Surveillance of primary antibiotic resistance of Helicobacter pylori at centres in England and Wales over a six-year period (2000-2005).
Antibiotic resistance is a key factor in the failure of Helicobacter pylori eradication therapy, yet few sentinel schemes exist to monitor trends in resistance at local, national or international levels. This study aimed, over a six-year period, to monitor resistance levels of H. pylori in England and Wales to the four antibiotics used in its treatment. A total of 1,310 isolates from Gwynedd in north Wales and from mid-Essex in south-east England were collected from 2000 to 2005 and tested for susceptibilities to metronidazole, clarithromycin, amoxicillin and tetracycline. Overall, metronidazole and clarithromycin resistance rates were 28.6% and 8.3% in Gwynedd and significantly higher (36.3%, p=0.0031, and 12.7%, p=0.0112) in mid-Essex. Rates of resistance to metronidazole and clarithromycin increased in both areas over this six-year period. Resistance rates were higher in female compared with male patients (38.1% vs 26.6% for metronidazole, p<0.0001, and 12.9% vs 7.5% for clarithromycin, p=0.0024), and were higher in patients <45 years compared with those ?45 years (44.0% vs 29.0% for metronidazole, p=0.0002, and 15.0% vs 9.4% for clarithromycin, p=0.0233). This study highlights the importance of antibiotic resistance surveillance in H. pylori for providing information on local resistance rates for test and treat strategies.
Chisholm
S A
SA
Laboratory of Enteric Pathogens, Centre for Infections, Health Protection Agency, London, United Kingdom. stephanie.chisholm@hpa.org.uk
Teare
E L
EL
Davies
K
K
Owen
R J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial; D004739:England / Q000453:epidemiology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000517:prevention & control*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D011322:Primary Prevention / Q000379:methods / Q000706:statistics & numerical data*; D014852:Wales / Q000453:epidemiology
D000900:Anti-Bacterial Agents