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Analysis of antibiotic susceptibility patterns of Helicobacter pylori isolates from Malaysia

Norazah Ahmad1, Wan Rasinah Zakaria, Ramelah Mohamed

  • 1Bacteriology Unit, Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur, Malaysia. norazah@imr.gov.my

Helicobacter
|January 19, 2011
PubMed
Abstract

Insights

Antibiotic resistance in Helicobacter pylori is generally low in Malaysia, with multi-drug resistant strains being uncommon. However, high resistance to metronidazole is a concern for H. pylori treatment.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Antibiotic resistance patterns for Helicobacter pylori (H. pylori) vary geographically.
  • Understanding local susceptibility is crucial for effective H. pylori treatment strategies.

Purpose of the Study:

  • To determine primary antibiotic resistance rates of H. pylori strains in Malaysian patients.
  • To guide empirical treatment choices for H. pylori infections.

Main Methods:

  • Collected 777 gastric biopsy samples from Malaysian patients between 2004 and 2007.
  • Isolated H. pylori and determined Minimum Inhibitory Concentrations (MICs) against six key antibiotics using E-test.
  • Tested resistance to metronidazole, clarithromycin, levofloxacin, ciprofloxacin, amoxicillin, and tetracycline.

Main Results:

  • 119 patients (15.3%) were H. pylori positive, yielding 187 strains.
  • High resistance observed for metronidazole (37.4%), low for clarithromycin (2.1%), levofloxacin/ciprofloxacin (1%), and none for amoxicillin/tetracycline.
  • Mono-resistance to metronidazole was most common (36.4%); multi-resistance (≥2 antibiotics) was rare (3.3%).
  • Metronidazole-resistant strains exhibited high MICs (≥256 μg/mL).

Conclusions:

  • Primary antibiotic resistance rates for H. pylori in Malaysia are low, with uncommon multi-drug resistance.
  • Mixed populations of sensitive and resistant H. pylori strains were detected.
  • High MIC values for metronidazole-resistant strains warrant attention for treatment protocols.

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