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Antimicrobial Resistance of Helicobacter pylori in Gastric Biopsy Samples from Lima/Peru
Ceren Bilgilier1, Jakob Thannesberger1, Manuel Ojeda Cisneros2
1Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Abstract:
Helicobacter pylori prevalence and gastric cancer rates are remarkably high in Peru. Effective antimicrobial regimens are essential for successful H. pylori eradication. We aimed at assessing antimicrobial resistance rates to first- and second-line therapeutic agents in H. pylori strains detected in gastric biopsy samples. Gastric biopsy samples (antrum and corpus) were collected from therapy-naive patients (n = 154). H. pylori presence in the samples was confirmed by histopathology. Genotypic resistance to clarithromycin and quinolones was determined by real-time PCR. Histology results were 100% concordant with PCR results (97/154; 63% H. pylori-positive in both). In 6% (6/97) of the patients, we found discordant results of H. pylori infection in antrum and corpus samples from the same patient. Resistance rates to clarithromycin and quinolone were 34% (33/97) and 68% (56/82), respectively. Antimicrobial resistance to both antimicrobials was 30% (25/82). Antimicrobial resistance rates of H. pylori to clarithromycin and quinolones are very high in Lima, Peru. Many first- and second-line, empiric eradication regimens may not be recommended for Peruvian patients.
Insights
High rates of antimicrobial resistance to clarithromycin and quinolones were found in Helicobacter pylori strains in Peru. This suggests many standard eradication regimens may be ineffective for Peruvian patients.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Peru has high rates of Helicobacter pylori infection and gastric cancer.
- Effective H. pylori eradication is crucial for reducing gastric cancer incidence.
- Understanding antimicrobial resistance patterns is essential for guiding treatment strategies.
Purpose of the Study:
- To determine the antimicrobial resistance rates of H. pylori strains to common first- and second-line therapeutic agents in Peru.
- To assess resistance to clarithromycin and quinolones in H. pylori isolates from gastric biopsies.
Main Methods:
- Gastric biopsy samples were collected from 154 therapy-naive Peruvian patients.
- H. pylori presence was confirmed by histopathology.
- Genotypic resistance to clarithromycin and quinolones was determined using real-time PCR.
Main Results:
- H. pylori was detected in 63% of patients (97/154).
- Resistance rates were 34% for clarithromycin and 68% for quinolones.
- Resistance to both antimicrobials was observed in 30% of cases.
Conclusions:
- Antimicrobial resistance to clarithromycin and quinolones is very high in H. pylori strains from Lima, Peru.
- Current empiric eradication regimens may not be suitable for Peruvian patients due to high resistance rates.
- Further research is needed to develop effective H. pylori treatment strategies in this region.
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