title: Prevalence of multiple drug-resistant Helicobacter pylori strains among patients with different gastric disorders in Iran.
abstract: Emergence of multidrug-resistant (MDR) strains of Helicobacter pylori is a global health concern. This study was aimed to determine the frequency of MDR H. pylori strains in Iran. H. pylori isolates were obtained from cultured gastric biopsy samples on selective culture media after their characterization by PCR and conventional biochemical methods. The minimal inhibitory concentrations of rifampicin, ciprofloxacin, levofloxacin, ampicillin, clarithromycin, erythromycin, metronidazole, and tetracycline were determined for 111 strains that were isolated from 197 dyspeptic patients by the agar dilution method. The primary resistance rates were 61.3% (68/111) for metronidazole, 15.3% (17/111) for ampicillin, and 14.4% (16/111) for rifampicin. Resistance rates for other antimicrobials were as follows: macrolides (erythromycin or clarithromycin) 32.4% (36/111) and quinolones (levofloxacin or ciprofloxacin) 30.6% (34/111). Among the resistant strains, the rates of double and multiple drug resistance phenotypes were 22.6% (19/84) and 34.5% (29/84), respectively. The quadruple drug resistance phenotype encompasses 37.9% of the MDR strains, of which 90% of them was resistant to metronidazole. In conclusion, these results showed a high frequency of MDR phenotypes among the studied H. pylori strains in Iran. The eradication of the H. pylori strains presenting high resistance rates to macrolides, fluoroquinolones, or metronidazole could be achieved by approved tetracycline- or amoxicillin-containing regimens as alternative regimens to standard triple therapy.
authors.affiliation: 1 Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
authors.forename: Leila
authors.initials: L
authors.lastname: Shokrzadeh
authors.forename: Masoud
authors.initials: M
authors.lastname: Alebouyeh
authors.forename: Tabassom
authors.initials: T
authors.lastname: Mirzaei
authors.forename: Nastaran
authors.initials: N
authors.lastname: Farzi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zali
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001706:Biopsy; D015169:Colony Count, Microbial; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D013272:Stomach Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents