Lage prevalentie van metronidazol- en claritromycineresistente Helicobacter pylori in de regio 's-Hertogenbosch, 1998-2003

To measure the prevalence of metronidazole- or clarithromycin-resistant Helicobacter pylori.

Design

Retrospective.

Method

All positive H. pylori cultures with known susceptibility to metronidazole or clarithromycin between 1998 and 2003 were selected from the database of the Microbiology Laboratory in ’s-Hertogenbosch, the Netherlands. Resistance to clarithromycin and metronidazole was determined using the E-test with cut-off minimum inhibitory concentrations of ≥ 2 μg/ml and ≥ 8 μg/ml, respectively.

Results

Of the 960 cultures with known metronidazole susceptibility, 135 (14) were resistant. Of the 959 cultures with known clarithromycin susceptibility, 26 (3) were resistant. The percentages of resistant cultures were higher in women than in men (17 versus 12 and 4 versus 2, respectively). There was no relationship between age and resistance. Over the course of the study period, resistance to metronidazole decreased slightly, whereas resistance to clarithromycin increased slightly.

Conclusion

Prevalence of metronidazole- and clarithromycin-resistant H. pylori strains in the ’s-Hertogenbosch region was so low that the combination of a proton pump inhibitor, clarithromycin and amoxicillin can be used in patients with H. pylori infection without first determining susceptibility.

Ned Tijdschr Geneeskd 2005;149:2175-7