Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study. Issue 4 (20th May 2019)

• Record Type: Journal Article
• 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; Kim, Jae J.; Kim, Seung Young
• Is Part Of: Helicobacter. Volume 24:Issue 4(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-05-20
• Subjects: antibiotics -- Helicobacter pylori -- Korea -- resistance; Helicobacter -- Periodicals; Helicobacter infections -- Periodicals; Stomach -- Diseases -- Periodicals; 616.3301405
• DOI: 10.1111/hel.12592
• Languages: English
• ISSNs: 1083-4389

Abstract

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.