Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China
The number of antibiotics that are appropriate for Helicobacter pylori eradication in children is limited. Profiling regional or population-specific antibiotic resistance is essential in guiding the H. pylori eradication treatment in children. The aim of this study was to evaluate the antibiotic res...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-01-01
|
Series: | Frontiers in Microbiology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2020.621791/full |
id |
doaj-cdc190ffd7844c6cb974763c607c93ed |
---|---|
record_format |
Article |
spelling |
doaj-cdc190ffd7844c6cb974763c607c93ed2021-01-26T05:00:45ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-01-011110.3389/fmicb.2020.621791621791Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest ChinaJuan Li0Juan Li1Juan Li2Jianjun Deng3Jianjun Deng4Zhiling Wang5Hong Li6Chaomin Wan7Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaDepartment of Infection Control, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaDepartment of Infection Control, West China Second University Hospital, Sichuan University, Chengdu, ChinaDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaWest China Marshall Research Center for Infectious Diseases, Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, ChinaThe number of antibiotics that are appropriate for Helicobacter pylori eradication in children is limited. Profiling regional or population-specific antibiotic resistance is essential in guiding the H. pylori eradication treatment in children. The aim of this study was to evaluate the antibiotic resistance in H. pylori strains isolated from children and adolescents in Southwest China. Gastric biopsies from 157 pediatric patients with or without previous H. pylori eradication treatment were collected for H. pylori culture. Susceptibility to amoxicillin (AML), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET), furazolidone (FZD), and rifampicin (RIF) was determined by E-test or a disk diffusion assay. A total of 87 patients from three ethnic groups (Han/Tibetan/Yi) were H. pylori culture positive (55.4%). The overall resistance rates were 55.2% for CLR, 71.3% for MTZ, 60.9% for RIF, and 18.4% for LEV. No isolate was found to be resistant to AML, TET, and FZD. Among the 53 treatment-naïve pediatric patients, primary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 45.3, 73.6, 15.1, and 60.4%, respectively. Among the 34 treatment-experienced patients, secondary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 70.6, 67.6, 23.5, and 61.8%, respectively. Isolates exhibiting simultaneous resistance to clarithromycin and metronidazole were 28.3 and 52.9% among the treatment-naïve and treatment-experienced patients, respectively. In conclusion, among pediatric patients in Southwest China, resistance rates were high for clarithromycin, metronidazole, levofloxacin, and rifampicin, whereas nil resistance was found to amoxicillin, tetracycline, and furazolidone. Our data suggest that the standard clarithromycin-based triple therapy should be abandoned as empiric therapy, whereas the bismuth quadruple therapy (bismuth/PPI/amoxicillin/tetracycline) would be suitable as first-line empiric treatment regimen for this pediatric population. Tetracycline and furazolidone may be considered for treating refractory H. pylori infections in adolescent patients.https://www.frontiersin.org/articles/10.3389/fmicb.2020.621791/fullHelicobacter pyloriantimicrobial susceptibility testingpediatric populationempiric therapyrifampicin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan Li Juan Li Juan Li Jianjun Deng Jianjun Deng Zhiling Wang Hong Li Chaomin Wan |
spellingShingle |
Juan Li Juan Li Juan Li Jianjun Deng Jianjun Deng Zhiling Wang Hong Li Chaomin Wan Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China Frontiers in Microbiology Helicobacter pylori antimicrobial susceptibility testing pediatric population empiric therapy rifampicin |
author_facet |
Juan Li Juan Li Juan Li Jianjun Deng Jianjun Deng Zhiling Wang Hong Li Chaomin Wan |
author_sort |
Juan Li |
title |
Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China |
title_short |
Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China |
title_full |
Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China |
title_fullStr |
Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China |
title_full_unstemmed |
Antibiotic Resistance of Helicobacter pylori Strains Isolated From Pediatric Patients in Southwest China |
title_sort |
antibiotic resistance of helicobacter pylori strains isolated from pediatric patients in southwest china |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Microbiology |
issn |
1664-302X |
publishDate |
2021-01-01 |
description |
The number of antibiotics that are appropriate for Helicobacter pylori eradication in children is limited. Profiling regional or population-specific antibiotic resistance is essential in guiding the H. pylori eradication treatment in children. The aim of this study was to evaluate the antibiotic resistance in H. pylori strains isolated from children and adolescents in Southwest China. Gastric biopsies from 157 pediatric patients with or without previous H. pylori eradication treatment were collected for H. pylori culture. Susceptibility to amoxicillin (AML), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), tetracycline (TET), furazolidone (FZD), and rifampicin (RIF) was determined by E-test or a disk diffusion assay. A total of 87 patients from three ethnic groups (Han/Tibetan/Yi) were H. pylori culture positive (55.4%). The overall resistance rates were 55.2% for CLR, 71.3% for MTZ, 60.9% for RIF, and 18.4% for LEV. No isolate was found to be resistant to AML, TET, and FZD. Among the 53 treatment-naïve pediatric patients, primary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 45.3, 73.6, 15.1, and 60.4%, respectively. Among the 34 treatment-experienced patients, secondary resistance rates to clarithromycin, metronidazole, levofloxacin, and rifampicin were 70.6, 67.6, 23.5, and 61.8%, respectively. Isolates exhibiting simultaneous resistance to clarithromycin and metronidazole were 28.3 and 52.9% among the treatment-naïve and treatment-experienced patients, respectively. In conclusion, among pediatric patients in Southwest China, resistance rates were high for clarithromycin, metronidazole, levofloxacin, and rifampicin, whereas nil resistance was found to amoxicillin, tetracycline, and furazolidone. Our data suggest that the standard clarithromycin-based triple therapy should be abandoned as empiric therapy, whereas the bismuth quadruple therapy (bismuth/PPI/amoxicillin/tetracycline) would be suitable as first-line empiric treatment regimen for this pediatric population. Tetracycline and furazolidone may be considered for treating refractory H. pylori infections in adolescent patients. |
topic |
Helicobacter pylori antimicrobial susceptibility testing pediatric population empiric therapy rifampicin |
url |
https://www.frontiersin.org/articles/10.3389/fmicb.2020.621791/full |
work_keys_str_mv |
AT juanli antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT juanli antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT juanli antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT jianjundeng antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT jianjundeng antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT zhilingwang antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT hongli antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina AT chaominwan antibioticresistanceofhelicobacterpyloristrainsisolatedfrompediatricpatientsinsouthwestchina |
_version_ |
1724323508078510080 |