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Antimicrobial resistance of H.pylori in Smolensk, Russia

Abstract number: P1042

Dekhnich N., Kostykova E., Punin A., Alimov A., Ivanchik N., Kozlov R.

Objectives: To evaluate the susceptibility to antimicrobials of H. pylori isolated from patients with H. pylori-associated gastrointestinal disorders in Smolensk (Russia).

Methods: Overall 210 adult patients with H. pylori-associated gastrointestinal disorders were included in the study in 2009–2010. From each patient 2 antral and 2 corpus gastric biopsy samples were taken for culture and placed in a phosphate buffer (Sigma, USA) or Portagerm pylori (BioMerieux, France) for transportation to the laboratory. Pylori agar (BioMerieux, France) plates were incubated for 3–5 days at 37°C under microaerophilic conditions (9% CO2, 80% N2, 11% O2). Antimicrobial susceptibility testing was performed on Mueller-Hinton agar (BBL, USA) supplemented with 5% sheep blood by the dilution method to amoxicillin, erythromycin, clarithromycin, levofloxacin, ciprofloxacin, tetracycline and metronidazole.

Results:H. pylori were isolated in 64% (n = 135) patients. Among them 18% were resistant to one antimicrobial agent, 3% were resistant to more than one antimicrobial agent. Seven (5.3%) isolates were resistant to clarithromycin (MIC geqslant R: gt-or-equal, slanted1 mg/L), 10 (7.6%) – to erythromycin (MIC >4 mg/L). The resistance rate of H. pylori to metronidazole was 3.8% (n = 5) (MIC >4 mg/L). No strains resistant to amoxicillin and tetracycline were found. Resistance to ciprofloxacin was detected in 12.8% (n = 17) (MIC >1 mg/L) of strains, to levofloxacin – in 8.3% (n = 11) (MIC >1 mg/L).

Conclusion: Our study highlights the importance of antibiotic resistance surveillance to guide test and treat policies. In Smolensk we can use current recommendations of the European H. pylori study group (proton pump inhibitor + clarithromycin + amoxicillin or metronidazole) as the initial treatment for H. pylori infection. Quadruple therapy (proton pump inhibitor + bismuth + metronidazole + tetracycline) could be an alternative initial therapy.

Session Details

Date: 07/05/2011
Time: 00:00-00:00
Session name: Abstracts of 21st ECCMID / 27th ICC
Subject:
Location: Milan, Italy, 7 - 10 May 2011
Presentation type:
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