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The Changing Profile of Helicobacter pylori Antibiotic Resistance in Singapore: A 15‐Year Study
Author(s) -
Ang Tiing Leong,
Fock Kwong Ming,
Ang Daphne,
Kwek Andrew Boon Eu,
Teo Eng Kiong,
Dhamodaran Subbiah
Publication year - 2016
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12291
Subject(s) - helicobacter pylori , antibiotic resistance , antibiotics , medicine , resistance (ecology) , microbiology and biotechnology , biology , ecology
Background Antibiotic resistance is an important cause of H. pylori treatment failure. This study aimed to examine the change in H. pylori antibiotic resistance profile in Singapore over the course of 15 years. Materials and methods The study period was from 2000 to 2014. Gastric mucosal biopsies obtained from H. pylori ‐positive patients were cultured. Antibiotic susceptibility to metronidazole, clarithromycin, levofloxacin, tetracycline, and amoxicillin was tested. The change in resistance rates over time was analyzed. Results A total of 708 H. pylori isolates were cultured. There was a significant increase in resistance rates for metronidazole (2000–2002: 24.8%; 2012–2014: 48.2%; p < .001), clarithromycin (2000–2002: 7.9%; 2012–2014: 17.1%; p = .022), and levofloxacin (2000–2002: 5%; 2012–2014: 14.7%; p = .007). The resistance rates for tetracycline (2000–2002: 5%; 2012–2014: 7.6%) and amoxicillin (2000–2002: 3%; 2012–2014: 4.4%) remained stable. Increase in dual (2000–2002: 6.9%; 2012–2014: 9.4%; p = .479) and triple antibiotic resistance rates (2000–2002: 0; 2012–2014: 7.6%; p < .001) were observed. Overall, the most common dual and triple resistance patterns were metronidazole/clarithromycin (4.4%) and metronidazole/clarithromycin/levofloxacin (1.8%), respectively. Conclusions Over 15 years, H. pylori resistance rates to metronidazole, clarithromycin and levofloxacin had increased. There was increased resistance to multiple antibiotics.