Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

High Prevalence of Helicobacter pylori Resistance to Clarithromycin: a Hospital-Based Cross-Sectional Study in Nakhon Ratchasima Province, Northeast of Thailand

  • Tongtawee, Taweesak (Department of surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Dechsukhum, Chavaboon (Pathological Unit, Institute of Medicine, Suranaree University of Technology) ;
  • Matrakool, Likit (Department of surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Panpimanmas, Sukij (Department of surgery, Institute of Medicine, Suranaree University of Technology) ;
  • Loyd, Ryan A (Suranaree University of Technology Hospital, Suranaree University of Technology) ;
  • Kaewpitoon, Soraya J (Suranaree University of Technology Hospital, Suranaree University of Technology) ;
  • Kaewpitoon, Natthawut (Suranaree University of Technology Hospital, Suranaree University of Technology)
  • Published : 2016.01.11
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

Keywords

References

  1. Beswick EJ, Suarez G, Reyes VE (2006). Helicobacter pylori and host interactions that influence pathogenesis. World J Gastroenterol, 12, 5599-605. https://doi.org/10.3748/wjg.v12.i35.5599
  2. Chey WD,Wong BC (2007). American college of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol, 102, 1808-25. https://doi.org/10.1111/j.1572-0241.2007.01393.x
  3. Deenonpoe R, Chomvarin C, Pairojkul C, et al (2015). The carcinogenic liver fluke Opisthorchis viverrini is a reservoir for species of Helicobacter. Asian Pac J Cancer Prev, 16, 1751-8. https://doi.org/10.7314/APJCP.2015.16.5.1751
  4. De Francesco V, Giorgio F, Hassan C, et al (2010). Worldwide H.pylori antibiotic resistance. A systemic review. J Gastrointestin Liver Dis, 19, 409-14.
  5. Dixon MF, Genta RM, Yardley JH et al (1994). Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol, 20, 1161-81.
  6. Fock KM, Katelaris P, Sugano K, et al (2009). Second Asia Pacific consensus guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol, 24, 1587-600. https://doi.org/10.1111/j.1440-1746.2009.05982.x
  7. Fischbach L, Evan E (2007). Meta-analysis: the effect of antibiotic resistance status on the efficacy of triple and quadruple first line therapies for Helicobacter pylori. Aliment Pharmacol Ther, 26, 343-57. https://doi.org/10.1111/j.1365-2036.2007.03386.x
  8. Gerrits MM, van Vliet AH, Kuipers EJ, Kusters JG (2006). Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis, 6, 699-709. https://doi.org/10.1016/S1473-3099(06)70627-2
  9. Hishida A, Matsuo K, Goto Y, et al (2010). Smoking behavior and risk of Helicobacter pylori infection, gastric atrophy and gastric cancer in Japanese. Asian Pac J Cancer Prev, 11, 669-73.
  10. Kobayashi I, Murakami K, Kato M, et al (2002).Changing antimicrobial susceptibility epidemiology of Helicobacter pylori strain in Japan between 2002 and 2005. J Clin Gastroenterol, 14, 879-10.
  11. Ko JK, Cho CH (2000). Alcohol drinking and cigarette smoking: a "partner" for gastric ulceration. Zhonghua Yi Xue Za Zhi, 63, 845-54.
  12. Komoto K, Haruma K, Kamada T, et al (1998). Helicobacter pylori infection and gastric neoplasia: correlations with histological gastritis and tumor histology, Am J Gastroenterol, 93, 1271-6. https://doi.org/10.1111/j.1572-0241.1998.00408.x
  13. Megraud F (2004). Helicobacter pylori antibiotic resistance. Prevalence, importance and advance in testing. GUT, 53, 1374-84. https://doi.org/10.1136/gut.2003.022111
  14. Mihara M, Haruma K, Kamada T, et al (1999). The role of endoscopic findings for the diagnosis of Helicobacter pylori infection: evaluation in a country with high prevalence of atrophic gastritis, Helicobacter, 4, 40-8. https://doi.org/10.1046/j.1523-5378.1999.09016.x
  15. Menard, A., M. Oleastro, A. Santos, and F et al (2002). PCRrestriction fragment length polymorphism can also detect point mutation A2142C in the 23S rRNA gene, associated with helicobacter pylori resistance to clarithromycin. Antimicrob Agents Chemother, 46, 1156-7. https://doi.org/10.1128/AAC.46.4.1156-1157.2002
  16. Patel SK, Pratap CB, Jain AK et al (2014). Diagnosis of Helicobacter pylori: What should be the gold standard? World J Gastroenterol, 20, 12847-59. https://doi.org/10.3748/wjg.v20.i36.12847
  17. Tan HJ, Goh K (2008). Changing epidemiology of Helicobacter pylori in Asia. Dig Dis, 9, 1808-25.
  18. Vilaichone RK, Gumnarai P, Ratanachu-Ek T, et al (2013). Nationwide survey of Helicobacter pylori antibiotic resistance in Thailand. Diagn Microbiol Infect Dis, 77, 346-9. https://doi.org/10.1016/j.diagmicrobio.2013.08.010
  19. Wang WH, Wong BC, et al (2000). High prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kong., 14, 901-10. https://doi.org/10.1046/j.1365-2036.2000.00795.x

Cited by

  1. eradication vol.33, pp.11, 2018, https://doi.org/10.1111/jgh.14292
  2. Infection vol.12, pp.2, 2018, https://doi.org/10.5009/gnl17177