High rates of clarithromycin and levofloxacin resistance of Helicobacter pylori in patients with chronic gastritis in the south east area of Vietnam

Abstract

Background: The increasing rates of clarithromycin (CLR)- and levofloxacin (LVX)-resistant Helicobacter pylori are the main causes of the considerable decrease in the eradication rates of triple therapy and LVX-based regimens. The aims of this study were to determine the rates of CLR- and LVX-resistant H. pylori by the Epsilometer test and to assess the risk factors for this antibiotic resistance among patients with chronic gastritis in the south east area of Vietnam. Methods: Gastric biopsy specimens were obtained from 153 patients with H. pylori-positive chronic gastritis for use in culture and in the Epsilometer test to determine CLR and LVX susceptibilities. Results: The rates of H. pylori resistance to CLR and LVX were 72.6% and 40.5%, respectively. Dual-resistant H. pylori (to both CLR and LVX) accounted for 30.7% of patients. The rates of high-level resistance to CLR and LVX were 18.9% and 83.9%, respectively. Multivariate analysis showed that age older than 30 years (odds ratio [OR] = 3.80, 95% confidence interval [CI] 1.61–8.97) and history of H. pylori treatment (OR = 8.72, 95% CI 1.90–39.91) were independent risk factors for CLR resistance, whereas only age older than 35 years (OR = 2.42, 95% CI 1.23–4.76) was an independent risk factor for LVX resistance. Conclusions: These results revealed high rates of resistance of H. pylori to CLR and LVX in patients with chronic gastritis in the south east area of Vietnam. This suggests that CLR-based triple therapy should not be used for the eradication treatment of H. pylori, and LVX susceptibility testing of H. pylori strains should be performed before choosing alternative regimens.

Keywords

• Helicobacter pylori
• Antibiotic resistance
• Clarithromycin
• Levofloxacin
• Epsilometer test