Resistencia a metronidazol y claritromicina en aislamientos de Helicobacter pylori de pacientes dispépticos en Colombia / Antimicrobial susceptibility of Helicobacter pylori strains isolated in Colombia

ABSTRACT

Background: Helicobacter pylori antimicrobial resistance rates differ among countries and even between different areas of a country. In Colombia, the most commonly used antimicrobials for the treatment of H pylori infection are amoxicillin, clarithromycin and metronidazole. Aim: To determine antimicrobial susceptibility of H pylori strains isolated in Colombia. Materials and methods: Eighty eight strains of H pylori were isolated and identified by microbiological methods and confirmed with polymerase chain reaction (PCR). The detection of antimicrobial resistance to amoxicillin, clarithromycin, metronidazole and tetraclycline, was conducted by the Etest method. Mutations in the 23S rDNA, involved in resistance to clarithromycin, were detected using PCR and restriction fragment lenght polymorphism. Results: Eighty eight and 2.2 percent of the strains were resistant to metronidazole and clarithromycin, respectively. No isolate was simultaneously resistant to amoxicillin or tetracycline. The two clarithromycin resistant strains were homozygous for the A2143G mutation. No mutations were found in the remaining 86 susceptible strains. Conclusions: The high rate of metronidazole resistance in our population precludes the use of this drug for the empirical treatment of Hpylori infection.