Antibacterial resistance in Helicobacter pylori strains isolated from Bulgarian children and adult patients over 9 years.
The aim of this study was to evaluate the primary, combined and post-treatment antibacterial resistance rates in 1205 Helicobacter pylori strains from non-treated (786 adults, 282 children) and treated (109 adults, 28 children) patients in Bulgaria. Susceptibility was tested by the limited agar dilution method. Overall primary resistance rates to metronidazole, clarithromycin, amoxicillin, tetracycline and both metronidazole and clarithromycin were respectively 15.0, 12.5, 1.5, 3.4 and 4.7% in children and 25.6, 12.6, 0.8, 5.2 and 4.9% in adults. Primary metronidazole resistance in adults was more common than in children, but the differences for other agents tested were not significant. Primary resistance rates were in the range of those reported worldwide. There was no significant increase in primary resistance rates from 1996/1999 to 2003/2004; however, clarithromycin resistance rates exhibited a slight tendency to increase. Post-treatment resistance to amoxicillin was detected in 1.6% of 63 strains. Post-treatment resistance to metronidazole was common (81.6%) and that to clarithromycin was considerable (36%). Alarming emergence of strains with triple resistance to amoxicillin, metronidazole and clarithromycin was found in two non-treated and three treated patients. The results motivate a larger and continuing surveillance of H. pylori resistance in Bulgaria and worldwide.
Boyanova
Lyudmila
L
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria.
Nikolov
Rossen
R
Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria.
Lazarova
Elena
E
Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Gergova
Galina
G
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria.
Katsarov
Nikolai
N
Second Surgery Department of Alexander Hospital, Sofia, Bulgaria.
Kamburov
Victor
V
Urgent Endoscopy Unit, Emergency Hospital Pirogov, Sofia, Bulgaria.
Spassova
Zoya
Z
Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria.
Derejian
Sirigan
S
Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria.
Jelev
Christo
C
Department of Gastroenterology, University Paediatric Hospital, Sofia, Bulgaria.
Mitov
Ivan
I
Department of Microbiology, Medical University of Sofia, Zdrave Street 2, 1431 Sofia, Bulgaria.
Krastev
Zacharii
Z
Department of Gastroenterology, University Hospital St Ivan Rilski, Sofia, Bulgaria.
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D024881:Drug Resistance, Bacterial; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005756:Gastritis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification*; D006801:Humans; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents