Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study

Objective: The choice of the Helicobacter pylori (H. pylori) eradication regimen should depend on the antibiotic resistance of this major gastric pathogen. In Latvia, resistance patterns of H. pylori strains have not been described in the general population. The aim of the study is to evaluate the p...

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Main Authors: D. Rudzīte, R. Vangravs, I. Daugule, Ģ. Šķenders, I. Poļaka, A. Vanags, J. Atstupens, I. Tolmanis, P. Pūpola, Y. Tarasenko, J. Park
Format: Article
Language:English
Published: Verduci Editore 2024-06-01
Series:Microbiota in Health and Disease
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Online Access:https://www.microbiotajournal.com/wp-content/uploads/sites/7/2024/06/e1000.pdf
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author D. Rudzīte
R. Vangravs
I. Daugule
Ģ. Šķenders
I. Poļaka
A. Vanags
J. Atstupens
I. Tolmanis
P. Pūpola
Y. Tarasenko
J. Park
author_facet D. Rudzīte
R. Vangravs
I. Daugule
Ģ. Šķenders
I. Poļaka
A. Vanags
J. Atstupens
I. Tolmanis
P. Pūpola
Y. Tarasenko
J. Park
author_sort D. Rudzīte
collection DOAJ
description Objective: The choice of the Helicobacter pylori (H. pylori) eradication regimen should depend on the antibiotic resistance of this major gastric pathogen. In Latvia, resistance patterns of H. pylori strains have not been described in the general population. The aim of the study is to evaluate the primary susceptibility of H. pylori to antibiotics used in recommended eradication regimens for the middle-aged population in Latvia. Materials and Methods: H. pylori antibiotic resistance was assessed in asymptomatic individuals aged 40-64 years, recruited as part of the GISTAR pilot study. H. pylori culture was recovered from initially frozen biopsies taken during the endoscopic examinations. Antimicrobial susceptibility to metronidazole, clarithromycin, amoxicillin, tetracycline, rifampicin, and levofloxacin was successfully determined in 89 isolates using the Epsilomer test (E-test, BioMerieux, France), and interpreted according to EUCAST clinical breakpoint standard. Results: Among the 89 tested isolates, 49 isolates (55%) were resistant to at least one of the tested antibiotics. Resistance to metronidazole was detected in 31 cases (34.8%; 95% CI: 25.2-45.7), followed by rifampicin in nine cases (10.1%; 95% CI: 5.0-18.8%), clarithromycin in five (5.6%; 95% CI: 2.1-13.2) and to levofloxacin in four cases (4.5%; 95% CI: 1.5-11.8). None of the cultures displayed resistance to tetracycline or amoxicillin. Eight resistance patterns were detected: 34 participants had resistance to one of the tested antibiotics; six participants had double resistance, and one participant had resistance to metronidazole, clarithromycin, and levofloxacin. Conclusions: H. pylori’s primary resistance to clarithromycin is still low; therefore, the use of standard clarithromycin-based triple therapies may be justified as the first-line therapy for H. pylori eradication in the middle-aged population in Latvia.
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spelling doaj-art-6f4a1e889e9d4335b619287a109f716d2025-01-03T10:30:12ZengVerduci EditoreMicrobiota in Health and Disease2704-88452024-06-01610.26355/mhd_20246_10001000Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot studyD. Rudzīte0R. Vangravs1I. Daugule2Ģ. Šķenders3I. Poļaka4A. Vanags5J. Atstupens6I. Tolmanis7P. Pūpola8Y. Tarasenko9J. Park10Institute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaInsights-A, Ludza, LatviaDigestive Diseases Centre GASTRO, Riga, LatviaInstitute of Clinical and Preventive Medicine, University of Latvia, Riga, LatviaJiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USAInternational Agency for Research on Cancer, World Health Organization, Lyon, FranceObjective: The choice of the Helicobacter pylori (H. pylori) eradication regimen should depend on the antibiotic resistance of this major gastric pathogen. In Latvia, resistance patterns of H. pylori strains have not been described in the general population. The aim of the study is to evaluate the primary susceptibility of H. pylori to antibiotics used in recommended eradication regimens for the middle-aged population in Latvia. Materials and Methods: H. pylori antibiotic resistance was assessed in asymptomatic individuals aged 40-64 years, recruited as part of the GISTAR pilot study. H. pylori culture was recovered from initially frozen biopsies taken during the endoscopic examinations. Antimicrobial susceptibility to metronidazole, clarithromycin, amoxicillin, tetracycline, rifampicin, and levofloxacin was successfully determined in 89 isolates using the Epsilomer test (E-test, BioMerieux, France), and interpreted according to EUCAST clinical breakpoint standard. Results: Among the 89 tested isolates, 49 isolates (55%) were resistant to at least one of the tested antibiotics. Resistance to metronidazole was detected in 31 cases (34.8%; 95% CI: 25.2-45.7), followed by rifampicin in nine cases (10.1%; 95% CI: 5.0-18.8%), clarithromycin in five (5.6%; 95% CI: 2.1-13.2) and to levofloxacin in four cases (4.5%; 95% CI: 1.5-11.8). None of the cultures displayed resistance to tetracycline or amoxicillin. Eight resistance patterns were detected: 34 participants had resistance to one of the tested antibiotics; six participants had double resistance, and one participant had resistance to metronidazole, clarithromycin, and levofloxacin. Conclusions: H. pylori’s primary resistance to clarithromycin is still low; therefore, the use of standard clarithromycin-based triple therapies may be justified as the first-line therapy for H. pylori eradication in the middle-aged population in Latvia.https://www.microbiotajournal.com/wp-content/uploads/sites/7/2024/06/e1000.pdfh. pyloriantibiotic resistanceeradicationantrum biopsies.
spellingShingle D. Rudzīte
R. Vangravs
I. Daugule
Ģ. Šķenders
I. Poļaka
A. Vanags
J. Atstupens
I. Tolmanis
P. Pūpola
Y. Tarasenko
J. Park
Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
Microbiota in Health and Disease
h. pylori
antibiotic resistance
eradication
antrum biopsies.
title Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
title_full Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
title_fullStr Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
title_full_unstemmed Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
title_short Helicobacter pylori antibacterial resistance patterns in Latvia: results from the Gistar pilot study
title_sort helicobacter pylori antibacterial resistance patterns in latvia results from the gistar pilot study
topic h. pylori
antibiotic resistance
eradication
antrum biopsies.
url https://www.microbiotajournal.com/wp-content/uploads/sites/7/2024/06/e1000.pdf
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