution of antibiotic MICs for Helicobacter pylori strains over a 16-year period in patients from Seoul, South Korea. Antimicrob Agents Chemother 48, 4843–4847.[CrossRef]
    [Google Scholar]
  27. Kumala, W. & Rani, A. ( 2006; ). Patterns of Helicobacter pylori isolate resistance to fluoroquinolones, amoxicillin, clarithromycin and metronidazole. Southeast Asian J Trop Med Public Health 37, 970–974.
    [Google Scholar]
  28. Lee, C. C., Lee, V. W., Chan, F. K. & Ling, T. K. ( 2008; ). Levofloxacin-resistant Helicobacter pylori in Hong Kong. Chemotherapy 54, 50–53.[CrossRef]
    [Google Scholar]
  29. Malfertheiner, P., Megraud, F., O'Morain, C., Bazzoli, F., El-Omar, E., Graham, D., Hunt, R., Rokkas, T., Vakil, N. & Kuipers, E. J. ( 2007; ). Current concepts in the management of Helicobacter pylori infection: The Maastricht III Consensus Report. Gut 56, 722–781.
    [Google Scholar]
  30. Miyachi, H., Miki, I., Aoyama, N., Shirasaka, D., Matsumoto, Y., Toyoda, M., Mitani, T., Morita, Y., Tamura, T. & other authors ( 2006; ). Primary levofloxacin resistance and gyrA/B mutations among Helicobacter pylori in Japan. Helicobacter 11, 243–249.[CrossRef]
    [Google Scholar]
  31. Moore, R. A., Beckthold, B., Wong, S., Kureishi, A. & Bryan, L. E. ( 1995; ). Nucleotide sequence of the gyrA gene and characterization of ciprofloxacin-resistant mutants of Helicobacter pylori. Antimicrob Agents Chemother 39, 107–111.[CrossRef]
    [Google Scholar]
  32. Muller, A., Coenen, S., Monnet, D. L., Goossens, H. & ESAC Project Group ( 2007; ). European Surveillance of Antimicrobial Consumption (ESAC): outpatient antibiotic use in Europe, 1998–2005. Euro Surveill 12, E071011.1
    [Google Scholar]
  33. Reece, R. J. & Maxwell, A. ( 1991; ). DNA gyrase: structure and function. Crit Rev Biochem Mol Biol 26, 335–375.[CrossRef]
    [Google Scholar]
  34. Sherif, M., Mohran, Z., Fathy, H., Rockabrand, D. M., Rozmajzl, P. J. & Frenck, R. W. ( 2004; ). Universal high-level primary metronidazole resistance in Helicobacter pylori isolated from children in Egypt. J Clin Microbiol 42, 4832–4834.[CrossRef]
    [Google Scholar]
  35. Suerbaum, S. & Michetti, P. ( 2002; ). Helicobacter pylori infection. N Engl J Med 347, 1175–1186.[CrossRef]
    [Google Scholar]
  36. Tankovic, J., Lascols, C., Sculo, Q., Petit, J.-C. & Soussy, C.-J. ( 2003; ). Single and double mutations in gyrA but not in gyrB are associated with low- and high-level fluoroquinolone resistance in Helicobacter pylori. Antimicrob Agents Chemother 47, 3942–3944.[CrossRef]
    [Google Scholar]
  37. Toracchio, S., Capodicasa, S., Soraja, D. B., Cellini, L. & Marzio, L. ( 2005; ). Rifabutin based triple therapy for eradication of H. pylori primary and secondary resistant to tinidazole and clarithromycin. Dig Liver Dis 37, 33–38.[CrossRef]
    [Google Scholar]
  38. Wang, G., Wilson, T. J., Jiang, Q. & Taylor, D. E. ( 2001; ). Spontaneous mutations that confer antibiotic resistance in Helicobacter pylori. Antimicrob Agents Chemother 45, 727–733.[CrossRef]
    [Google Scholar]
  39. Zullo, A., Perna, F., Hassan, C., Ricci, C., Saracino, I., Morini, S. & Vaira, D. ( 2007; ). Primary antibiotic resistance in Helicobacter pylori strains isolated in northern and central Italy. Aliment Pharmacol Ther 25, 1429–1434.[CrossRef]
    [Google Scholar]
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