Low-level primary clarithromycin resistance of Helicobacter pylori in Reunion Island

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES Infectious diseases now Pub Date : 2025-01-11 DOI:10.1016/j.idnow.2025.105025

Arthur Charazac , Raphael Delage , Maxime Pichon , Laure Kamus , Benoit Pichard , Laura Peyret-Moreau , Olivier Belmonte , Guillaume Miltgen , Christophe Burucoa

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Abstract

Introduction

The increasing resistance of Helicobacter pylori to clarithromycin leads to an ongoing adaptation of empirical first-line treatment for H. pylori infections.

Patients and methods

Prospective study (2022–2023) of 364 patients with no previous treatment for H. pylori infection, addressed for gastroduodenal endoscopy to the University Hospital of Reunion Island.

Results

PCR tests (Allplex^TM H. pylori & ClariRAssay, Seegene) performed on gastric biopsy samples detected H. pylori DNA in 100 samples (100/364; 27.5 %) and mutations conferring resistance to clarithromycin in 10 of the positive samples (10/100; 10 %). Prevalence of resistance determined by MICs (E-test method) was 41.2 % for metronidazole, 13.2 % for levofloxacin, 8.8 % for clarithromycin. No resistance was detected for tetracycline, rifampicin, and amoxicillin.

Conclusion

The prevalence of primary clarithromycin-resistant H. pylori in Reunion Island is below 15 %. Recommendation for the standard clarithromycin-based triple therapy as a first-line treatment can thus be maintained, even though antimicrobial susceptibility testing seems preferable.

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留尼旺岛幽门螺杆菌低水平原发性克拉霉素耐药。

导论：幽门螺杆菌对克拉霉素的耐药性日益增强，导致幽门螺杆菌感染的经验一线治疗不断适应。患者和方法：前瞻性研究（2022-2023）364例既往未接受过幽门螺杆菌感染治疗的患者，在留尼旺岛大学医院进行胃十二指肠内镜检查。结果：PCR检测(AllplexTMH；对胃活检样本进行了pylori & ClariRAssay， Seegene)，在100个样本中检测到幽门螺杆菌DNA (100/364；27.5% %)和在10个阳性样本中产生克拉霉素耐药突变(10/100；10 %)。mic法测定的耐药率甲硝唑为41.2 %，左氧氟沙星为13.2 %，克拉霉素为8.8 %。对四环素、利福平和阿莫西林均未发现耐药。结论：留尼旺岛原发性耐克拉霉素幽门螺杆菌感染率低于15% %。因此，可以继续推荐标准的克拉霉素三联疗法作为一线治疗，尽管抗菌药敏试验似乎更可取。

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