Antibiotic resistance, heteroresistance, and eradication success of Helicobacter pylori infection in children

被引:13
作者
Kotilea, Kallirroi [1 ]
Iliadis, Eleni [1 ]
Nguyen, Julie [1 ]
Salame, Assad [1 ]
Mahler, Tania [1 ]
Miendje Deyi, Veronique Yvette [2 ]
Bontems, Patrick [1 ]
机构
[1] Univ Libre Bruxelles, Hop Univ Enfants Reine Fabiola, Pediat Gastroenterol, Ave Jean Joseph Crocq 15, B-1020 Brussels, Belgium
[2] Univ Libre Bruxelles, Microbiol Dept, Lab Hosp Univ Bruxelles LHUB ULB, Brussels, Belgium
关键词
antimicrobial resistance; antimicrobial susceptibility; children; Helicobacter pylori; heteroresistance; SUSCEPTIBILITY; ADOLESCENTS; MANAGEMENT; UPDATE;
D O I
10.1111/hel.13006
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BackgroundAntibiotic resistance is a well-known factor of Helicobacter pylori eradication failure. Heteroresistance indicates the coexistence of resistant and susceptible strains and might lead to underestimating antimicrobial resistance. This study aims to evaluate the susceptibility profile, the frequency of heteroresistance of H. pylori strains, and their effect on eradication success in a pediatric population. Materials and MethodsChildren aged 2-17 years who underwent an upper gastrointestinal endoscopy from 2011 to 2019 with positive H. pylori status were included. Susceptibility was measured by disk diffusion and E-test. The difference in susceptibility profiles between isolates from the antrum and the corpus was used to detect heteroresistance. For those who received eradication treatment, we evaluated eradication rate and factors affecting treatment success. ResultsInclusion criteria were met by 565 children. Strains susceptible to all antibiotics were detected in 64.2%. Primary resistance rates for clarithromycin (CLA), metronidazole (MET), levofloxacin (LEV), tetracyclin (TET), and amoxicillin (AMO) were 11%, 22.9%, 6.9%, 0.4%, and 0% and secondary resistance rates were 20.4%, 29.4%, 9.3%, 0%, and 0%. Heteroresistance was present in untreated children in 2%, 7.1%, 0.7%, 0.7%, and 0% for CLA, MET, LEV, TET, and AMO. First-line eradication rates were 78.5% in intention-to-treat (ITT), 88.3% in full-analysis-set (FAS), and 94.1% in per-protocol (PP). Factors affecting eradication success were the duration of treatment when the triple-tailored treatment was used, the number of daily doses of amoxicillin administered, and the patient's adherence to treatment. ConclusionsThis study shows the presence of relatively low primary resistance rates for H. pylori isolates but demonstrates the presence of heteroresistance in our population. Routine biopsies from the antrum and corpus must be considered for susceptibility testing to allow tailored treatments and increase eradication rates. Treatment success is affected by treatment choice, correct dosing of medications, and adherence. All these factors should be considered when evaluating the efficacy of an eradication regimen.
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共 32 条
[1]   Multiple and mixed Helicobacter pylori infections: Comparison of two epidemiological situations in Tunisia and France [J].
Ben Mansour, Khansa ;
Fendri, Chedlia ;
Battikh, Hajer ;
Garnier, Martine ;
Zribi, Meriem ;
Jlizi, Asma ;
Burucoa, Christophe .
INFECTION GENETICS AND EVOLUTION, 2016, 37 :43-48
[2]   Twelve year observation of primary and secondary antibiotic-resistant Helicobacter pylori strains in children [J].
Bontems, P ;
Devaster, JM ;
Corvaglia, L ;
Dezsöfi, A ;
van den Borre, C ;
Goutier, S ;
Butzler, JP ;
Cadranel, S .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2001, 20 (11) :1033-1038
[3]   Sequential Therapy Versus Tailored Triple Therapies for Helicobacter pylori Infection in Children [J].
Bontems, Patrick ;
Kalach, Nicolas ;
Oderda, Giuseppina ;
Salame, Assad ;
Muyshont, Laurence ;
Miendje, D. Yvette ;
Raymond, Josette ;
Cadranel, Samy ;
Scaillon, Michele .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 2011, 53 (06) :646-650
[4]   Multicenter Survey of Routine Determinations of Resistance of Helicobacter pylori to Antimicrobials over the Last 20 Years (1990 to 2009) in Belgium [J].
Deyi, V. Y. Miendje ;
Bontems, P. ;
Vanderpas, J. ;
De Koster, E. ;
Ntounda, R. ;
Van den Borre, C. ;
Cadranel, S. ;
Burette, A. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2011, 49 (06) :2200-2209
[5]   Primary Helicobacter pylori resistance to antimicrobials in the Brussels area in 2021 [J].
Deyi, Veronique Yvette Miendje ;
Ntounda, Ruffin ;
Louis, Hubert ;
Kahegeshe, Nsimire L. ;
Nkuize, Marcel ;
Burette, Alain ;
Kotilea, Kalliroy ;
Van Gossum, Marc ;
Delhaye, Myriam ;
Bontems, Patrick .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2023, 105 (02)
[6]   Update of primary Helicobacter pylori resistance to antimicrobials in Brussels, Belgium [J].
Deyi, Veronique Yvette Miendje ;
Lare, M'Kinansoi Sylvestre ;
Burette, Alain ;
Ntounda, Ruffin ;
Elkilic, Okyay ;
Cadranel, Samy ;
Bontems, Patrick ;
Hallin, Marie .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2019, 95 (04)
[7]   Characterization of clarithromycin heteroresistance among Helicobacter pylori strains isolated from the antrum and corpus of the stomach [J].
Farzi, Nastaran ;
Behzad, Catherine ;
Hasani, Zahra ;
Alebouyeh, Masoud ;
Zojaji, Homayoun ;
Zali, Mohammad Reza .
FOLIA MICROBIOLOGICA, 2019, 64 (02) :143-151
[8]   Effect of Dosing Schemes of Amoxicillin on Eradication Rates of Helicobacter pylori With Amoxicillin-Based Triple Therapy [J].
Furuta, Takahisa ;
Sugimoto, Mitsushige ;
Yamade, Mihoko ;
Uotani, Takahiro ;
Sahara, Shu ;
Ichikawa, Hitomi ;
Yamada, Takanori ;
Osawa, Satoshi ;
Sugimoto, Ken ;
Watanabe, Hiroshi ;
Umemura, Kazuo .
JOURNAL OF CLINICAL PHARMACOLOGY, 2014, 54 (03) :258-266
[9]   EVALUATION OF THE E-TEST FOR QUANTITATIVE ANTIMICROBIAL SUSCEPTIBILITY TESTING OF HELICOBACTER-PYLORI [J].
GLUPCZYNSKI, Y ;
LABBE, M ;
HANSEN, W ;
CROKAERT, F ;
YOURASSOWSKY, E .
JOURNAL OF CLINICAL MICROBIOLOGY, 1991, 29 (09) :2072-2075
[10]   Frequency of infection with Helicobacter pylori isolates of different antimicrobial profiles in children and adolescents: A preliminary study [J].
Gosciniak, Grazyna ;
Biernat, Monika M. ;
Binkowska, Aldona ;
Kus, Agnieszka ;
Iwanczak, Barbara .
ADVANCES IN CLINICAL AND EXPERIMENTAL MEDICINE, 2017, 26 (02) :263-268