Helicobacter pylori resistance to clarithromycin in Reunion Island

Med Mal Infect. 2016 Oct;46(7):385-389. doi: 10.1016/j.medmal.2016.06.004. Epub 2016 Jul 15.

Abstract

Objective: The increasing resistance of Helicobacter pylori to clarithromycin led to developing new eradication treatment regimens. The objective of our observational study was to determine the proportion of H. pylori strains resistant to clarithromycin in infected patients in Reunion Island and to suggest a first-line treatment in agreement with the local ecology.

Patients and methods: We included 200 patients who underwent esophagogastroduodenoscopy at the University Hospital of Saint-Pierre from February to July 2014. H. pylori was isolated from 73 patients.

Results: A wild-type susceptibility profile to clarithromycin was observed in 64 isolates (87.7%) and nine isolates (12.3%) had a resistant mutation profile.

Conclusion: With a proportion of resistant strains below the critical threshold of 15%, physicians in Reunion Island may continue to prescribe the usual treatment regimen as a first-line option (clarithromycin, amoxicillin, and proton pump inhibitor for 14 days).

Keywords: Clarithromycin resistance; Helicobacter pylori; La Réunion; Reunion Island; Résistance à la clarithromycine.

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / microbiology
  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Clarithromycin / pharmacology*
  • DNA, Bacterial / genetics
  • Drug Resistance, Microbial / genetics
  • Drug Therapy, Combination
  • Dyspepsia / epidemiology*
  • Dyspepsia / etiology
  • Gastric Fundus / microbiology
  • Gastritis, Atrophic / drug therapy
  • Gastritis, Atrophic / epidemiology
  • Gastritis, Atrophic / microbiology*
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / microbiology*
  • Helicobacter pylori / drug effects*
  • Helicobacter pylori / genetics
  • Helicobacter pylori / isolation & purification
  • Humans
  • Metaplasia
  • Mutation
  • Proton Pump Inhibitors / therapeutic use
  • Pyloric Antrum / microbiology
  • Reunion / epidemiology
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / microbiology

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Proton Pump Inhibitors
  • Amoxicillin
  • Clarithromycin