Rates of Antimicrobial Resistance in Helicobacter pylori Isolates From Clinical Trial Patients Across the US and Europe.

Autor:	Mégraud F; UMR BRIC, INSERM U1312, University of Bordeaux, Bordeaux, France., Graham DY; Department of Medicine, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas, USA., Howden CW; Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, Tennessee, USA., Trevino E; Microbiology Specialists Incorporated, Houston, Texas, USA., Weissfeld A; Microbiology Specialists Incorporated, Houston, Texas, USA., Hunt B; Phathom Pharmaceuticals, Research and Development, Chicago, Illinois, USA., Smith N; Phathom Pharmaceuticals, Research and Development, Chicago, Illinois, USA., Leifke E; Phathom Pharmaceuticals, Research and Development, Chicago, Illinois, USA., Chey WD; Division of Gastroenterology, Michigan Medicine, Ann Arbor, Michigan, USA.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2023 Feb 01; Vol. 118 (2), pp. 269-275. Date of Electronic Publication: 2022 Sep 30.
DOI:	10.14309/ajg.0000000000002045
Abstrakt:	Introduction: Guidelines recommend that proton pump inhibitor-based triple regimens with clarithromycin not be used for Helicobacter pylori infection in areas where clarithromycin resistance is ≥15%, or in patients with prior macrolide use. Up-to-date information on local resistance patterns is limited, especially in the US. Here, we report resistance rates to antibiotics commonly used to treat H. pylori from a large study conducted in the US and Europe (pHalcon-HP). Methods: Gastric mucosal biopsies were collected from adult participants with H. pylori infection during screening. Minimum inhibitory concentrations were determined via agar dilution for clarithromycin, amoxicillin, and metronidazole, with breakpoints ≥1 μg/mL, >0.125 μg/mL, and >8 μg/mL, respectively. Resistance rates were obtained for the US and Europe, and also for US subregions and participating European countries. Results: Resistance rates were established in isolates from 907 participants. Overall, 22.2% were resistant to clarithromycin, 1.2% to amoxicillin, and 69.2% to metronidazole. Resistance in the US and Europe was similar; metronidazole resistance was the most prevalent (50%-79%) and amoxicillin the least (≤5%). In all subregions, ≥15% of isolates were resistant to clarithromycin, except the UK (0/8 isolates). Among clarithromycin-resistant isolates, 75% were also metronidazole-resistant. Two US isolates were resistant to clarithromycin and amoxicillin; one of these was also metronidazole-resistant. Discussion: The resistance rates observed in this study argue against the continued empiric use of proton pump inhibitor-based triple therapy containing clarithromycin, per treatment guidelines, and highlight the need for antibiotic resistance surveillance and novel treatment strategies for H. pylori infection in the US and Europe. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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