title: Antibiotics resistance rate of Helicobacter pylori in Bhutan.
abstract: OBJECTIVE
  To survey the antibiotic resistance pattern of Helicobacter pylori (H. pylori) strains isolated from Bhutanese population.
  
  
  METHODS
  We isolated 111 H. pylori strains from the gastric mucosa of H. pylori-infected patients in Bhutan in 2010. The Epsilometer test was used to determine the minimum inhibitory concentrations (MICs) of amoxicillin (AMX), clarithromycin (CLR), metronidazole (MNZ), levofloxacin (LVX), ciprofloxacin (CIP), and tetracycline (TET).
  
  
  RESULTS
  Nineteen of the isolated H. pylori strains were susceptible to all antibiotics tested. The isolated strains showed the highest rate of antibiotic resistance to MNZ (92/111, 82.9%). Among the 92 MNZ-resistant strains, 74 strains (80.4%) showed high-level resistance (MIC ≥ 256 μg/mL). Three strains were resistance to LVX (2.7%). These strains were also resistance to CIP. None of the strains showed resistance to CLR, AMX and TET.
  
  
  CONCLUSIONS
  CLR-based triple therapy is a more effective treatment approach over MNZ-based triple therapy for H. pylori infection in Bhutan.
authors.affiliation: Ratha-korn Vilaichone, Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani 12120, Thailand.
authors.forename: Ratha-korn
authors.initials: RK
authors.lastname: Vilaichone
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-ek
authors.forename: Lotay
authors.initials: L
authors.lastname: Tshering
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Uchida
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
mesh_terms: D000328:Adult; D001631:Bhutan; D024881:Drug Resistance, Bacterial; D005260:Female; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D055815:Young Adult
keywords: Bhutan; Drug resistance; Helicobacter pylori
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