engleski

H. pylori resistance to various antibiotics in Croatia ; results of Croatian Reference Centre for H. pylori infection

Introduction: The progresive increasing of antimicrobial resistance is now recognised as the main reason for decline success rate of H. pylori infection eradication. The aim of this study was to evaluate the prevalence of primary resistance to different antibiotics in H. pylori. Isolates were taken in Reference Centre for H. pylori in Republic Croatia during 15 years (1995–2010). Methods: In last 15 years, 2915 patients (F/M 1356/1559 ; age range 15–94) were prospectively included in scientific program for H. pylori detection and treatment. Endoscopy was performed before treatment, with 4 biopsies for histology and 2 for culture. Susceptibility testing was performed with agar dilution method for metronidazole (MIC>8), clarithromycin (MIC‡1), amoxicillin (MIC‡1), and tetracycline (MIC‡2). Primary resistance was calculated for every period of three years (1995–1997 ; 1998– 2000 ; 2001–2003 ; 2004–2006 ; and 2007–2010). Results: H. pylori was isolated from 1240 of 2915 (42, 5%) persons undergoing upper endoscopy The primary resistance in 5 time periods for clarithromycin/azithromycin was, respectively: 7, 2%, 10, 5%, 11, 0%, 10, 9% and 19, 4% ; for metronidazole: 26, 2%, 28, 4%, 26, 3%, 29, 7%, and 34, 3%, for amoxicillin 0%, and for tetracycline 1, 6% in first period, and 0% after that. We also calculated the prevalence of primary multidrug antibacterial resistance during all five periods. Conclusion: This result shows that solitary resistance to clarithromycin/azithromycin, and metronidazole, and multidrug resistance to both drugs, among HP positive Croatian patientshas progressively increased, particularly in last three years. We are now in Croatia reached Maastricht’s limit for necessary use of sensitivity testing before decision for the best treatment option.

H. pylori; resistance to antibiotics; Croatian Reference Centre for H. pylori infection

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