Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study
Aim: To assess the pattern of antimicrobial resistance of Helicobacter pylori isolates from peptic ulcer disease patients of Chandigarh, Delhi, Lucknow, Hyderabad and Chennai in India, and to recommend an updated anti‐H. pylori treatment regimen to be used in these areas. Methods: Two hundred and...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2003-12, Vol.18 (12), p.1373-1378 |
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| creator | THYAGARAJAN, SP RAY, PALLAB DAS, BIMAL KUMAR AYYAGARI, ARCHANA KHAN, ALEEM AHMED DHARMALINGAM, S RAO, USHA ANAND RAJASAMBANDAM, P RAMATHILAGAM, B BHASIN, DEEPAK SHARMA, MP NAIK, SR HABIBULLAH, CM |
| description | Aim: To assess the pattern of antimicrobial resistance of Helicobacter pylori isolates from peptic ulcer disease patients of Chandigarh, Delhi, Lucknow, Hyderabad and Chennai in India, and to recommend an updated anti‐H. pylori treatment regimen to be used in these areas.
Methods: Two hundred and fifty‐nine H. pylori isolates from patients with peptic ulcer disease reporting for clinical management to the Post Graduate Institute of Medical Education and Research, Chandigarh; All India Institute of Medical Sciences, New Delhi; Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Deccan College of Medical Sciences and Allied Hospitals, Hyderabad; and hospitals in Chennai in collaboration with the Dr ALM Post Graduate Institute of Basic Medical Sciences were analyzed for their levels of antibiotic susceptibility to metronidazole, clarithromycin, amoxycillin, ciprofloxacin and tetracycline. The Epsilometer test (E‐test), a quantitative disc diffusion antibiotic susceptibility testing method, was adopted in all the centers. The pattern of single and multiple resistance at the respective centers and at the national level were analyzed.
Results: Overall H. pylori resistance rate was 77.9% to metronidazole, 44.7% to clarithromycin and 32.8% to amoxycillin. Multiple resistance was seen in 112/259 isolates (43.2%) and these were two/three and four drug resistance pattern to metronidazole, clarithromycin, amoxycillin observed (13.2, 32 and 2.56%, respectively). Metronidazole resistance was high in Lucknow, Chennai and Hyderabad (68, 88.2 and 100%, respectively) and moderate in Delhi (37.5%) and Chandigarh (38.2%). Ciprofloxacin and tetracycline resistance was the least, ranging from 1.0 to 4%.
Conclusion: In the Indian population, the prevalence of resistance of H. pylori is very high to metronidazole, moderate to clarithromycin and amoxycillin and low to ciprofloxacin and tetracycline. The rate of resistance was higher in southern India than in northern India. The E‐test emerges as a reliable quantitative antibiotic susceptibility test. A change in antibiotic policy to provide scope for rotation of antibiotics in the treatment of H. pylori in India is a public health emergency. |
| doi_str_mv | 10.1046/j.1440-1746.2003.03174.x |
| format | Article |
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Methods: Two hundred and fifty‐nine H. pylori isolates from patients with peptic ulcer disease reporting for clinical management to the Post Graduate Institute of Medical Education and Research, Chandigarh; All India Institute of Medical Sciences, New Delhi; Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Deccan College of Medical Sciences and Allied Hospitals, Hyderabad; and hospitals in Chennai in collaboration with the Dr ALM Post Graduate Institute of Basic Medical Sciences were analyzed for their levels of antibiotic susceptibility to metronidazole, clarithromycin, amoxycillin, ciprofloxacin and tetracycline. The Epsilometer test (E‐test), a quantitative disc diffusion antibiotic susceptibility testing method, was adopted in all the centers. The pattern of single and multiple resistance at the respective centers and at the national level were analyzed.
Results: Overall H. pylori resistance rate was 77.9% to metronidazole, 44.7% to clarithromycin and 32.8% to amoxycillin. Multiple resistance was seen in 112/259 isolates (43.2%) and these were two/three and four drug resistance pattern to metronidazole, clarithromycin, amoxycillin observed (13.2, 32 and 2.56%, respectively). Metronidazole resistance was high in Lucknow, Chennai and Hyderabad (68, 88.2 and 100%, respectively) and moderate in Delhi (37.5%) and Chandigarh (38.2%). Ciprofloxacin and tetracycline resistance was the least, ranging from 1.0 to 4%.
Conclusion: In the Indian population, the prevalence of resistance of H. pylori is very high to metronidazole, moderate to clarithromycin and amoxycillin and low to ciprofloxacin and tetracycline. The rate of resistance was higher in southern India than in northern India. The E‐test emerges as a reliable quantitative antibiotic susceptibility test. A change in antibiotic policy to provide scope for rotation of antibiotics in the treatment of H. pylori in India is a public health emergency.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1046/j.1440-1746.2003.03174.x</identifier><identifier>PMID: 14675265</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Science Pty</publisher><subject>Amoxicillin - pharmacology ; Anti-Infective Agents - pharmacology ; Anti-Infective Agents - therapeutic use ; antibiotic susceptibility ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Ciprofloxacin - pharmacology ; Clarithromycin - pharmacology ; Drug Resistance, Bacterial ; Epsilometer-test ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter pylori ; Helicobacter pylori - drug effects ; Helicobacter pylori - isolation & purification ; Human bacterial diseases ; Humans ; India - epidemiology ; Infectious diseases ; Medical sciences ; Metronidazole - pharmacology ; Microbial Sensitivity Tests ; Peptic Ulcer - microbiology ; Tetracycline - pharmacology ; Tropical medicine</subject><ispartof>Journal of gastroenterology and hepatology, 2003-12, Vol.18 (12), p.1373-1378</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5494-45b6210d4dfef499f52ca23c4011ebb715b9e0b4a907b6212c5d28392cb1cb2d3</citedby><cites>FETCH-LOGICAL-c5494-45b6210d4dfef499f52ca23c4011ebb715b9e0b4a907b6212c5d28392cb1cb2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1440-1746.2003.03174.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1440-1746.2003.03174.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15385855$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14675265$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>THYAGARAJAN, SP</creatorcontrib><creatorcontrib>RAY, PALLAB</creatorcontrib><creatorcontrib>DAS, BIMAL KUMAR</creatorcontrib><creatorcontrib>AYYAGARI, ARCHANA</creatorcontrib><creatorcontrib>KHAN, ALEEM AHMED</creatorcontrib><creatorcontrib>DHARMALINGAM, S</creatorcontrib><creatorcontrib>RAO, USHA ANAND</creatorcontrib><creatorcontrib>RAJASAMBANDAM, P</creatorcontrib><creatorcontrib>RAMATHILAGAM, B</creatorcontrib><creatorcontrib>BHASIN, DEEPAK</creatorcontrib><creatorcontrib>SHARMA, MP</creatorcontrib><creatorcontrib>NAIK, SR</creatorcontrib><creatorcontrib>HABIBULLAH, CM</creatorcontrib><title>Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Aim: To assess the pattern of antimicrobial resistance of Helicobacter pylori isolates from peptic ulcer disease patients of Chandigarh, Delhi, Lucknow, Hyderabad and Chennai in India, and to recommend an updated anti‐H. pylori treatment regimen to be used in these areas.
Methods: Two hundred and fifty‐nine H. pylori isolates from patients with peptic ulcer disease reporting for clinical management to the Post Graduate Institute of Medical Education and Research, Chandigarh; All India Institute of Medical Sciences, New Delhi; Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Deccan College of Medical Sciences and Allied Hospitals, Hyderabad; and hospitals in Chennai in collaboration with the Dr ALM Post Graduate Institute of Basic Medical Sciences were analyzed for their levels of antibiotic susceptibility to metronidazole, clarithromycin, amoxycillin, ciprofloxacin and tetracycline. The Epsilometer test (E‐test), a quantitative disc diffusion antibiotic susceptibility testing method, was adopted in all the centers. The pattern of single and multiple resistance at the respective centers and at the national level were analyzed.
Results: Overall H. pylori resistance rate was 77.9% to metronidazole, 44.7% to clarithromycin and 32.8% to amoxycillin. Multiple resistance was seen in 112/259 isolates (43.2%) and these were two/three and four drug resistance pattern to metronidazole, clarithromycin, amoxycillin observed (13.2, 32 and 2.56%, respectively). Metronidazole resistance was high in Lucknow, Chennai and Hyderabad (68, 88.2 and 100%, respectively) and moderate in Delhi (37.5%) and Chandigarh (38.2%). Ciprofloxacin and tetracycline resistance was the least, ranging from 1.0 to 4%.
Conclusion: In the Indian population, the prevalence of resistance of H. pylori is very high to metronidazole, moderate to clarithromycin and amoxycillin and low to ciprofloxacin and tetracycline. The rate of resistance was higher in southern India than in northern India. The E‐test emerges as a reliable quantitative antibiotic susceptibility test. A change in antibiotic policy to provide scope for rotation of antibiotics in the treatment of H. pylori in India is a public health emergency.</description><subject>Amoxicillin - pharmacology</subject><subject>Anti-Infective Agents - pharmacology</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>antibiotic susceptibility</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Ciprofloxacin - pharmacology</subject><subject>Clarithromycin - pharmacology</subject><subject>Drug Resistance, Bacterial</subject><subject>Epsilometer-test</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter pylori</subject><subject>Helicobacter pylori - drug effects</subject><subject>Helicobacter pylori - isolation & purification</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Metronidazole - pharmacology</subject><subject>Microbial Sensitivity Tests</subject><subject>Peptic Ulcer - microbiology</subject><subject>Tetracycline - pharmacology</subject><subject>Tropical medicine</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUtv1DAUhS0EokPhLyBvYJfUduw8kFjQAjMtBYTEY2nZzjV4cB7YiZj5Ef3POJ1Ru2XlI9_vXFvnIIQpySnh5dk2p5yTjFa8zBkhRU6KpPPdA7S6GzxEK1JTkTUFbU7Qkxi3hBBOKvEYnVBeVoKVYoVu1jD8DGr85YzyuHXWQoDeAHY9Vv3kOmfCoF2aBYguTmqZjWqaIPR4sHgD3plBK5Mu8Lj3Q3DYeNffrnNx8GqCiG0YOnzZt071i9lBP8VX-OPsJ2eSDs7gOM3t_il6ZJWP8Ox4nqJv7999vdhk15_XlxdvrjMjeMMzLnTJKGl5a8HyprGCGcUKwwmloHVFhW6AaK4aUi0kM6JlddEwo6nRrC1O0cvD3jEMf2aIk-xcNOC96mGYo6xSQIwzmsD6AKYUYgxg5Rhcp8JeUiKXKuRWLonLJXG5VCFvq5C7ZH1-fGPWHbT3xmP2CXhxBFRMadmQsnXxnhNFLWqxcK8P3F_nYf_fH5BX682ikj87-FN9sLvzq_BbllVRCfnj01puvr-94l8-nMvz4h84Y7ch</recordid><startdate>200312</startdate><enddate>200312</enddate><creator>THYAGARAJAN, SP</creator><creator>RAY, PALLAB</creator><creator>DAS, BIMAL KUMAR</creator><creator>AYYAGARI, ARCHANA</creator><creator>KHAN, ALEEM AHMED</creator><creator>DHARMALINGAM, S</creator><creator>RAO, USHA ANAND</creator><creator>RAJASAMBANDAM, P</creator><creator>RAMATHILAGAM, B</creator><creator>BHASIN, DEEPAK</creator><creator>SHARMA, MP</creator><creator>NAIK, SR</creator><creator>HABIBULLAH, CM</creator><general>Blackwell Science Pty</general><general>Blackwell Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200312</creationdate><title>Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study</title><author>THYAGARAJAN, SP ; RAY, PALLAB ; DAS, BIMAL KUMAR ; AYYAGARI, ARCHANA ; KHAN, ALEEM AHMED ; DHARMALINGAM, S ; RAO, USHA ANAND ; RAJASAMBANDAM, P ; RAMATHILAGAM, B ; BHASIN, DEEPAK ; SHARMA, MP ; NAIK, SR ; HABIBULLAH, CM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5494-45b6210d4dfef499f52ca23c4011ebb715b9e0b4a907b6212c5d28392cb1cb2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Amoxicillin - pharmacology</topic><topic>Anti-Infective Agents - pharmacology</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>antibiotic susceptibility</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Biological and medical sciences</topic><topic>Ciprofloxacin - pharmacology</topic><topic>Clarithromycin - pharmacology</topic><topic>Drug Resistance, Bacterial</topic><topic>Epsilometer-test</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter pylori</topic><topic>Helicobacter pylori - drug effects</topic><topic>Helicobacter pylori - isolation & purification</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Infectious diseases</topic><topic>Medical sciences</topic><topic>Metronidazole - pharmacology</topic><topic>Microbial Sensitivity Tests</topic><topic>Peptic Ulcer - microbiology</topic><topic>Tetracycline - pharmacology</topic><topic>Tropical medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>THYAGARAJAN, SP</creatorcontrib><creatorcontrib>RAY, PALLAB</creatorcontrib><creatorcontrib>DAS, BIMAL KUMAR</creatorcontrib><creatorcontrib>AYYAGARI, ARCHANA</creatorcontrib><creatorcontrib>KHAN, ALEEM AHMED</creatorcontrib><creatorcontrib>DHARMALINGAM, S</creatorcontrib><creatorcontrib>RAO, USHA ANAND</creatorcontrib><creatorcontrib>RAJASAMBANDAM, P</creatorcontrib><creatorcontrib>RAMATHILAGAM, B</creatorcontrib><creatorcontrib>BHASIN, DEEPAK</creatorcontrib><creatorcontrib>SHARMA, MP</creatorcontrib><creatorcontrib>NAIK, SR</creatorcontrib><creatorcontrib>HABIBULLAH, CM</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>THYAGARAJAN, SP</au><au>RAY, PALLAB</au><au>DAS, BIMAL KUMAR</au><au>AYYAGARI, ARCHANA</au><au>KHAN, ALEEM AHMED</au><au>DHARMALINGAM, S</au><au>RAO, USHA ANAND</au><au>RAJASAMBANDAM, P</au><au>RAMATHILAGAM, B</au><au>BHASIN, DEEPAK</au><au>SHARMA, MP</au><au>NAIK, SR</au><au>HABIBULLAH, CM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2003-12</date><risdate>2003</risdate><volume>18</volume><issue>12</issue><spage>1373</spage><epage>1378</epage><pages>1373-1378</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Aim: To assess the pattern of antimicrobial resistance of Helicobacter pylori isolates from peptic ulcer disease patients of Chandigarh, Delhi, Lucknow, Hyderabad and Chennai in India, and to recommend an updated anti‐H. pylori treatment regimen to be used in these areas.
Methods: Two hundred and fifty‐nine H. pylori isolates from patients with peptic ulcer disease reporting for clinical management to the Post Graduate Institute of Medical Education and Research, Chandigarh; All India Institute of Medical Sciences, New Delhi; Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Deccan College of Medical Sciences and Allied Hospitals, Hyderabad; and hospitals in Chennai in collaboration with the Dr ALM Post Graduate Institute of Basic Medical Sciences were analyzed for their levels of antibiotic susceptibility to metronidazole, clarithromycin, amoxycillin, ciprofloxacin and tetracycline. The Epsilometer test (E‐test), a quantitative disc diffusion antibiotic susceptibility testing method, was adopted in all the centers. The pattern of single and multiple resistance at the respective centers and at the national level were analyzed.
Results: Overall H. pylori resistance rate was 77.9% to metronidazole, 44.7% to clarithromycin and 32.8% to amoxycillin. Multiple resistance was seen in 112/259 isolates (43.2%) and these were two/three and four drug resistance pattern to metronidazole, clarithromycin, amoxycillin observed (13.2, 32 and 2.56%, respectively). Metronidazole resistance was high in Lucknow, Chennai and Hyderabad (68, 88.2 and 100%, respectively) and moderate in Delhi (37.5%) and Chandigarh (38.2%). Ciprofloxacin and tetracycline resistance was the least, ranging from 1.0 to 4%.
Conclusion: In the Indian population, the prevalence of resistance of H. pylori is very high to metronidazole, moderate to clarithromycin and amoxycillin and low to ciprofloxacin and tetracycline. The rate of resistance was higher in southern India than in northern India. The E‐test emerges as a reliable quantitative antibiotic susceptibility test. A change in antibiotic policy to provide scope for rotation of antibiotics in the treatment of H. pylori in India is a public health emergency.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Science Pty</pub><pmid>14675265</pmid><doi>10.1046/j.1440-1746.2003.03174.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Amoxicillin - pharmacology Anti-Infective Agents - pharmacology Anti-Infective Agents - therapeutic use antibiotic susceptibility Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Ciprofloxacin - pharmacology Clarithromycin - pharmacology Drug Resistance, Bacterial Epsilometer-test Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter pylori Helicobacter pylori - drug effects Helicobacter pylori - isolation & purification Human bacterial diseases Humans India - epidemiology Infectious diseases Medical sciences Metronidazole - pharmacology Microbial Sensitivity Tests Peptic Ulcer - microbiology Tetracycline - pharmacology Tropical medicine |
| title | Geographical difference in antimicrobial resistance pattern of Helicobacter pylori clinical isolates from Indian patients: Multicentric study |
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