Pattern of Primary Resistance of <i>Helicobacter pylori</i> to Clarithromycin among Pediatric Patients from North-Eastern Romania
Oana-Maria Rosu,
Nicoleta Gimiga,
Roxana Popescu,
Ileana Ioniuc,
Carmen Daniela Rusu,
Tatiana Clipa,
Diana-Maria Florea,
Doina-Anca Pleșca,
Alexandru Nemtoi,
Elena Tataranu,
Gabriela Stefanescu,
Smaranda Diaconescu
Affiliations
Oana-Maria Rosu
Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Str., 540139 Targu Mures, Romania
Nicoleta Gimiga
Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Roxana Popescu
Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Ileana Ioniuc
Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Carmen Daniela Rusu
Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Tatiana Clipa
Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
Diana-Maria Florea
Medical Genetics Department, “Cuza Voda” Clinical Hospital of Obstetrics and Gynecology, 34 Cuza Voda Str., 700038 Iasi, Romania
Doina-Anca Pleșca
Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 21 Dionisie Lupu Str., 020021 Bucharest, Romania
Alexandru Nemtoi
Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
Elena Tataranu
Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 13 Universitatii Str., 720229 Suceava, Romania
Gabriela Stefanescu
Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
Smaranda Diaconescu
Faculty of Medicine, “Titu Maiorescu” University of Medicine, 67A Gheorghe Petrascu Str., 031592 Bucharest, Romania
Background: Helicobacter pylori antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with Helicobacter pylori by gastric biopsy. Methods: We studied 84 positive gastric samples for Helicobacter pylori. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. Results: Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6–17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. Conclusions: One in 2.4 children infected with Helicobacter pylori had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.
