Institutional difference of antibiotic resistance of Helicobacter pylori strains in Korea.
OBJECTIVE
This study was performed to evaluate whether the prevalence rates of primary antibiotic resistance in Helicobacter pylori isolates could be different between 2 institutions, which are located in the different areas in Korea, and to evaluate the effect of antibiotic resistance on the eradication rate of H. pylori.


METHODS
H. pylori were isolated from gastric mucosal biopsy specimens obtained from 113 Koreans, who did not have any eradication history. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and moxifloxacin were examined according to the agar dilution method by 1 technician.


RESULTS
All of these patients were treated with the same regimen, proton pump inhibitor-amoxicillin-clarithromycin triple therapy. There was a statistical difference in resistance to metronidazole, levofloxacin, and moxifloxacin among 6 antibiotics between 2 institutions located in Seoul and Gyeonggi province. The rates of eradication were 94.2% for the clarithromycin and amoxicillin-susceptible strains, and 42.8% for the amoxicillin-susceptible and clarithromycin-resistant strains. In contrast, eradication rate was 100% for the amoxicillin-resistant strains.


CONCLUSIONS
These results show that there is institutional difference of antibiotic resistance of H. pylori, explaining the institutional difference of eradication rate of H. pylori. The resistance to clarithromycin seems to be an important determinant for the eradication by proton pump inhibitor triple therapy but resistance to amoxicillin does not have any effect.
Kim
Nayoung
N
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Seoul, Korea.
Kim
Jung Mogg
JM
Kim
Chung Hyun
CH
Park
Young Soo
YS
Lee
Dong Ho
DH
Kim
Joo Sung
JS
Jung
Hyun Chae
HC
Song
In Sung
IS
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001706:Biopsy; D024881:Drug Resistance, Bacterial; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005767:Gastrointestinal Diseases / 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; D006785:Hospitals, University; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors