title: The incidence of primary antibiotic resistance of Helicobacter pylori in Vietnam.
abstract: OBJECTIVE
  To determine the susceptibility of Helicobacter pylori strains isolated from a Vietnamese population to 5 antibiotics.
  
  
  BACKGROUND
  The incidence of antibiotic resistance in H. pylori infection is increasing worldwide and has become a leading cause for failure of treatment. Antibiotic susceptibility testing is very important to provide optimal regimens in a clinical setting.
  
  
  METHODS
  We isolated 103 H. pylori strains from the gastric mucosa of H. pylori-infected patients from 2 areas in Vietnam (Ho Chi Minh and Hanoi) in 2008. Epsilometer test was used to determine the minimum inhibitory concentrations of amoxicillin, clarithromycin (CLR), metronidazole (MNZ), levofloxacin, and tetracycline.
  
  
  RESULTS
  Among the 103 strains, the resistance rates were 0% (amoxicillin), 33% (CLR), 69.9% (MNZ), 18.4% (levofloxacin), and 5.8% (tetracycline). The resistant strains showed a high-level of resistance (≥ 256 µg/mL) to CLR, 23.5% (8/34), and MNZ, 29.1% (21/72). The resistance rate for CLR was significantly higher in Ho Chi Minh than in Hanoi (49% vs. 18.5%, P=0.001). Resistance to both CLR and MNZ was most commonly observed (24.3%). Two strains (1.9%) were resistant to 4 of the 5 antibiotics. No significant association was observed between antibiotic resistance rates and age, sex, or clinical outcomes of the patients.
  
  
  CONCLUSIONS
  High incidence of resistance to CLR and MNZ suggests that standard triple therapies may not be useful as first-line treatment in Vietnam. Alternative strategies such as bismuth-based quadruple therapies or sequential therapy may be more effective in Vietnam.
authors.affiliation: Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
authors.forename: Tran T
authors.initials: TT
authors.lastname: Binh
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.forename: Lam T
authors.initials: LT
authors.lastname: Nguyen
authors.forename: Dung D Q
authors.initials: DD
authors.lastname: Ho
authors.forename: Hai H
authors.initials: HH
authors.lastname: Hoang
authors.forename: Long
authors.initials: L
authors.lastname: Ta
authors.forename: Dung T
authors.initials: DT
authors.lastname: Trinh
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014744:Vietnam; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents