Antibiotic susceptibility of Helicobacter pylori isolates in Dakar, Senegal.
BACKGROUND
Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. A high frequency of H. pylori infection has been reported from resource-poor regions. H. pylori infection is curable with regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics.


METHODS
H. pylori isolates from gastric biopsies from outpatients > or = 18 years old affected by a gastro-duodenal ulcer were used in this study. Susceptibility testing was performed for amoxicillin, ciprofloxacin and metronidazole by using the Epsilometer test (E-test) method.


RESULTS
H. pylori strains were isolated from 40 patients of whom 36 were diagnosed as having duodenal ulcer, two with gastric ulcer, and two with gastro-duodenal ulcer. Thirty-six (90%) of the isolates were resistant to metronidazole (MICs > or = 8 microg/l), whereas all isolates were susceptible to amoxicillin (MICs < or = 0.5 microg/ml) and ciprofloxacin (MICs < or = 1 microg/ml).


CONCLUSIONS
These data suggest that metronidazole should not be used therapeutically among Senegalese patients in first-line therapy, while ciprofloxacin could be recommended in association with amoxicillin and a proton pump inhibitor in Senegal.
Seck
Abdoulaye
A
Laboratoire de Biologie Médicale, Institut Pasteur, Dakar, Senegal. seck@pasteur.sn
Mbengue
Mouhamadou
M
Gassama-Sow
Amy
A
Diouf
Lamine
L
Ka
Mouhamadou Mourtalla
MM
Boye
Cheikh Saad-Bouh
CS
D000328:Adult; D000658:Amoxicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000453:epidemiology / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D012675:Senegal / Q000453:epidemiology; D013276:Stomach Ulcer / Q000453:epidemiology / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D000658:Amoxicillin