Antibiotic resistance amongHelicobacter pyloriclinical isolates in Lima, Peru.
Gastric carcinoma is the most common cancer and cause of cancer mortality in Peru.Helicobacter pylori, a bacterium that colonizes the human stomach, is a Group 1 carcinogen due to its causal relationship to gastric carcinoma. While eradication ofH. pylorican help prevent gastric cancer, characterizing regional antibiotic resistance patterns is necessary to determine targeted treatment for each region. Thus, we examined primary antibiotic resistance in clinical isolates ofH. pyloriin Lima, Peru.



H. pyloristrains were isolated from gastric biopsies of patients with histologically provenH. pyloriinfection. Primary antibiotic resistance among isolates was examined using E-test strips. Isolates were examined for the presence of thecagApathogenicity island and thevacAm1/m2 alleles via polymerase chain reaction.



Seventy-six isolates were recovered from gastric biopsies. Clinical isolates showed evidence of antibiotic resistance to 1 (27.6%, n=21/76), 2 (28.9%, n=22/76), or ≥3 antibiotics (40.8%). Of 76 isolates, eight (10.5%) were resistant to amoxicillin and clarithromycin, which are part of the standard triple therapy forH. pyloriinfection. No trends were seen between the presence ofcagA,vacAm1, orvacAm2 and antibiotic resistance.



The rate of antibiotic resistance amongH. pyloriisolates in Lima, Peru, is higher than expected and presents cause for concern. To develop more targeted eradication therapies forH. pyloriin Peru, more research is needed to better characterize antibiotic resistance among a larger number of clinical isolates prospectively.
Department of Environmental Health Sciences, School of Public Health.
Kevin F
KF
Boehnke
Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Manuel
M
Valdivieso
Departamento Académico de Clínicas Médicas, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Alejandro
A
Bussalleu
Cancer Research and Biostatistics, Seattle, WA, USA.
Rachael
R
Sexton
Department of Environmental Health Sciences, School of Public Health.
Kathryn C
KC
Thompson
Dirección General de Salud Ambiental, Ministerio de Salud del Perú, Lima, Perú.
Soledad
S
Osorio
Departamento Académico de Clínicas Médicas, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Italo
I
Novoa Reyes
Cancer Research and Biostatistics, Seattle, WA, USA.
John J
JJ
Crowley
Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Laurence H
LH
Baker
Department of Environmental Health Sciences, School of Public Health.
Chuanwu
C
Xi
H. pylori; Peru; amoxicillin; antibiotic resistance