Antibiotic susceptibility of Helicobacter pylori isolates in Dakar, Senegal

Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. A high frequency of H. pylori infection has been reported from resource-poor regions. H. pylori infection is curable with regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics. H. pylori isolates from gastric biopsies from outpatients > or = 18 years old affected by a gastro-duodenal ulcer were used in this study. Susceptibility testing was performed for amoxicillin, ciprofloxacin and metronidazole by using the Epsilometer test (E-test) method. H. pylori strains were isolated from 40 patients of whom 36 were diagnosed as having duodenal ulcer, two with gastric ulcer, and two with gastro-duodenal ulcer. Thirty-six (90%) of the isolates were resistant to metronidazole (MICs > or = 8 microg/l), whereas all isolates were susceptible to amoxicillin (MICs < or = 0.5 microg/ml) and ciprofloxacin (MICs < or = 1 microg/ml). These data suggest that metronidazole should not be used therapeutically among Senegalese patients in first-line therapy, while ciprofloxacin could be recommended in association with amoxicillin and a proton pump inhibitor in Senegal.