Heterogeneity in susceptibility to metronidazole among Helicobacter pylori isolates from patients with gastritis or peptic ulcer disease

J F Weel, R W van der Hulst, Y Gerrits, G N Tytgat, A van der Ende, J Dankert, J F Weel, R W van der Hulst, Y Gerrits, G N Tytgat, A van der Ende, J Dankert

Abstract

Combination therapies that include metronidazole (MTZ) are the most successful therapies used in eradicating Helicobacter pylori. In this study, the prevalence and the relevance of heterogeneity in susceptibility to MTZ among H. pylori populations of 156 patients were evaluated. The results of this study show that 37 patients (24%) were infected with MTZ-resistant H. pylori (MIC > or = 8 micrograms/ml). Furthermore, 33% (52 of 156) of the patients were found to be infected with H. pylori populations heterogeneous for their susceptibility to MTZ. The reassessment of the MICs of MTZ for these 52 H. pylori populations revealed MTZ resistance in 28 of them, increasing the number of MTZ-resistant H. pylori populations among the 156 patients to 65 (42%). Out of 20 isolates, 2 (10%) heterogeneous in their susceptibility to MTZ also appeared to be heterogeneous at the genome level as determined by randomly amplified polymorphic DNA fingerprinting. In conclusion, the results show the limitations and risk of possible misinterpretations when only a single colony, picked from the primary H. pylori populations isolated from patients, is analyzed for its susceptibility to MTZ.

References

    1. Scand J Infect Dis. 1994;26(3):321-7
    1. Helicobacter. 1996 Mar;1(1):6-19
    1. J Clin Microbiol. 1995 Apr;33(4):918-23
    1. Lancet. 1995 Jun 17;345(8964):1525-8
    1. J Clin Microbiol. 1986 Sep;24(3):414-7
    1. Gastroenterology. 1988 Jan;94(1):33-40
    1. Antimicrob Agents Chemother. 1987 Nov;31(11):1727-33
    1. J Clin Microbiol. 1990 Mar;28(3):559-65
    1. Lancet. 1990 Apr 21;335(8695):976-7
    1. Lancet. 1991 Nov 16;338(8777):1249-52
    1. Lancet. 1992 Mar 21;339(8795):745-6
    1. J Antimicrob Chemother. 1992 Feb;29(2):115-20
    1. Nucleic Acids Res. 1992 Oct 11;20(19):5137-42
    1. J Med Microbiol. 1993 Jan;38(1):6-12
    1. J Antimicrob Chemother. 1993 Jul;32(1):45-9
    1. Am J Gastroenterol. 1994 Jan;89(1):116-8
    1. Antimicrob Agents Chemother. 1994 Feb;38(2):360-2
    1. Antimicrob Agents Chemother. 1994 Apr;38(4):724-8
    1. Eur J Clin Microbiol Infect Dis. 1994 May;13(5):406-9
    1. J Antimicrob Chemother. 1995 Jun;35(6):751-64
    1. J Infect Dis. 1996 May;173(5):1171-5
    1. Aliment Pharmacol Ther. 1996 Apr;10(2):165-71
    1. Antimicrob Agents Chemother. 1994 Oct;38(10):2357-61

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa