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. 2020 Dec 10:13:1756284820976990.
doi: 10.1177/1756284820976990. eCollection 2020.

Trend of changes in antibiotic resistance in Helicobacter pylori from 2013 to 2019: a multicentre report from Taiwan

Chih-Ming Liang  1 , Wei-Chen Tai  1 , Pin-I Hsu  2 , Deng-Chyang Wu  3 , Chao-Hung Kuo  3 , Feng-Woey Tsay  4 , Chia-Long Lee  5 , Kuan-Yang Chen  6 , Seng-Kee Chuah  7
Affiliations

Trend of changes in antibiotic resistance in Helicobacter pylori from 2013 to 2019: a multicentre report from Taiwan

Chih-Ming Liang et al. Therap Adv Gastroenterol. .

Abstract

Background: Antibiotic resistance plays a crucial role in the treatment failure of Helicobacter pylori (H. pylori) infection. This study aimed to determine the trend of changes in the primary, secondary and tertiary antibiotic resistance of H. pylori in Taiwan over the last 7 years.

Methods: We retrospectively analysed H. pylori-infected isolates from patients with primary resistance (n = 1369), secondary resistance (n = 196) and tertiary resistance (n = 184) from January 2013 to December 2019. The H. pylori strains were tested for susceptibility to amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline using the Epsilometer test method.

Results: A progressively higher primary resistance rate was observed for clarithromycin (11.8-20.4%, p = 0.039 in χ2 test for linear trend), levofloxacin (17.3-38.8%, p < 0.001) and metronidazole (25.6-42.3%, p < 0.001) among naïve patients who received first-line eradication therapy. The dual primary resistance to clarithromycin and metronidazole also progressively increased in a linear trend (2.4-10.4%, p = 0.009). For secondary resistance, an increase was observed for levofloxacin (30.5-64.7%, p = 0.006) and metronidazole (40.5-77.4%, p < 0.001). For tertiary resistance, the observed increase was even more significant for levofloxacin (65.9-100.0%, p = 0.106) and metronidazole (44.4-88.2%, p < 0.001). The resistance to amoxicillin and tetracycline remained very low in Taiwan regardless of primary, secondary and tertiary resistance.

Conclusion: Primary, secondary and tertiary antibiotic resistance to clarithromycin, levofloxacin and metronidazole for H. pylori has been increasing in Taiwan since 2013. Treatment should be targeted for eradication success rates of more than 90%. Third-line treatment should be based on antibiotic susceptibility.

Keywords: Helicobacter pylori; Taiwan; antibiotic resistance; seven-year trend.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
The trend of annual antibiotic resistance rates in the first-line treatment of Helicobacter pylori (n culture  = 1369).
Figure 2.
Figure 2.
The trend of annual antibiotic resistance rates in the second-line treatment of Helicobacter pylori (n culture = 196).
Figure 3.
Figure 3.
The trend of annual antibiotic resistance rates in the third-line treatment of Helicobacter pylori (n culture  = 184).
See this image and copyright information in PMC

References

    1. Wu W, Yang Y, Sun G. Recent insights into antibiotic resistance in Helicobacter pylori eradication. Gastroenterol Res Pract 2012; 2012: 723183. - PMC - PubMed
    1. De Francesco V, Giorgio F, Hassan C, et al. Worldwide H. pylori antibiotic resistance: a systematic review. J Gastrointestin Liver Dis 2010; 19: 409–414. - PubMed
    1. Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. - PubMed
    1. Sasaki H, Nagahara A, Hojo M, et al. Ten-year trend of the cumulative Helicobacter pylori eradication rate for the ‘Japanese eradication strategy’. Digestion 2013; 88: 272–278. - PubMed
    1. Sheu BS, Wu MS, Chiu CT, et al. Consensus on the clinical management, screening-to-treat, and surveillance of Helicobacter pylori infection to improve gastric cancer control on a nationwide scale. Helicobacter 2017; 22: e12368. - PMC - PubMed

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