Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Antibiotic Resistant Pattern of Helicobacter Pylori Infection Based on Molecular Tests in Laos

  • Vannarath, Sengdao (Department of Gastroenterology, Mahosot Hospital) ;
  • Vilaichone, Ratha-korn (Gastroenterology Unit, Department of Medicine, Thammasat University Hospital) ;
  • Rasachak, Bouachanh (Department of Gastroenterology, Mahosot Hospital) ;
  • Mairiang, Pisaln (Department of Gastroenterology, Srinagarind Hospital, Khonkaen University) ;
  • Yamaoka, Yoshio (Department of Medicine, Michael E. Debakey Veterans Affairs Medical Center and Baylor College of Medicine) ;
  • Mahachai, Varocha (Division of Gastroenterology, Department of Medicine, Chulalongkorn University Hospital)
  • Published : 2016.02.05
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The efficacy of standard treatment of Helicobacter pylori (H. pylori) is declining because of antibiotic resistance. Clarithromycin resistance is also increasing in many Asian countries. The aim of this study was to determine the antibiotic susceptibility patterns of H. pylori infection and clinical association in Laos. Materials and Methods: A total of 329 Lao dyspeptic patients who underwent gastroscopy at Mahosot Hospital, Vientiane, Laos during December 2010-March 2012 were enrolled in this study. During gastroscopy, 4 biopsies were collected (2 each from the antrum and body) for CLO-test and histopathology. Only the positive CLO-test gastric tissues was stored at $-80^{\circ}C$ in a freezer until DNA was extracted and a GenoType$^{(R)}$HelicoDR test was conducted for detecting mutations in the rrl gene encoding 23S rRNA (clarithromycin resistance) and mutations in gyrA gene (fluoroquinolone resistance). Results: Of the total, 119 Lao patients (36.2%) were infected with H. pylori including 59 males (49.6%) and 60 females (50.4%) with a mean age of 46 years. Clarithromycin and fluoroquinolone resistance of H. pylori infection was demonstrated in 15 (12.6%) and 16 strains (13.4%) respectively. In clarithromycin resistance, the number of patients who had education above primary school and $BMI{\geq}25kg/m^2$ were significantly higher than those who had education below primary school and BMI<$25kg/m^2$ (23.1% vs 7.5%, P-value= 0.036 and 20.5% vs 8%, P-value= 0.048, respectively). In fluoroquinolone resistance, the number of lowland Lao was significantly higher than those of non-lowland (highland and midland) Lao ethnic groups (16.7% vs 0%, P-value= 0.039). Conclusions: H. pylori infections remain common in Laos. Clarithromycin and fluoroquinolone resistance with H. pylori infection are growing problems. Education above primary school and $BMI{\geq}25kg/m^2$ might be predictors for clarithromycin resistance and lowland Lao ethnicity might be predictors for fluoroquinolone resistance with H. pylori infection in Laos.

Keywords

References

  1. Cambau E, Allerheiligen V, Coulon C, et al (2009). Evaluation of a New Test, GenoType HelicoDR, for molecular detection of antibiotic resistance in Helicobacter pylori. J Clin Microbiol, 47, 3600-07. https://doi.org/10.1128/JCM.00744-09
  2. Dixon MF (1991). Helicobacter pylori and peptic ulceration: Histopathological aspect. J Gastroenterol Hepatol, 6, 125-30. https://doi.org/10.1111/j.1440-1746.1991.tb01451.x
  3. Hopkins RJ, Girardi LS, Turney EA (1996). Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review. Gastroenterology, 110, 1244-52. https://doi.org/10.1053/gast.1996.v110.pm8613015
  4. KM Fock, NJ Talley, U Kachintorn, et al (2009). Second Asia Pacific consensus guidelines for Helicobacter pylori infection. J Gastroenterology and Hepatology, 24, 1587-600. https://doi.org/10.1111/j.1440-1746.2009.05982.x
  5. Nguyen LT, Mai HM, Ta L, (2011). Helicobacter pylori infection and gastroduodenal disease in Vietnam. Helicobacter Research, 15, 220-27.
  6. Malfertheiner P, Megraud F, O'Morain C, et al (2007). Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut, 56, 772-81. https://doi.org/10.1136/gut.2006.101634
  7. Malfertheiner P, Megraud F, O'Morain C, et al (2012). Management of Helicobacter pylori infection-the maastricht IV/ florence consensus report. Gut, 61, 646-64. https://doi.org/10.1136/gutjnl-2012-302084
  8. Megraud F (2004). Helicobacter pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut, 53, 1374-84. https://doi.org/10.1136/gut.2003.022111
  9. Megraud, F., and Lehours P (2007). Helicobacter pylori detection and antimicrobial susceptibility testing. ClinMicrobiol Rev, 20, 280-322.
  10. Moore, R. A, B. Beckthold, S. Wong, et al (1995). Nucleotide sequence of the gyrA gene and characterization of ciprofloxacin resistant mutants of Helicobacter pylori. Antimicrob Agents Chemother, 39, 107-111. https://doi.org/10.1128/AAC.39.1.107
  11. Prapitpaiboon H, Mahachai V, Vilaichone RK (2015). High efficacy of levofloxacin-dexlansoprazole-based quadruple therapy as a first line treatment for Helicobacter pylori Eradication in Thailand. Asian Pac J Cancer Prev, 16, 4353-6. https://doi.org/10.7314/APJCP.2015.16.10.4353
  12. Parsonnet J, Friedman GD, Vandersteen DP, et al (1991). Helicobacter pylori infection and the risk of gastric carcinoma. N Eng J Med, 325, 1127-31. https://doi.org/10.1056/NEJM199110173251603
  13. Perez Aldan L, Kato M, Nakagawa S, et al (2002). The relationship between consumption of antimicrobial agents and the prevalence of primary Helicobacter pylori resistance. Helicobacter, 7, 306-9. https://doi.org/10.1046/j.1523-5378.2002.00096.x
  14. Rasachak B, Bounkong S (2000). Epidemiologic and endoscopic aspects of Helicobacter pylori infection in Vientian Laos. Bull Soc Pathol Exot, 93, 91-4.
  15. Srinarong C, Mahachai V, Vilaichone RK (2014). High efficacy of 14-day standard triple therapy plus bismuth with probiotic supplement for Helicobacter pylori eradication in low clarithromycin resistance areas. Asian Pac J Cancer Prev, 15, 9909-13. https://doi.org/10.7314/APJCP.2014.15.22.9909
  16. Tankovic, JC, Lascols, Q, Sculo JC, et al (2003). Single and double mutations in gyrA but not in gyrB are associated with low- and high-level fluoroquinolone resistance in Helicobacter pylori. Antimicrob Agents Chemother, 47, 3942-44. https://doi.org/10.1128/AAC.47.12.3942-3944.2003
  17. Tytgat GNJ, Noach LA, Rauws EAJ (1993). Helicobacter pylori infection and duodenal ulcer disease. Gastroenterol Clin North Am, 22, 127-39.
  18. Vannarath S, Vilaichone RK, Rasachak B, et al (2014). Virulence genes of Helicobacter pylori in gastritis, peptic ulcer and gastric cancer in Laos. Asian Pac J Cancer Prev, 15, 9027-31. https://doi.org/10.7314/APJCP.2014.15.20.9027
  19. Vilaichone RK, Gumnarai P, Ratanachuek T, et al (2013). Nationwide survey of Helicobacter pylori antibiotic resistance in Thailand. Diagnostic Microbiology Infectious Disease, 77, 346-49. https://doi.org/10.1016/j.diagmicrobio.2013.08.010
  20. Vilaichone RK, Mahachai V, Graham DY (2006). Helicobacter pylori: diagnosis and management. Gastroenterol Clin North Am, 35, 229-47. https://doi.org/10.1016/j.gtc.2006.03.004
  21. Vilaichone RK, Panarat W, Aekpongpaisit S, et al (2014). Clinical characteristics and Helicobacter pylori status of gastric cancer in Thailand. Asian Pac J Cancer Prev, 15, 9005-8. https://doi.org/10.7314/APJCP.2014.15.20.9005
  22. Vilaichone RK, Prapitpaiboon H, Gamnarai P, et al (2015). Seven-day bismuth-based quadruple therapy as an initial treatment for Helicobacter pylori infection in a high metronidazole resistant Area. Asian Pac J Cancer Prev, 16, 6089-92. https://doi.org/10.7314/APJCP.2015.16.14.6089
  23. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, et al (1999). Helicobacter pylori associated gastritis and primary B-cell lymphoma. Lancet, 338, 1175-6.