Skip to main content
NCBI home page
Gut logoLink to Gut
. 1996 May;38(5):675–678. doi: 10.1136/gut.38.5.675

Prevalence of metronidazole resistant Helicobacter pylori strains among Chinese peptic ulcer disease patients and normal controls in Hong Kong.

C K Ching 1, K P Leung 1, R W Yung 1, S K Lam 1, B C Wong 1, K C Lai 1, C L Lai 1
PMCID: PMC1383147  PMID: 8707111

Abstract

BACKGROUND--A study was conducted to evaluate the prevalence of metronidazole resistant Helicobacter pylori strains among the Chinese in Hong Kong. The efficacy of the triple therapy that contains metronidazole as one of the anti-microbial agents in eradication of the metronidazole susceptible and the metronidazole resistant strains was also assessed. METHODS--Culture for H pylori was attempted from antral biopsy specimens of 70 peptic ulcer and 51 control subjects. Successfully cultured H pylori strains were tested for metronidazole susceptibility. Twenty six peptic ulcer disease subjects who had received a course of triple therapy were also reassessed four to six weeks later for successful eradication of H pylori infection. RESULTS AND CONCLUSIONS--H pylori was successfully cultured from antral biopsy specimens in 69 of 80 (86%) of the infected subjects. The overall metronidazole resistance rate was 53.5% (37 of 69). There was a significantly higher metronidazole resistance rate among H pylori isolates from the asymptomatic controls (20 of 25) than the peptic ulcer disease subjects (17 of 44) (p = 0.0007). Twenty three of 32 (73%) women and 14 of 37 (38%) men harboured the metronidazole resistant strains. There was no sex or age difference as far as the prevalence of metronidazole resistant strains were concerned within each study group. Pre-treatment metronidazole susceptible H pylori were significantly more likely to respond to the triple therapy used than those with the metronidazole resistant ones (14 of 15 v five of 10) (p = 0.021).

Full text

PDF
675

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell G. D., Powell K. U., Burridge S. M., Spencer G., Bolton G., Purser K., Brooks S., Prosser S., Harrison G., Gant P. W. Short report: omeprazole plus antibiotic combinations for the eradication of metronidazole-resistant Helicobacter pylori. Aliment Pharmacol Ther. 1992 Dec;6(6):751–758. doi: 10.1111/j.1365-2036.1992.tb00740.x. [DOI] [PubMed] [Google Scholar]
  2. Bell G. D., Powell K., Burridge S. M., Pallecaros A., Jones P. H., Gant P. W., Harrison G., Trowell J. E. Experience with 'triple' anti-Helicobacter pylori eradication therapy: side effects and the importance of testing the pre-treatment bacterial isolate for metronidazole resistance. Aliment Pharmacol Ther. 1992 Aug;6(4):427–435. doi: 10.1111/j.1365-2036.1992.tb00556.x. [DOI] [PubMed] [Google Scholar]
  3. Ching C. K., Buxton C., Holgate C., Holmes G. K. Cytological brushing urea broth test: a highly sensitive and specific test for Helicobacter pylori infection. Gastrointest Endosc. 1991 Sep-Oct;37(5):550–551. doi: 10.1016/s0016-5107(91)70827-4. [DOI] [PubMed] [Google Scholar]
  4. DeCross A. J., Marshall B. J., McCallum R. W., Hoffman S. R., Barrett L. J., Guerrant R. L. Metronidazole susceptibility testing for Helicobacter pylori: comparison of disk, broth, and agar dilution methods and their clinical relevance. J Clin Microbiol. 1993 Aug;31(8):1971–1974. doi: 10.1128/jcm.31.8.1971-1974.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Glupczynski Y., Burette A., De Koster E., Nyst J. F., Deltenre M., Cadranel S., Bourdeaux L., De Vos D. Metronidazole resistance in Helicobacter pylori. Lancet. 1990 Apr 21;335(8695):976–977. doi: 10.1016/0140-6736(90)91043-a. [DOI] [PubMed] [Google Scholar]
  6. Graham D. Y., Lew G. M., Klein P. D., Evans D. G., Evans D. J., Jr, Saeed Z. A., Malaty H. M. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med. 1992 May 1;116(9):705–708. doi: 10.7326/0003-4819-116-9-705. [DOI] [PubMed] [Google Scholar]
  7. Graham D. Y., Lew G. M., Malaty H. M., Evans D. G., Evans D. J., Jr, Klein P. D., Alpert L. C., Genta R. M. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology. 1992 Feb;102(2):493–496. doi: 10.1016/0016-5085(92)90095-g. [DOI] [PubMed] [Google Scholar]
  8. Hosking S. W., Ling T. K., Chung S. C., Yung M. Y., Cheng A. F., Sung J. J., Li A. K. Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial. Lancet. 1994 Feb 26;343(8896):508–510. doi: 10.1016/s0140-6736(94)91460-5. [DOI] [PubMed] [Google Scholar]
  9. Labenz J., Börsch G. Evidence for the essential role of Helicobacter pylori in gastric ulcer disease. Gut. 1994 Jan;35(1):19–22. doi: 10.1136/gut.35.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Logan R. P., Gummett P. A., Misiewicz J. J., Karim Q. N., Walker M. M., Baron J. H. One week eradication regimen for Helicobacter pylori. Lancet. 1991 Nov 16;338(8777):1249–1252. doi: 10.1016/0140-6736(91)92111-e. [DOI] [PubMed] [Google Scholar]
  11. Rautelin H., Seppälä K., Renkonen O. V., Vainio U., Kosunen T. U. Role of metronidazole resistance in therapy of Helicobacter pylori infections. Antimicrob Agents Chemother. 1992 Jan;36(1):163–166. doi: 10.1128/aac.36.1.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sung J. J., Chung S. C., Ling T. K., Yung M. Y., Leung V. K., Ng E. K., Li M. K., Cheng A. F., Li A. K. Antibacterial treatment of gastric ulcers associated with Helicobacter pylori. N Engl J Med. 1995 Jan 19;332(3):139–142. doi: 10.1056/NEJM199501193320302. [DOI] [PubMed] [Google Scholar]
  13. Thijs J. C., Van Zwet A. A., Moolenaar W., Oom J. A., De Korte H., Runhaar E. A. Short report: clarithromycin, an alternative to metronidazole in the triple therapy of Helicobacter pylori infection. Aliment Pharmacol Ther. 1994 Feb;8(1):131–134. doi: 10.1111/j.1365-2036.1994.tb00170.x. [DOI] [PubMed] [Google Scholar]
  14. Thijs J. C., Van Zwet A. A., Oey H. B. Efficacy and side effects of a triple drug regimen for the eradication of Helicobacter pylori. Scand J Gastroenterol. 1993 Nov;28(11):934–938. doi: 10.3109/00365529309098287. [DOI] [PubMed] [Google Scholar]
  15. Thijs J. C., Van Zwet A. A., Oey H. B. Efficacy and side effects of a triple drug regimen for the eradication of Helicobacter pylori. Scand J Gastroenterol. 1993 Nov;28(11):934–938. doi: 10.3109/00365529309098287. [DOI] [PubMed] [Google Scholar]
  16. al-Assi M. T., Ramirez F. C., Lew G. M., Genta R. M., Graham D. Y. Clarithromycin, tetracycline, and bismuth: a new non-metronidazole therapy for Helicobacter pylori infection. Am J Gastroenterol. 1994 Aug;89(8):1203–1205. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES