title: Low rate of recurrence of Helicobacter pylori infection in spite of high clarithromycin resistance in Pakistan.
abstract: BACKGROUND
  The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy.
  
  
  METHODS
  One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41±13 years (range 18-77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). 14C urea breath test (14C-UBT) was performed 4 weeks after the eradication therapy. The successfully treated patients were observed for 12 months with 14C-UBT to assess H. pylori status. If 14C-UBT was negative, it was repeated after every 12 weeks. If 14C-UBT was positive, endoscopy was repeated with biopsies.
  
  
  RESULTS
  The eradication therapy was successful in 102(85%) patients. Out of forty-seven H. pylori isolates cultured, clarithromycin sensitivity was present in 30(64%) and amoxicillin in 45(98%), respectively. Follow-up 14C-urea breath tests of all 102 patients who eradicated H. pylori remained negative up to 9 months. However, in 6 patients, the 14C-UBT confirmed recurrence at 12 months. The recurrence rate was 6%.
  
  
  CONCLUSIONS
  A low rate of recurrence of H. pylori infection was found in patients with dyspeptic symptoms. H. pylori isolates demonstrated a high invitro clarithromycin resistance.
authors: Department of Medicine, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan. shahab.abid@aku.edu.
authors: Javed
authors: J
authors: Yakoob
authors: Shahab
authors: S
authors: Abid
authors: Wasim
authors: W
authors: Jafri
authors: Zaigham
authors: Z
authors: Abbas
authors: Khalid
authors: K
authors: Mumtaz
authors: Saeed
authors: S
authors: Hamid
authors: Rashida
authors: R
authors: Ahmed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010437:Peptic Ulcer / Q000382:microbiology; D015995:Prevalence; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D017291:Clarithromycin