Low rate of recurrence of Helicobacter pylori infection in spite of high clarithromycin resistance in Pakistan

Authors

Javed Yakoob, Aga Khan UniversityFollow
Shahab Abid, Aga Khan UniversityFollow
Wasim Jafri, Aga Khan UniversityFollow
Zaigham Abbas, Agha Khan UniversityFollow
Khalid Mumtaz, Aga Khan University
Saeed Hamid, Aga Khan UniversityFollow
Rashida Ahmed, Aga Khan UniversityFollow

Document Type

Article

Department

Medicine; Gastroenterology

Abstract

Background

The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy.

Methods

One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). ¹⁴C urea breath test (¹⁴C-UBT) was performed 4 weeks after the eradication therapy. The successfully treated patients were observed for 12 months with ¹⁴C-UBT to assess H. pylori status. If ¹⁴C-UBT was negative, it was repeated after every 12 weeks. If ¹⁴C-UBT was positive, endoscopy was repeated with biopsies.

Result

The eradication therapy was successful in 102(85%) patients. Out of forty-seven H. pylori isolates cultured, clarithromycin sensitivity was present in 30(64%) and amoxicillin in 45(98%), respectively. Follow-up ¹⁴C-urea breath tests of all 102 patients who eradicated H. pylori remained negative up to 9 months. However, in 6 patients, the ¹⁴C-UBT confirmed recurrence at 12 months. The recurrence rate was 6%.

Conclusion

A low rate of recurrence of H. pylori infection was found in patients with dyspeptic symptoms. H. pylori isolates demonstrated a high invitro clarithromycin resistance.

Publication (Name of Journal)

BMC Gastroenterology

Recommended Citation

Yakoob, J., Abid, S., Jafri, W., Abbas, Z., Mumtaz, K., Hamid, S., Ahmed, R. (2013). Low rate of recurrence of Helicobacter pylori infection in spite of high clarithromycin resistance in Pakistan. BMC Gastroenterology, 13(33), 1-7.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_gastroenterol/42

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.