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Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study
Author(s) -
Lee Jeong Hoon,
Ahn Ji Yong,
Choi Kee Don,
Jung HwoonYong,
Kim Jung Mogg,
Baik Gwang Ho,
Kim ByungWook,
Park Jun Chul,
Jung HyeKyung,
Cho Soo Jeong,
Shin Cheol Min,
Choi Yoon Jin,
Lee Si Hyung,
Kim Ji Hyun,
Lee Wan Sik,
Sung Jae Kyu,
Chung JunWon,
Cheung Dae Young,
Lee Hyuk,
Min Yang Won,
Kim Jae J.,
Kim Seung Young
Publication year - 2019
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.12592
Subject(s) - levofloxacin , metronidazole , clarithromycin , helicobacter pylori , amoxicillin , tetracycline , ciprofloxacin , medicine , antibiotics , antibiotic resistance , gastroenterology , drug resistance , microbiology and biotechnology , biology
The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.