title: Antimicrobial susceptibility of Helicobacter pylori isolates from Lower Silesia, Poland.
abstract: BACKGROUND
  In recent years the failure of standard therapy for Helicobacter pylori infections has been observed, which results primarily from the increasing resistance of H. pylori strains to antibiotics. The aim of the study was to estimate the prevalence of antimicrobial resistance of H. pylori strains isolated from adult symptomatic patients with primary infection in the Lower Silesia Region in Poland.
  
  
  METHODS
  One hundred and seventy-eight adults aged 19-89 years with dyspeptic symptoms suggesting gastroduodenal pathology were enrolled in the study. The study was performed in the years 2008-2011. Fifty H. pylori strains were isolated from gastric biopsy samples of examined patients. Antimicrobial susceptibility to 6 drugs (amoxicillin (AM), clarithromycin (CH), metronidazole (MZ), tetracycline (TC), levofloxacin (LEV), and rifabutin (RB)) was tested by the gradient-diffusion method (E-test method).
  
  
  RESULTS
  The incidence of H. pylori infection among examined patients was 35%. From 50 isolated H. pylori strains, 24% showed resistance to CH, 42% to MZ and 8% to LEV alone. Multidrug resistance was detected in 26% of strains, whereas 20% of isolates were resistant to MZ and CH. Examined strains were fully susceptible to AM, TC and RB.
  
  
  CONCLUSIONS
  Resistance to clarithromycin strains isolated from adults of the Lower Silesia Region in Poland is high and is almost always associated with resistance to metronidazole (CH + MZ). It is necessary to continuously monitor H. pylori resistance to drugs used in therapy, especially to clarithromycin. Verification of the existing recommendations of eradication therapy is also needed.
authors.affiliation: Department of Microbiology, Medical University of Wroclaw, Poland.
authors.forename: Monika Maria
authors.initials: MM
authors.lastname: Biernat
authors.affiliation: Department and Clinic of Gastroenterology and Hepatology, Medical University of Wroclaw, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Poniewierka
authors.affiliation: Department and Clinic of Gastrointestinal and General Surgery, Medical University of Wroclaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Błaszczuk
authors.affiliation: Department and Clinic of Gastrointestinal and General Surgery, Medical University of Wroclaw, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Czapla
authors.affiliation: Department and Clinic of Gastroenterology and Hepatology, Medical University of Wroclaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Kempiński
authors.affiliation: Department and Clinic of Gastroenterology and Hepatology, Medical University of Wroclaw, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Ksiądzyna
authors.affiliation: Department of Microbiology, Medical University of Wroclaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Grabińska
authors.affiliation: Department of Microbiology, Medical University of Wroclaw, Poland.
authors.forename: Aldona
authors.initials: A
authors.lastname: Bińkowska
authors.affiliation: Laboratoire de Bactériologie, C.H.U. Pellegrin, Bordeaux, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Megraud
authors.affiliation: Department of Microbiology, Medical University of Wroclaw, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Gościniak
keywords: Helicobacter pylori; resistance; symptomatic patients
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