[Evaluation of metronidazole resistance Helicobacter pylori strains isolated from Shahrekord]

ABSTRACT

Metronidazole is one of the most important antibiotics in Helicobacter pylori [H.pylori] eradication regimens. This study was designed to determine metronidazole resistance H. pylori isolates from patients referred to Hajar hospital, Shahrekord, Iran. In this cross-sectional study, 263 patients who referred to endoscopy department of Hajar hospital, Shahrekord in 2007 were randomly selected. Gastric biopsy samples were cultured on selective Brucella agar containing 10% blood and incubated under microerophilic condition at 37°C between 3 and 7 days. Gram stain, urease, catalase and oxidase tests were used to detect H. Pylori isolates, and PCR [polymerase chain reaction] to determine ureC gene. H.pylori indentified. Standard CLSI [Clinical and Laboratory Standard Institute] was used to evaluate metronidazole resistance. Rapid urease test [RUT], culture and PCR detect H. pylori infection in 54.37%, 84% and 84.79%, respectively. Of isolated strains, 49 [58.33%] metronidazole resistance and 7 [8.33%] semisensitive were recognized. Of 49 metronidazole resistant patients, 32.65%, 20.40%, 12.24%, 6.10%, 4.80% and 24.48% had gastritis, gastric ulcer, duodenal ulcer, esophagitis, gastric cancer and normal endoscopy, respectively. Fisher exact test shows that there are relation between metronidazole resistance and women. Regarding high metronidazole resistance among studied patients, alternative antibiotics with less resistance is recommended in Helicobacter pylori [H.pylori] eradication regimens