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Revista Colombiana de Gastroenterologia

Print version ISSN 0120-9957

Abstract

TRESPALACIOS, Alba Alicia; OTERO REGINO, William  and  MERCADO REYES, Marcela. Helicobacter pylori resistance to metronidazole, clarithromycin and amoxicillin in Colombian patients. Rev Col Gastroenterol [online]. 2010, vol.25, n.1, pp.31-38. ISSN 0120-9957.

Helicobacter pylori (H. pylori), is a universal pathogen that infects more than half the world population. In the last two decades, the recommended treatment for its eradication, as first-line scheme is the standard triple therapy, consisting of an inhibitor of the proton pump, clarithromycin and amoxicillin or metronidazole. In recent years the effectiveness of this therapy has declined, especially due to the resistance of bacteria to metronidazole and clarithromycin. Objectives: In this study, we evaluated the prevalence of primary resistance of Colombian H. pylori isolates to metronidazole, clarithromycin, amoxicillin. In addition, the vacA and cagA genotypes of strains isolated were determined and associated to correlate the virulence markers and antibiotic resistance. Methods: Minimum inhibitory concentration (MIC) for metronidazole, clarithromycin and amoxicillin were determined by E-test method. Genomic DNA was extracted, and allelic variants of vacA and cagA were identified by the polymerase chain reaction (PCR). Results: Resistance to metronidazole was 81.01 % (IC95% 70.3%-88.6%), to amoxicillin 3,8% (IC 95% 0-8,6%), and to clarithromycin 17.72% (IC95% 10.37-28.29). No significant correlation between pathogenicity and resistance or susceptibility was detected when MIC values for each antibiotic were compared with different vacA and cagA genotypes. Conclusion: We find a high rate of resistance to three principal antibiotics used in the majority of the successful schemes of eradication of the infection, which implies the need to investigate with priority new schemes of treatment for the eradication of the infection in Colombia.

Keywords : Helicobacter pylori; genotypes; clarithromycin; amoxicillin; metronidazole.

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