title: Antimicrobial susceptibility testing for Helicobacter pylori in times of increasing antibiotic resistance.
abstract: The gram-negative bacterium Helicobacter pylori (H. pylori) causes chronic gastritis, gastric and duodenal ulcers, gastric cancer and mucosa-associated lymphoid tissue lymphoma. Treatment is recommended in all symptomatic patients. The current treatment options for H. pylori infection are outlined in this review in light of the recent challenges in eradication success, largely due to the rapid emergence of antibiotic resistant strains of H. pylori. Antibiotic resistance is a constantly evolving process and numerous studies have shown that the prevalence of H. pylori antibiotic resistance varies significantly from country to country, and even between regions within the same country. In addition, recent data has shown that previous antibiotic use is associated with harbouring antibiotic resistant H. pylori. Local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy. Antimicrobial resistance is assessed by H. pylori culture and antimicrobial susceptibility testing. Recently developed molecular tests offer an attractive alternative to culture and allow for the rapid molecular genetic identification of H. pylori and resistance-associated mutations directly from biopsy samples or bacterial culture material. Accumulating evidence indicates that surveillance of antimicrobial resistance by susceptibility testing is feasible and necessary to inform clinicians in their choice of therapy for management of H. pylori infection.
authors.affiliation: Sinéad M Smith, Colm O'Morain, Deirdre McNamara, Department of Clinical Medicine, Trinity College Dublin, Trinity Centre, Adelaide and Meath Hospital, Dublin 24, Ireland.
authors.forename: Sinéad M
authors.initials: SM
authors.lastname: Smith
authors.affiliation: Sinéad M Smith, Colm O'Morain, Deirdre McNamara, Department of Clinical Medicine, Trinity College Dublin, Trinity Centre, Adelaide and Meath Hospital, Dublin 24, Ireland.
authors.forename: Colm
authors.initials: C
authors.lastname: O'Morain
authors.affiliation: Sinéad M Smith, Colm O'Morain, Deirdre McNamara, Department of Clinical Medicine, Trinity College Dublin, Trinity Centre, Adelaide and Meath Hospital, Dublin 24, Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: McNamara
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005838:Genotype; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D008826:Microbial Sensitivity Tests; D025202:Molecular Diagnostic Techniques; D009154:Mutation; D018579:Patient Selection; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Antimicrobial susceptibility testing; Helicobacter pylori; Molecular test; Polymerase chain reaction
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