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Increase in amoxicillin resistance in Helicobacter pylori from Bulgarian patients over 15 years

Lyudmila Boyanova1, Nayden Kandilarov2, Petyo Hadzhiyski3

  • 1Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria.

Diagnostic Microbiology and Infectious Disease
|July 13, 2022
PubMed

Insights

Amoxicillin resistance in Helicobacter pylori is increasing. This study tracked 474 strains over 15 years, revealing a significant rise in resistance rates, posing a challenge for H. pylori infection treatment.

Area of Science:

  • Microbiology and Infectious Diseases
  • Antimicrobial Resistance
  • Gastroenterology

Background:

  • Helicobacter pylori is a common human pathogen.
  • Amoxicillin is a key antibiotic for H. pylori eradication.
  • Historically, amoxicillin resistance in H. pylori has been infrequent.

Purpose of the Study:

  • To investigate the evolution of amoxicillin resistance in Helicobacter pylori strains.
  • To quantify changes in resistance rates over a 15-year period.

Main Methods:

  • Analysis of 474 H. pylori strains collected between 2007 and 2021.
  • Determination of minimum inhibitory concentrations (MICs) for amoxicillin.
  • Comparison of resistance rates between two time subgroups: 2007-2014 and 2015-2021.

Main Results:

  • The overall rate of amoxicillin resistance (MICs >0.125-3 mg/L) significantly increased.
  • Resistance rose from 4.2% in the 2007-2014 period to 8.9% in the 2015-2021 period.
  • MIC50 and MIC90 values remained similar across subgroups, indicating a shift in the distribution of resistance.

Conclusions:

  • A notable increase in amoxicillin resistance among H. pylori strains has occurred.
  • This trend highlights the evolving challenge of H. pylori treatment.
  • Continued surveillance of antibiotic resistance is crucial for effective eradication strategies.
Keywords:
AmoxicillinEvolutionHelicobacter pyloriMinimal inhibitory concentrationResistance

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