title: Emerging trends of antimicrobial resistance in Helicobacter pylori isolates obtained from Pakistani patients: The need for consideration of amoxicillin and clarithromycin.
abstract: To present antimicrobial susceptibility profile of helicobacter pylori isolated from gastric biopsies of dyspeptic patients.
  
  
  
  The cross-sectional study was conducted from March 2008 to May 2013 at the Jinnah Postgraduate Medical Centre (JPMC), Karachi, and comprised patients with suspected peptic ulcer disease who underwent upper gastrointestinal endoscopy. Multiple gastric antral biopsies were taken. One sample was imbedded in the Campylobacter-like organism test, while other biopsies were processed for culture and confirmed on polymerase chain reaction. Isolates were subjected to antimicrobial susceptibility testing and minimum inhibitory concentrations of antimicrobial agents were estimated by Epsilometer test. SPSS 21 was used for statistical analysis.
  
  
  
  Of the 889 samples available, 254(28.6%) were positive after campylo-like organism test, of them, 92(36.2%) isolates were cultured. Susceptibility test showed 90(97.8%) resistance to metronidazole, 25(30.1%) ofloxacin, 6(16.2%) levofloxacin, 14(15.2%) furazolidone, 5(5.4%) clarithromycin, 4(4.3%) tetracycline and 2(2.2%) isolates showed resistance to amoxicillin. Resistance to more than one drug was observed in 37(40.2%) isolates.
  
  
  
  Low clarithromycin resistance was surprising since Pakistan is considered a hot bed of drug-resistant bacteria.
authors.affiliation: Pakistan Medical Research Council, Pakistan.
authors.forename: Taranum Ruba
authors.initials: TR
authors.lastname: Siddiqui
authors.affiliation: Pakistan Medical Research Council, Pakistan.
authors.forename: Waquaruddin
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: Toronto Western Hospital, Canada, Gastroenterology and Hepatology unit & Pakistan Medical Research Council, Pakistan.
authors.forename: Ambreen
authors.initials: A
authors.lastname: Arif
authors.affiliation: Pakistan Medical Research Council, Pakistan.
authors.forename: Safia
authors.initials: S
authors.lastname: Bibi
authors.affiliation: Department of Microbiology, University of Karachi, Pakistan.
authors.forename: Adnan
authors.initials: A
authors.lastname: Khan
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D010154:Pakistan
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Antimicrobial susceptibility, Amoxicillin, Clarithromycin, Furazolidone, Helicobacter pylori.