scholarly journals Correlation Analysis between the Characteristics of Helicobacter pylori Resistance and the Antibiotic Use Density in a Hospital from 2012 to 2018

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Chenglin Ru ◽  
Li Yin ◽  
Lixia Tian ◽  
Lanxiang Wang ◽  
Yi Yao ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Correlation Analysis ◽  
General Hospital ◽  
Antibiotic Use ◽  
Resistance Rate ◽  
Clinical Treatment ◽  
Outpatient Department ◽  
Resistant Strains ◽  
Inpatient Department

Objective. To explore the correlation between the resistance characteristics of Helicobacter pylori (HP) and antibiotic use density (AUD) in a hospital from 2012 to 2018. Methods. HP strains isolated from Chinese PLA General Hospital from 2012 to 2018 were collected to analyze the drug resistance of clarithromycin, levofloxacin, amoxicillin, and metronidazole, and their correlation with the AUD of the outpatient department and inpatient department was analyzed, respectively. Results. From 2012 to 2018, metronidazole-resistant strains accounted for the largest proportion, followed by clarithromycin and levofloxacin, and amoxicillin-resistant strains accounted for the least. In 2012–2018, the resistance rate of clarithromycin, levofloxacin, amoxicillin, and metronidazole has basically increased year by year; from 2012 to 2018, the highest outpatient AUD in a hospital was amoxicillin, followed by clarithromycin and levofloxacin, metronidazole was the lowest, and the inpatient AUD from high to low was levofloxacin, metronidazole, amoxicillin, and clarithromycin. The drug resistance rate of HP in the hospital from 2012 to 2018 was positively correlated with the AUD of clarithromycin (r = 0.884, P = 0.017 ) and levofloxacin (r = 0.934, P = 0.002 ) in the outpatient department. Conclusions. Helicobacter pylori has the strongest resistance to metronidazole and the worst resistance to amoxicillin in the hospital from 2012 to 2018, being related to the intensity of clarithromycin and levofloxacin in the outpatient department. It may provide certain reference significance for the clinical treatment of Helicobacter pylori.

Temporal association between antibiotic use and resistance in Gram-negative bacteria

2023 ◽  
Vol 83 ◽  
Author(s):  
X. Wu ◽  
G. Zhong ◽  
H. Wang ◽  
J. Zhu
Keyword(s):  
Correlation Analysis ◽  
Cross Correlation ◽  
Clinical Laboratory ◽  
Antibiotic Use ◽  
Resistance Rate ◽  
Temporal Association ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Cross Correlation Analysis ◽  
Increasing Trend

Abstract The β-lactam/lactamase inhibitors (BLBLIs) combination drugs are considered an effective alternative to carbapenems. However, there is a growing concern that the increased use of BLBLIs may lead to increased resistance. This study determined the temporal association between the consumption of BLBLI and the antimicrobial resistance in Gram-negative bacteria. In this retrospective study, electronic data on the Gram-negative bacterial isolates, including A. baumannii, P. aeruginosa, E. coli, and K. pneumoniae from in-patients and susceptibility testing results were retrieved from the medical records of the clinical laboratory. A linear regression and cross-correlation analysis were performed on the acquired data. Increasing trends (p<0.05) in the consumption of BIBLI and carbapenem with a median use of 27.68 and 34.46 DDD/1000 PD per quarter were observed, respectively. A decreased trend (p=0.023) in the consumption of fluoroquinolones with a median use of 29.13 DDD/1000 PD per quarter was observed. The resistance rate of K. pneumoniae was synchronized with the BIBLI and carbapenem consumptions with a correlation coefficient of 0.893 (p=0.012) and 0.951 (p=0.016), respectively. The cross-correlation analysis against the consumption of BIBLI and meropenem resistant K. pneumoniae was peaked at 0-quarter lag (r=951, p=0.016). There was an increasing trend in the consumption of BLBLI and carbapenems. The increasing trend in the rates of resistance to piperacillin/tazobactam, in line with the increasing consumption of BLBLI, suggests that BLBLI has to be used with caution and cannot be directly considered as a long-term alternative to carbapenems.

scholarly journals Impact of Helicobacter pylori resistance in unsuccessfully pluritreated patients in a Department of Infectious Diseases in Rome

2010 ◽  
Vol 1 (1) ◽  
pp. 3
Author(s):  
Maria Teresa Mascellino ◽  
Barbara Porowska ◽  
Rosa Nicosia ◽  
Alessandra Oliva ◽  
Priscilla Boccia ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Resistance Rate ◽  
Test Method ◽  
Resistance Testing ◽  
Antibiotic Resistant ◽  
Diffusion Technique ◽  
Resistant Strains ◽  
Unrelated Strain ◽  
H Pylori ◽  
Rapid Emergence

Twenty-five pluritreated patients were examined. Fifty-six percent yielded Helicobacter pylori (H. Pilory); of these, 9 patients showed a concomitant colonization of the three gastric regions. The highest resistance rate was found for metronidazole (71.8%) followed by chlaritromycin (53.1%). Amoxycillin showed the best susceptibility (only 6% of resistance), tetracycline showed 12% of resistant strains and levofloxacin appeared to be a promising antibacterial agent (18% of resistance). The E-test method was shown to be more suitable than disk diffusion technique for resistance testing. Combined resistance to both chlaritromycin and metronidazole appeared in 50% of the strains. The isolates showing this dual resistance are known to be difficult to eradicate. Resistotypes were shown to be genotypically different even if the strains with the resistance to both chlaritromycin and metronidazole are more likely to belong to genotype cagA+ and vacA s1m1. Heteroresistance (different susceptibility of the isolated strains in a single stomach) resulted in 36% of patients with pangastritis. Indeed, the concomitant presence of H. pylori strains in the same subject, either susceptible or resistant or vice versa, may interfere with the eradication outcomes. In our study, antibiotic resistant H. pylori typically develops from pre-existing susceptible strains rather than from co-infection with a different and unrelated strain. In fact, each pair of isolates detected in our 4 patients with heteroresistance belonged to the same genotype (cagA+ s1m2 in patient 1 and cagA+ s1m1 in patients 2, 3 and 4). In conclusion, H. pylori antibiotic resistance does present several issues in pluritreated patients owing to the rapid emergence of multi-resistant strains.

scholarly journals Analysis of drug resistance in Helicobacter pylori by complete genome sequencing in Bama County, Guangxi, China

2020 ◽  
Author(s):  
yanqiang huang ◽  
Xiao-Hua Li ◽  
Yong-Yi Huang ◽  
Xian-ke Luo ◽  
Li-juan Zhao ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Genome Sequencing ◽  
Complete Genome ◽  
Gene Knockout ◽  
Resistance Rate ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Complete Genome Sequencing ◽  
Clarithromycin Resistance

Abstract The resistance rate of clinical Helicobacter pylori (Hp) isolates has increased, however, the mechanism of drug resistance is unclear. In this study, we isolated drug-resistant Hp strains isolated from different areas and different populations of China for genomic analysis. The aim of this study was to investigate drug resistance in Hp from Bama County, Guangxi, China. Minimal inhibitory concentrations (MICs) of clarithromycin, metronidazole and levofloxacin were determined and complete genome sequencing was performed with annotation. The presence of hp1181 and hp1184 genes was detected by RT-PCR. The relationships between hp1181, hp1184 and clarithromycin resistance were confirmed by gene mutation and drug-resistant strains. Three drug-resistant Hp strains were isolated from patients with gastritis in Bama County. The strains showed a high degree of homology with hp26695 through complete genome detection and identification. Differences in genome sequences, gene quantity and gene characteristics were detected amongst the three strains. Prediction and analysis of the function on drug-resistant genes indicated that the RNA expression of hp1181 and hp1184 increased in the three strains that were the same in the artificially induced clarithromycin-resistant bacteria. After gene knockout, the drug sensitivity of the strains increased significantly. In summary, The expressions of the genes hp1184 and hp1181 were associated with clarithromycin resistance in the Hp from Bama, Guangxi.

scholarly journals Analysis of Helicobacter pylori’s Antibiotic Resistance Rate and Research on Its Eradication Treatment Plan

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Li Jiao ◽  
Junmin Wang ◽  
Huan Ma
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Treatment Plan ◽  
Drug Susceptibility ◽  
Resistance Rate ◽  
Clinical Isolates ◽  
Treatment Plans ◽  
H Pylori ◽  
The Right

How to choose the right plan is the key to treatment, and this must take into account the local eradication of Helicobacter pylori and the drug resistance of Helicobacter pylori. In order to better eradicate Helicobacter pylori, in the current clinical treatment process, most of the combined treatments of triple drugs are used, but the therapeutic effect is still not ideal. In addition, many studies have focused on changing the types and dosages of drugs, but they have not yet achieved good results. This paper combines experimental research to analyze the drug resistance rate of Helicobacter pylori and obtains gastric mucosal specimens of patients through gastroscopy to cultivate clinical isolates of H. pylori.. Furthermore, this study used the Kirby-Bauer drug susceptibility disc technique to determine the sensitivity of H. pylori clinical isolates to a range of regularly used clinical antibiotics, as well as a set of instances of H. pylori antibiotic resistance. Finally, this research integrates experimental analyses and various successful eradication treatment plans to provide a unique eradication treatment strategy.

Helicobacter pylori – 2012

2012 ◽  
Vol 153 (36) ◽  
pp. 1407-1418
Author(s):  
György Miklós Buzás
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Local Population ◽  
Genetic Research ◽  
Eradication Therapy ◽  
Antibiotic Use ◽  
Resistance Rate ◽  
Published Data ◽  
First Line Therapy ◽  
Third Line

The author overviews some aspects of literature data of the past 2 years. Genetic research has dentified polymorphisms of Helicobacter pylori virulence factors and the host which could play a role in the clinical outcome of the infection (peptic ulcer or gastric cancer). So far they have been performed in research centers but with a decrease of costs, they will take their place in diagnosing the diseaes and tailoring the treatment. Antibiotic resistance is still growing in Southern European countries and is decreasing in Belgium and Scandinavia. Currently, the clarithromycin resistance rate is of 17–33% in Budapest and levofloxacin resistance achieved 27%. With careful assessment of former antibiotic use the resistance to certain antibiotics can be avoided and the rates of eradication improved. Immigration is a growing problem worldwide: according to Australian, Canadian and Texan studies, the prevalence of Helicobacter pylori is much higher in the immigrant groups than in the local population. An Italian study showed that the eradication rate of triple therapy is significantly lower in the Eastern European immigrants than in the Italians. A recent research has suggested a link between female/male infertility, habitual abortion and Helicobacter pylori infection. However, there are no published data or personal experience to show whether successful eradication of the virus in these cases is followed by successful pregnancies or not. The author overviews the Maastricht process and analyzes the provisions of the Maastricht IV/Florence consensus, in which the new diagnostic algorithms and indications of eradication therapy are reformulated according to the latest levels of evidence and recommendation grading. According to the “test and treat” strategy, either the urea breath test or the stool monoclonal antigen test are recommended as a non-invasive diagnostic method in primary care. Endoscopy is still recommended in case of alarm symptoms, complicated ulcer, or if there is a suspicion of malignancy or MALT lymphoma. Local resistance to clarithromycin and levofloxacin should be considered in the choice of first-line therapy, in case of levels >15–20% these compounds should not be used. In regions with low resistance rates, classical triple therapy remains the regimen of choice; its alternative is the bismuth-based quadruple therapy. Determining antimicrobial resistance is justified after failed second- or third-line therapies; where available, molecular methods (fluorescence in situ hybridization, polymerase chain reaction) should be used. As second/third line treatments, the sequential, bismuth-based quadruple, concomitant quadruple regimens, hybrid are all possible alternatives. The Hungarian diagnostic and therapeutic approach in practice is different in some aspects from the provisions of the European consensus. Orv. Hetil., 2012, 153, 1407–1418.

DIFFUSION METHODS FOR CLARITHROMYCIN AND LEVOFLOXACIN SUSCEPTIBILITY TESTING OF HELICOBACTER PYLORI

2014 ◽  
pp. 63-70
Author(s):  
Trung Nam Phan ◽  
Van Huy Tran ◽  
Thi Nhu Hoa Tran ◽  
Van An Le
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Alternative Therapy ◽  
Resistance Rate ◽  
Disk Diffusion ◽  
Primary Resistance ◽  
Secondary Resistance ◽  
Central Vietnam ◽  
Resistant Strains ◽  
H Pylori

Background: The rate of antibiotic resistance in H. pylori is increasing and has become a main cause for failure of treatment. Antibiogram is very important to provide optimal regimens for eradication of H.pylori infected patients. Objective: To determine the resistance prevalence to clarithromycin, levofloxacin of H.pylori strains from patients in Central Vietnam by E-test and disk diffusion isolated, assess the relationship between two diffusion methods. Methods: 56 H.pylori strains were isolated from gastric biopsies of H.pylori infected patients from 7/2012 to 8/2013, of which 13 strains originated from patients in whom eradication of the infection failed after treatment. E-test was used to determine the minimum inhibitory concentrations of clarithromycin (CH) and levofloxacin (LE). Disk diffusion was evaluated as an alternative method to determine susceptibility and compared with the E-test results. Results: In total, the resistant strains (regardless of previous eradication history) to CH, LE were 42,9% and 44,6%, respectively. The ratio of strains with secondary resistance was significantly greater than that of the strains with primary resistance, CH: 84.6% vs. 30.2%, LE: 61.5% vs 39,5% (p < 0.05). The resistance rate to LE in female was significantly higher than in male (p < 0.05). All CH-sensitive strains by E-test had the inhibition diameters of CH was ≥ 24mm and all CH-resistant strains had the inhibition diameters was ≤ 18mm (breakpoint for MIC: 1µg/ml). To LE, the inhibition diameters was ≥ 30mm can determine all LE-sensitive strains and the inhibition diameters was ≤ 26mm can determine all LE-resistant strains by E-test (breakpoint for MIC: 1µg/ml). Conclusions: High resistance rate to CH and LE, suggests that standard CH-based triple therapie may not be useful as the first-line treatment and LE-based triple therapy should not use as an alternative therapy in Central Vietnam. The disk diffusion can use as alternative phenotypic method to determine the susceptbility of H.pylori, which is more practical and inexpensive. Keywords: Helicobacter pylori, levofloxacin, clarithromycin, E-test antibiotic resistance, disk diffusion.

scholarly journals Mutations of Helicobacter pylori RdxA are mainly related to the phylogenetic origin of the strain and not to metronidazole resistance

2020 ◽  
Vol 75 (11) ◽  
pp. 3152-3155
Author(s):  
Shuzhen Zhang ◽  
Xiangyu Wang ◽  
Michael J Wise ◽  
Yongsheng He ◽  
Haiting Chen ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Helicobacter Pylori ◽  
Phylogenetic Analyses ◽  
Clinical Problem ◽  
23S Rrna ◽  
Rrna Gene ◽  
Metronidazole Resistance ◽  
Resistant Strains ◽  
H Pylori ◽  
Technology Mutation

Abstract Objectives Drug resistance of Helicobacter pylori is a major clinical problem worldwide. The objective of the present study was to investigate the prevalence of antibiotic-resistant H. pylori in the city of Shenzhen in China, as well as to identify the genetic mutations specifically associated with drug resistance rather than unrelated phylogenetic signals. Methods Antibiotic susceptibility testing was performed on 238 clinical strains successfully isolated from H. pylori-positive dyspeptic patients who underwent gastroscopy at the Department of Gastroenterology in Shenzhen People’s Second Hospital. Following WGS of all strains using Illumina technology, mutation and phylogenetic analyses were performed. Results The resistance rates were 84.9%, 35.3%, 25.2% and 2.1% for metronidazole, clarithromycin, ciprofloxacin and rifampicin, respectively. An A2143G conversion in the 23S rRNA gene was the primary mutation observed in clarithromycin-resistant strains, whilst N87K/I and D91G/N/Y in GyrA were detected in ciprofloxacin-resistant strains. In RdxA, our results demonstrated that only R16H/C and M21A are significant contributors to metronidazole resistance; there were 15 other sites, but these are phylogenetically related and thus unrelated to metronidazole resistance. Conclusions There is a high prevalence of metronidazole, clarithromycin and ciprofloxacin resistance and a low prevalence of rifampicin resistance in H. pylori from Shenzhen, China. Omission of phylogenetically related sites will help to improve identification of sites genuinely related to antibiotic resistance in H. pylori and, we believe, other species.

scholarly journals Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 606
Author(s):  
Fauna Herawati ◽  
Rika Yulia ◽  
Bustanul Arifin ◽  
Ikhwan Frasetyo ◽  
Setiasih ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
General Hospital ◽  
Sampling Technique ◽  
Knowledge Score ◽  
Antibiotic Use ◽  
Public Hospitals ◽  
Educational Video ◽  
Inappropriate Use ◽  
Quasi Experimental ◽  
The Difference

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

scholarly journals Utilization of Health Care Services and Common Disease Diagnoses among University Students: An Analysis of 35,249 Students from Thailand

2021 ◽  
Vol 18 (13) ◽  
pp. 7148
Author(s):  
Suphawita Pliannuom ◽  
Kanokporn Pinyopornpanish ◽  
Chaisiri Angkurawaranon ◽  
Kanokwan Pinyopornpanish ◽  
Anawat Wisetborisut ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
University Students ◽  
Health Care Services ◽  
Outpatient Department ◽  
Common Disease ◽  
Care Services ◽  
Common Diseases ◽  
Academic Year ◽  
Inpatient Department

The health care services for university students are important to improve student health and well-being. Analyzing the database of health conditions in the health service system will identify common health problems, which could be useful in further appropriate and specific health service planning. This study aims to investigate the utilization of health care services and common disease diagnoses among university students enrolled at Chiang Mai University during the academic year of 2018. A retrospective study was carried out using health data from the electronic health records (EHR) database of the university hospital. Ethical procedures were followed. Out of the overall 35,249 students in the academic year 2018, 17,284 students (49.03%) had visited an outpatient department (65,150 outpatient department visits), and 407 students (1.15%) had been admitted to the hospital (458 inpatient department admissions). The proportions of utilization between each field of education and training were similar across both groups. The top five categories of diagnosis, for both outpatient department visits and inpatient department admissions, differed between gender. Some of the most common diseases included trauma and injury conditions, respiratory diseases, and mental health. The conclusion of the study is that integration of a health promotion program with preventive methods, especially regarding traffic injury, transmitted diseases, mental health support, and safe environments are essential for university students. A general overview of utilization and common diseases among university students, which is still lacking in the literature, could be useful as a platform to enhance health care services for common diseases.

The situation of antibiotic use for diarrhea treatment on pediatric inpatient at Pediatrics - Kien Giang General Hospital in 2019-2020

2020 ◽  
pp. 15-24
Author(s):  
Nhon Tran Van ◽  
Mai Do Van ◽  
Hien Ha Minh
Keyword(s):  
General Hospital ◽  
Blood Cells ◽  
Antibiotic Prescription ◽  
White Blood Cells ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Loose Stool ◽  
Cross Sectional ◽  
Watery Stool ◽  
Pediatric Inpatient

Background: To survey for evaluation the use of antibiotic for diarrhea treatment on pediatric inpatient in compliance with MOH, WHO or treatment regimen. Objectives: (1) To describe the situation of antibiotic use for diarrhea treatment and (2) to determine factors that affected on indication of antibiotic for pediatric inpatient under 15 years at Kien Giang General Hospital in 2019. Subjects and methods: A cross-sectional study on 251 medical records of pediatric inpatients who treated by one of any drug from 01/2019 to 12/2019. Results: one antibiotic was prescribed in 71.7% in comparison with 17.1% on two antibiotics. The antibiotic prescription was based on the results of blood test including examinations of white blood cells (WBC), the percentage of neutrophils (Neu%) and/or C-reactive protein (CRP) (59.4%), stool with white blood cells and/or red blood cells (1.6%), high fever without causes (27.9%), watery stool (86.3%), loose stool with blood (100%), loose stool (97.9%). The most used antibiotics are ceftriaxone (53.4%), ciprofloxacin (12.4%). Duration of antibiotic use is 5 days in median. Conclusion: The rate of antibiotic prescription that met MOH and WHO guidelines was 88.3% in comparison with 11.7% of non-conformance. The compliance prescriptions based on antibiogram were 77.8%, non-compliance were 22.5%. The compliance dosage refered to guideline was 86.4%, non-conpliance was 2.4%. The duration of hospitalization and neutrophil are factors that affected the use of antibiotics (p < 0.05). Keywords: diarrhea, pediatric inpatient, antibiotic, Pediatrics-Kien Giang General Hospital

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