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