Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea

A prospective multicenter study

Korean College of Helicobacter, Upper Gastrointestinal Research

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.

Original languageEnglish
Article numbere12592
JournalHelicobacter
Volume24
Issue number4
DOIs
StatePublished - 1 Aug 2019

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Pylorus
Korea
Microbial Drug Resistance
Helicobacter pylori
Multicenter Studies
Metronidazole
Prospective Studies
Clarithromycin
Quinolones
Amoxicillin
Tetracycline
Levofloxacin
Multiple Drug Resistance
Ciprofloxacin
Microbial Sensitivity Tests
Endoscopy
Agar
Stomach
Anti-Bacterial Agents
Bacteria

Keywords

  • Helicobacter pylori
  • Korea
  • antibiotics
  • resistance

Cite this

Korean College of Helicobacter ; Upper Gastrointestinal Research. / Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea : A prospective multicenter study. In: Helicobacter. 2019 ; Vol. 24, No. 4.
@article{5b1c1406721f4d2da6e8cc1d7423416d,
title = "Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study",
abstract = "Introduction: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: The culture success rate was 60.2{\%} (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8{\%}, 29.5{\%}, 9.5{\%}, 0{\%}, 37.0{\%}, and 37.0{\%}, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2{\%} (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2{\%} (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.",
keywords = "Helicobacter pylori, Korea, antibiotics, resistance",
author = "{Korean College of Helicobacter} and {Upper Gastrointestinal Research} and Lee, {Jeong Hoon} and Ahn, {Ji Yong} and Choi, {Kee Don} and Jung, {Hwoon Yong} and Kim, {Jung Mogg} and Baik, {Gwang Ho} and Kim, {Byung Wook} and Park, {Jun Chul} and Jung, {Hye Kyung} and Cho, {Soo Jeong} and Shin, {Cheol Min} and Choi, {Yoon Jin} and Lee, {Si Hyung} and Kim, {Ji Hyun} and Lee, {Wan Sik} and Cho, {Soo Jeong} and Shin, {Cheol Min} and Cheung, {Dae Young} and Hyuk Lee and Min, {Yang Won} and Kim, {Jae J.} and Kim, {Seung Young}",
year = "2019",
month = "8",
day = "1",
doi = "10.1111/hel.12592",
language = "English",
volume = "24",
journal = "Helicobacter",
issn = "1083-4389",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "4",

}

Korean College of Helicobacter & Upper Gastrointestinal Research 2019, 'Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study', Helicobacter, vol. 24, no. 4, e12592. https://doi.org/10.1111/hel.12592

Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea : A prospective multicenter study. / Korean College of Helicobacter; Upper Gastrointestinal Research.

In: Helicobacter, Vol. 24, No. 4, e12592, 01.08.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea

T2 - A prospective multicenter study

AU - Korean College of Helicobacter

AU - Upper Gastrointestinal Research

AU - Lee, Jeong Hoon

AU - Ahn, Ji Yong

AU - Choi, Kee Don

AU - Jung, Hwoon Yong

AU - Kim, Jung Mogg

AU - Baik, Gwang Ho

AU - Kim, Byung Wook

AU - Park, Jun Chul

AU - Jung, Hye Kyung

AU - Cho, Soo Jeong

AU - Shin, Cheol Min

AU - Choi, Yoon Jin

AU - Lee, Si Hyung

AU - Kim, Ji Hyun

AU - Lee, Wan Sik

AU - Cho, Soo Jeong

AU - Shin, Cheol Min

AU - Cheung, Dae Young

AU - Lee, Hyuk

AU - Min, Yang Won

AU - Kim, Jae J.

AU - Kim, Seung Young

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Introduction: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.

AB - Introduction: The eradication rates for Helicobacter pylori have decreased in Korea although the prevalence of this bacterium has also decreased. Antibiotic resistance is likely to be a crucial factor in H. pylori eradication success, and we therefore mapped these resistance patterns nationwide in Korea. Materials and Methods: Five hundred and ninety adult subjects were prospectively enrolled from 2017 to 2018 from 15 centers across six geographic areas of Korea. A total of 580 biopsy tissues had been sampled from these patients during an upper endoscopy and were frozen at −80°C and delivered to a central laboratory. The agar dilution method was used to determine the minimum inhibitory concentration of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: The culture success rate was 60.2% (349/580). Resistance rates against clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and ciprofloxacin were 17.8%, 29.5%, 9.5%, 0%, 37.0%, and 37.0%, respectively. The geographic distribution of metronidazole and quinolone resistance was highly variable. Some subjects had multiple H. pylori strains in the antrum and body of the stomach and showed a heterogeneous resistance profile between these anatomic areas. The H. pylori multidrug resistance (MDR) rate was 25.2% (88/349) among amoxicillin, clarithromycin, metronidazole, tetracycline, and quinolone and 11.2% (39/349) among four of these major antibiotics except for quinolone. The Seoul and Chungcheong areas showed a relatively lower MDR rate. Conclusion: The antibiotic resistance of H. pylori differs by drug and geographic area in Korea. Detailed nationwide antibiotic resistance mapping is needed to develop an effective H. pylori eradication strategy.

KW - Helicobacter pylori

KW - Korea

KW - antibiotics

KW - resistance

UR - http://www.scopus.com/inward/record.url?scp=85066098624&partnerID=8YFLogxK

U2 - 10.1111/hel.12592

DO - 10.1111/hel.12592

M3 - Article

VL - 24

JO - Helicobacter

JF - Helicobacter

SN - 1083-4389

IS - 4

M1 - e12592

ER -