Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

Background Helicobacter pylori infection is associated with chronic gastritis, ulcers and gastric cancer. Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance...

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Veröffentlicht in:European journal of clinical investigation 2019-08, Vol.49 (8), p.e13150-n/a
Hauptverfasser: Fernández‐Reyes, María, Tamayo, Esther, Rojas‐Rengifo, Diana, Fischer, Wolfgang, Carrasco‐García, Estefanía, Alonso, Marta, Lizasoain, Jacobo, Bujanda, Luis, Cosme, Ángel, Montes, Milagrosa
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container_issue 8
container_start_page e13150
container_title European journal of clinical investigation
container_volume 49
creator Fernández‐Reyes, María
Tamayo, Esther
Rojas‐Rengifo, Diana
Fischer, Wolfgang
Carrasco‐García, Estefanía
Alonso, Marta
Lizasoain, Jacobo
Bujanda, Luis
Cosme, Ángel
Montes, Milagrosa
description Background Helicobacter pylori infection is associated with chronic gastritis, ulcers and gastric cancer. Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. Materials and Methods Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild‐disease symptoms and in 22 isolates from patients with severe‐disease symptoms. Results Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild‐ and severe‐disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. Conclusions Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. The prevalence of H pylori carrying the virulent genotype cagA/vacAs1m1 was higher than 20% in the mild‐disease and 54% in the severe‐disease symptom group.
doi_str_mv 10.1111/eci.13150
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Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. Materials and Methods Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild‐disease symptoms and in 22 isolates from patients with severe‐disease symptoms. Results Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild‐ and severe‐disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. Conclusions Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. The prevalence of H pylori carrying the virulent genotype cagA/vacAs1m1 was higher than 20% in the mild‐disease and 54% in the severe‐disease symptom group.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13150</identifier><identifier>PMID: 31192451</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Amoxicillin ; Anti-Bacterial Agents - pharmacology ; Antibiotic resistance ; Antibiotics ; Antiinfectives and antibacterials ; Antimicrobial agents ; Antimicrobial resistance ; Chronic infection ; Clarithromycin ; Disease resistance ; Drug resistance ; Drug Resistance, Bacterial - genetics ; Female ; Gastric cancer ; Gastritis ; Genotype ; Genotypes ; Helicobacter Infections - microbiology ; Helicobacter pylori ; Helicobacter pylori - drug effects ; Helicobacter pylori - genetics ; Helicobacter pylori - pathogenicity ; Humans ; Levofloxacin ; Male ; Metronidazole ; Middle Aged ; Pathogenicity ; Pathogens ; Phylogeography ; Signs and symptoms ; Spain ; Test procedures ; Ulcers ; Virulence ; Virulence factors ; Virulence Factors - genetics ; Young Adult</subject><ispartof>European journal of clinical investigation, 2019-08, Vol.49 (8), p.e13150-n/a</ispartof><rights>2019 Stichting European Society for Clinical Investigation Journal Foundation</rights><rights>2019 Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>Copyright © 2019 Stichting European Society for Clinical Investigation Journal Foundation. 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Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. Materials and Methods Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild‐disease symptoms and in 22 isolates from patients with severe‐disease symptoms. Results Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild‐ and severe‐disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. Conclusions Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. 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Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. Materials and Methods Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild‐disease symptoms and in 22 isolates from patients with severe‐disease symptoms. Results Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild‐ and severe‐disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. Conclusions Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. The prevalence of H pylori carrying the virulent genotype cagA/vacAs1m1 was higher than 20% in the mild‐disease and 54% in the severe‐disease symptom group.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>31192451</pmid><doi>10.1111/eci.13150</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2513-1109</orcidid></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Amoxicillin
Anti-Bacterial Agents - pharmacology
Antibiotic resistance
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
Antimicrobial resistance
Chronic infection
Clarithromycin
Disease resistance
Drug resistance
Drug Resistance, Bacterial - genetics
Female
Gastric cancer
Gastritis
Genotype
Genotypes
Helicobacter Infections - microbiology
Helicobacter pylori
Helicobacter pylori - drug effects
Helicobacter pylori - genetics
Helicobacter pylori - pathogenicity
Humans
Levofloxacin
Male
Metronidazole
Middle Aged
Pathogenicity
Pathogens
Phylogeography
Signs and symptoms
Spain
Test procedures
Ulcers
Virulence
Virulence factors
Virulence Factors - genetics
Young Adult
title Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain
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