TY - JOUR
T1 - Helicobacter pylori primary and secondary genotypic resistance to clarithromycin and levofloxacin detection in stools
T2 - A 4-year scenario in Southern Italy
AU - Losurdo, Giuseppe
AU - Giorgio, Floriana
AU - Pricci, Maria
AU - Girardi, Bruna
AU - Russo, Francesco
AU - Riezzo, Giuseppe
AU - Martulli, Manuela
AU - Piazzolla, Mariano
AU - Cocomazzi, Francesco
AU - Abbruzzi, Francesco
AU - Parente, Elisabetta
AU - Paolillo, Rosa
AU - Mileti, Alessia
AU - Iannone, Andrea
AU - Principi, Mariabeatrice
AU - Ierardi, Enzo
AU - Di Leo, Alfredo
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/10
Y1 - 2020/10
N2 - Antibiotic resistance has become an emerging problem for treating Helicobacter pylori (H. pylori) infection. Clarithromycin and levofloxacin are two key antibiotics used for its eradication. Therefore, we reviewed our experience with genotypic resistance analysis in stools to both clarithromycin and levofloxacin in the last four years to evaluate time trends, both in naive and failure patients. Patients collected a fecal sample using the THD fecal test device. Real-time polymerase chain reaction was performed to detect point mutations conferring resistance to clarithromycin (A2142C, A2142G, and A2143G in 23S rRNA) and levofloxacin (substitutions at amino acid position 87 and 91 of gyrA). One hundred and thirty-five naive patients were recruited between 2017-2020. Clarithromycin resistance was detected in 37 (27.4%). The time trend did not show any significant variation from 2017 to 2020 (p = 0.33). Primary levofloxacin resistance was found in 26 subjects (19.2%), and we observed a dramatic increase in rates from 2017 (10%) to 2018 (3.3%), 2019 (20%), and 2020 (37.8%). Ninety-one patients with at least one eradication failure were recruited. Secondary resistance to clarithromycin and levofloxacin was found in 59 (64.8%) and 45 patients (59.3%), respectively. In conclusion, our geographic area has a high risk of resistance to clarithromycin. There is also a progressive spreading of levofloxacin-resistant strains.
AB - Antibiotic resistance has become an emerging problem for treating Helicobacter pylori (H. pylori) infection. Clarithromycin and levofloxacin are two key antibiotics used for its eradication. Therefore, we reviewed our experience with genotypic resistance analysis in stools to both clarithromycin and levofloxacin in the last four years to evaluate time trends, both in naive and failure patients. Patients collected a fecal sample using the THD fecal test device. Real-time polymerase chain reaction was performed to detect point mutations conferring resistance to clarithromycin (A2142C, A2142G, and A2143G in 23S rRNA) and levofloxacin (substitutions at amino acid position 87 and 91 of gyrA). One hundred and thirty-five naive patients were recruited between 2017-2020. Clarithromycin resistance was detected in 37 (27.4%). The time trend did not show any significant variation from 2017 to 2020 (p = 0.33). Primary levofloxacin resistance was found in 26 subjects (19.2%), and we observed a dramatic increase in rates from 2017 (10%) to 2018 (3.3%), 2019 (20%), and 2020 (37.8%). Ninety-one patients with at least one eradication failure were recruited. Secondary resistance to clarithromycin and levofloxacin was found in 59 (64.8%) and 45 patients (59.3%), respectively. In conclusion, our geographic area has a high risk of resistance to clarithromycin. There is also a progressive spreading of levofloxacin-resistant strains.
KW - Antibiotic resistance
KW - Clarithromycin
KW - Helicobacter pylori
KW - Levofloxacin
KW - Molecular analysis
KW - Stools
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U2 - 10.3390/antibiotics9100723
DO - 10.3390/antibiotics9100723
M3 - Article
AN - SCOPUS:85094612771
VL - 9
SP - 1
EP - 8
JO - Antibiotics
JF - Antibiotics
SN - 2079-6382
IS - 10
M1 - 723
ER -