[Antibiotic resistance of Helicobacter pylori isolated from Korean patients]

Area of Science:

• Microbiology
• Infectious Diseases
• Pharmacology

Background:

• Antibiotic resistance in Helicobacter pylori (H. pylori) is a growing global health concern.
• Previous studies have indicated varying resistance patterns, necessitating ongoing monitoring.

Purpose of the Study:

• To analyze the trends in antibiotic susceptibility of H. pylori strains in Korean patients from 1987 to 2003.
• To identify the prevalence of multi-drug resistance (MDR) and specific antibiotic resistance patterns.

Main Methods:

• Minimal inhibitory concentrations (MICs) for several antibiotics (amoxicillin, clarithromycin, metronidazole, tetracycline, azithromycin, fluoroquinolones) were determined for H. pylori isolates.
• Comparison of MIC values between primary and secondary isolates, and analysis of resistance in treatment-failure patients.

Main Results:

• A significant shift towards higher MICs for tested antibiotics was observed in H. pylori strains between 1987 and 2003.
• Secondary isolates exhibited higher MIC values compared to primary isolates.
• High rates of MDR were found, particularly in treatment-failure patients (89.6%) and those without prior antibiotic treatment (52.3%).
• Clarithromycin, metronidazole, and azithromycin were the most common agents involved in MDR.
• Dual resistance to amoxicillin/clarithromycin and clarithromycin/metronidazole was substantially higher in secondary isolates.

Conclusions:

• H. pylori antibiotic resistance has increased in Korea, with notable differences between primary and secondary infections.
• The high prevalence of MDR underscores the need for updated treatment guidelines.
• Continuous surveillance of antibiotic susceptibilities is essential for guiding clinical decisions in H. pylori eradication therapy.