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- Title
Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study.
- Authors
Lee, Jeong Hoon; Ahn, Ji Yong; Choi, Kee Don; Jung, Hwoon‐Yong; Kim, Jung Mogg; Baik, Gwang Ho; Kim, Byung‐Wook; Park, Jun Chul; Jung, Hye‐Kyung; Cho, Soo Jeong; Shin, Cheol Min; Choi, Yoon Jin; Lee, Si Hyung; Kim, Ji Hyun; Lee, Wan Sik; Sung, Jae Kyu; Chung, Jun‐Won; Cheung, Dae Young; Lee, Hyuk; Min, Yang Won
- Abstract
Introduction: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.
- Subjects
SEOUL (Korea); SOUTH Korea; HELICOBACTER pylori; DRUG resistance; DRUG resistance in bacteria; ANTIBIOTICS; CLARITHROMYCIN; TETRACYCLINES; AMOXICILLIN
- Publication
Helicobacter, 2019, Vol 24, Issue 4, pN.PAG
- ISSN
1083-4389
- Publication type
Article
- DOI
10.1111/hel.12592