Prevalence of primary fluoroquinolone resistance among clinical isolates of Helicobacter pylori at a University Hospital in Southern Taiwan

Kuei Hsiang Hung, Bor Shyang Sheu, Wei Lun Chang, Hsiu Mei Wu, Chin Cheng Liu, Jiunn Jong Wu

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Abstract

Background: Fluoroquinolone-containing therapy is effective in eradicating Helicobacter pylori. However, the resistance rate of H. pylori to fluoroquinolones in Taiwan has not yet been reported. In this study, we aimed to investigate the susceptibility to antibiotics commonly used in eradication schedules and fluoroquinolones in H. pylori. Methods: A total of 210 clinical isolates of H. pylori were collected from April 1998 to September 2007 from patients in southern Taiwan. The in vitro activities of six antimicrobial agents were determined by the agar dilution method and Etest. The mutations in quinolone resistance-determining regions of gyrA and gyrB were investigated by direct sequencing. Results: Overall, 5.7% of the isolates were resistant to ciprofloxacin and levofloxacin. The resistance rate to amoxicillin, clarithromycin, metronidazole, and tetracycline was 1.0% (two of 210), 9.5% (20 of 210), 27.6% (58 of 210), and 0.5% (one of 210), respectively. The resistance rate to either ciprofloxacin or to levofloxacin increased from 2.8% (1998-2003) to 11.8% (2004-2007). The mutations in gyrA at N87 or D91 had an impact on primary fluoroquinolone resistance in H. pylori. Garenoxacin, but not moxifloxacin, had a good in vitro inhibitory effect against ciprofloxacin/ levofloxacin-resistant strains compared with objective minimal inhibitory concentration values. Conclusions: Drug resistance to ciprofloxacin and levofloxacin in H. pylori collected from 2004 to 2007 increased significantly compared with resistance level observed during 1998-2003. The continuous surveillance of quinolone resistance among H. pylori is important in this area.

Original languageEnglish
Pages (from-to)61-65
Number of pages5
JournalHelicobacter
Volume14
Issue number1
DOIs
Publication statusPublished - 2009 Feb 1

Fingerprint

Fluoroquinolones
Taiwan
Helicobacter pylori
Levofloxacin
Ciprofloxacin
Quinolones
Disk Diffusion Antimicrobial Tests
Mutation
Clarithromycin
Amoxicillin
Metronidazole
Anti-Infective Agents
Tetracycline
Drug Resistance
Agar
Appointments and Schedules
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Infectious Diseases

Cite this

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title = "Prevalence of primary fluoroquinolone resistance among clinical isolates of Helicobacter pylori at a University Hospital in Southern Taiwan",
abstract = "Background: Fluoroquinolone-containing therapy is effective in eradicating Helicobacter pylori. However, the resistance rate of H. pylori to fluoroquinolones in Taiwan has not yet been reported. In this study, we aimed to investigate the susceptibility to antibiotics commonly used in eradication schedules and fluoroquinolones in H. pylori. Methods: A total of 210 clinical isolates of H. pylori were collected from April 1998 to September 2007 from patients in southern Taiwan. The in vitro activities of six antimicrobial agents were determined by the agar dilution method and Etest. The mutations in quinolone resistance-determining regions of gyrA and gyrB were investigated by direct sequencing. Results: Overall, 5.7{\%} of the isolates were resistant to ciprofloxacin and levofloxacin. The resistance rate to amoxicillin, clarithromycin, metronidazole, and tetracycline was 1.0{\%} (two of 210), 9.5{\%} (20 of 210), 27.6{\%} (58 of 210), and 0.5{\%} (one of 210), respectively. The resistance rate to either ciprofloxacin or to levofloxacin increased from 2.8{\%} (1998-2003) to 11.8{\%} (2004-2007). The mutations in gyrA at N87 or D91 had an impact on primary fluoroquinolone resistance in H. pylori. Garenoxacin, but not moxifloxacin, had a good in vitro inhibitory effect against ciprofloxacin/ levofloxacin-resistant strains compared with objective minimal inhibitory concentration values. Conclusions: Drug resistance to ciprofloxacin and levofloxacin in H. pylori collected from 2004 to 2007 increased significantly compared with resistance level observed during 1998-2003. The continuous surveillance of quinolone resistance among H. pylori is important in this area.",
author = "Hung, {Kuei Hsiang} and Sheu, {Bor Shyang} and Chang, {Wei Lun} and Wu, {Hsiu Mei} and Liu, {Chin Cheng} and Wu, {Jiunn Jong}",
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Prevalence of primary fluoroquinolone resistance among clinical isolates of Helicobacter pylori at a University Hospital in Southern Taiwan. / Hung, Kuei Hsiang; Sheu, Bor Shyang; Chang, Wei Lun; Wu, Hsiu Mei; Liu, Chin Cheng; Wu, Jiunn Jong.

In: Helicobacter, Vol. 14, No. 1, 01.02.2009, p. 61-65.

Research output: Contribution to journalArticle

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N2 - Background: Fluoroquinolone-containing therapy is effective in eradicating Helicobacter pylori. However, the resistance rate of H. pylori to fluoroquinolones in Taiwan has not yet been reported. In this study, we aimed to investigate the susceptibility to antibiotics commonly used in eradication schedules and fluoroquinolones in H. pylori. Methods: A total of 210 clinical isolates of H. pylori were collected from April 1998 to September 2007 from patients in southern Taiwan. The in vitro activities of six antimicrobial agents were determined by the agar dilution method and Etest. The mutations in quinolone resistance-determining regions of gyrA and gyrB were investigated by direct sequencing. Results: Overall, 5.7% of the isolates were resistant to ciprofloxacin and levofloxacin. The resistance rate to amoxicillin, clarithromycin, metronidazole, and tetracycline was 1.0% (two of 210), 9.5% (20 of 210), 27.6% (58 of 210), and 0.5% (one of 210), respectively. The resistance rate to either ciprofloxacin or to levofloxacin increased from 2.8% (1998-2003) to 11.8% (2004-2007). The mutations in gyrA at N87 or D91 had an impact on primary fluoroquinolone resistance in H. pylori. Garenoxacin, but not moxifloxacin, had a good in vitro inhibitory effect against ciprofloxacin/ levofloxacin-resistant strains compared with objective minimal inhibitory concentration values. Conclusions: Drug resistance to ciprofloxacin and levofloxacin in H. pylori collected from 2004 to 2007 increased significantly compared with resistance level observed during 1998-2003. The continuous surveillance of quinolone resistance among H. pylori is important in this area.

AB - Background: Fluoroquinolone-containing therapy is effective in eradicating Helicobacter pylori. However, the resistance rate of H. pylori to fluoroquinolones in Taiwan has not yet been reported. In this study, we aimed to investigate the susceptibility to antibiotics commonly used in eradication schedules and fluoroquinolones in H. pylori. Methods: A total of 210 clinical isolates of H. pylori were collected from April 1998 to September 2007 from patients in southern Taiwan. The in vitro activities of six antimicrobial agents were determined by the agar dilution method and Etest. The mutations in quinolone resistance-determining regions of gyrA and gyrB were investigated by direct sequencing. Results: Overall, 5.7% of the isolates were resistant to ciprofloxacin and levofloxacin. The resistance rate to amoxicillin, clarithromycin, metronidazole, and tetracycline was 1.0% (two of 210), 9.5% (20 of 210), 27.6% (58 of 210), and 0.5% (one of 210), respectively. The resistance rate to either ciprofloxacin or to levofloxacin increased from 2.8% (1998-2003) to 11.8% (2004-2007). The mutations in gyrA at N87 or D91 had an impact on primary fluoroquinolone resistance in H. pylori. Garenoxacin, but not moxifloxacin, had a good in vitro inhibitory effect against ciprofloxacin/ levofloxacin-resistant strains compared with objective minimal inhibitory concentration values. Conclusions: Drug resistance to ciprofloxacin and levofloxacin in H. pylori collected from 2004 to 2007 increased significantly compared with resistance level observed during 1998-2003. The continuous surveillance of quinolone resistance among H. pylori is important in this area.

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