Results of a multicentre European survey in 1991 of metronidazole resistance inHelicobacter pylori

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In 1991 a multicentre survey on the prevalence of metronidazole resistance inHelicobacter pylori in vitro was carried out in 12 hospitals in 11 different European countries. The susceptibility ofHelicobacter pylori to metronidazole was determined in each centre by measuring the MIC on agar with the PDM E-test (AB Biodisk) according to a standard procedure. Overall, 122 of 443 (27.5 %) strains tested were resistant to metronidazole (MIC>8 µg/ml). The level of resistance to metronidazole varied markedly between centres (from 7 % to 49 %) and was found to be substantially higher in Africans and other non-Caucasian subjects than in natives from European countries. The overall rate of resistance to metronidazole was higher in females (34.7 %) than in males (23.9 %), and varied according to the age group, being highest among women aged 20 to 39 (50 %). Previous use of metronidazole was reported in only 16 patients, 11 of whom (68.8 %) harboured resistantHelicobacter pylori strains. Although differences in the rate of metronidazole resistance inHelicobacter pylori most probably relate to variations in use of this drug in different populations, such use may frequently go unrecognized. This study emphasises the importance of monitoring the drug resistance ofHelicobacter pylori on a local basis. Standardisation of the methods for testing the susceptibility ofHelicobacter pylori in vitro is clearly needed for this purpose.

Y. Glupczynski (responsible author), Department of Clinical Microbiology, Brugmann University Hospital, 4 Place A. Van Gehuchten, B-1020 Brussels, Belgium; W. Langenberg, J. Dankert, L. Noach, E. Rauws, Department of Medical Microbiology and Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, The Netherlands; A. Mentis, Department of Bacteriology, Hellenic Pasteur Institute, Athens, Greece; F. Mégraud, H. Lamouliatte, Department of Microbiology and Department of Gastroenterology, Hôpital des Enfants, Bordeaux, France; D.S. Tompkins, Bradford Royal Infirmary, Bradford, UK; H. Xia, M. Daw, C. Keane, C. O'Morain, Department of Clinical Microbiology and Department of Gastroenterology, University of Dublin, Ireland; C.A.M. McNulty, Public Health Laboratory Service, Gloucester, UK; H. Gnarpe, C. Blomqvist, P. Unge, Department of Bacteriology, Gävle Hospital and Department of Medicine, Sandviken Hospital, Sweden; H. Rautelin, T. Kosunen, Department of Bacteriology and Immunology, University of Helsinki, Finland; J. Cabrita, I. Ribeiro Pires, Instituto Nacional de Saude, Lisboa, Portugal; M. Lopez-Brea, Department of Clinical Microbiology, Hospital de la Princesa, Madrid, Spain; N. Figura, Department of Microbiology, University of Siena, Italy.