Antibiotic resistance of Helicobacter pylori from patients in Ile-Ife, South-west, Nigeria.
BACKGROUND
Helicobacter pylori has become recognized as a major cause of gastroduodenal diseases in man. Evidence indicates that once acquired, H. pylori persists, usually for life unless eradicated by antimicrobial therapy. Over the past few years, we have accumulated some knowledge of the epidemiology of H. pylori in Ile-Ife, South-West Nigeria. In one collaborative study, we detected H. pylori in 195 (73%) patients referred for endoscopy at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). Furthermore we have observed a variegated gastric inflammatory response and atrophy including atrophic pangastritis but are yet to demonstrate MALToma in any of our patients. In addition we have demonstrated that dental plaque is a possible source of gastric H. pylori infection and such an endogenous source could account for difficulty in eradication leading to re-infection. Presently, infected patients are treated with standard combination therapy made up of amoxycilin and ciprofloxacin with a proton pump inhibitor/bismuth. Reports however have shown that the incidence of antimicrobial resistance in Helicobacter pylori is a growing problem and which has been linked with failures in treatment and eradication. Given this situation it has become necessary to have information about the susceptibility of isolates to particular antimicrobial agents before the selection of an appropriate treatment regimen.


OBJECTIVE
More recently, we sought to study antimicrobial susceptibility of locally isolated H. pylori strains.


METHODS
We subjected 32 isolates to antimicrobial susceptibility testing against seven agents.


RESULTS
All the isolates showed multiple acquired antimicrobial resistance as they were all resistant to amoxicillin, clarithromycin, metronidazole, while 29/31, 27/31 showed resistance to rifampicin and tetracycline respectively. Five (15.6%) of these isolates showed resistance to ciprofloxacin.


CONCLUSIONS
Our findings suggest that H. pylori strains isolated within our study environment have acquired resistance to all the commonly prescribed antibiotics. On the basis of the findings it would be necessary to re-evaluate the eradication treatment regime in our setting.
Department of Medical Microbiology & Parasitology, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. aaboderi@oauife.edu.ng
Oladiipo A
OA
Aboderin
Abdul R
AR
Abdu
Babatunde 'Wumi
B'
Odetoyin
Iruka N
IN
Okeke
Oladejo O
OO
Lawal
Dennis A
DA
Ndububa
Augustine E
AE
Agbakwuru
Adebayo
A
Lamikanra
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001706:Biopsy; D024881:Drug Resistance, Bacterial; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria
D000900:Anti-Bacterial Agents