Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, Philips M, Waters TE, Sanderson CR Prospective double-blind trial of duodenal ulcer relapse after eradication ofCampylobacter pylori. Lancet 1988, ii: 1439–1442.
Rauws EAJ, Tytgat GNJ Cure of duodenal ulcer associated with eradication ofHelicobacter pylori. Lancet 1990, 335: 1233–1235.
Axon ATR Helicobacter pylori: effect on peptic ulcer disease. Journal of Gastroenterology and Hepatology 1991, 6: 131–137.
Becx MC, Janssen AJ, Claesener HA, de Koning RW Metronidazole-resistantHelicobacter pylori. Lancet 1990, 335: 539–540.
Glupczynski Y, Burette A, De Koster E, Nyst JF, Deltenre M, Cadranel S, Bourdeaux L, DeVos D Helicobacter pylori and metronidazole resistance. Lancet 1990, 335: 976–977.
Glupczynski Y, Burette A Drug therapy forHelicobacter pylori infection: problems and pitfalls. American Journal of Gastroenterology 1990, 85: 1545–1551.
Weil J, Bell GD, Powell K, Jobson R, Trowell JE, Gant P, Jones PH Helicobacter pylori and metronidazole resistance. Lancet 1990, 336: 1445.
Logan RPH, Gummett PA, Misiewicz JJ, Karim QN, Walker MM, Baron JH One week eradication regimen forHelicobacter pylori. Lancet 1991, 338: 1249–1252.
Rautelin H, Seppälä K, Renkonen OV, Vainio U, Kosunen TU Role of metronidazole resistance in therapy ofHelicobacter pylori infection. Antimicrobial Agents and Chemotherapy 1992, 36: 163–166.
Goodwin CS, Marshall BJ, Blincow ED, Wilson DH, Blackbourn S, Philips M Prevention of nitroimidazole resistance inCampylobacter pylori by coadministration of colloidal bismuth subcitrate: clinical and in vitro studies. Journal of Clinical Pathology 1988, 41: 207–210.
Westblom TU Laboratory diagnosis and handling ofHelicobacter pylori. In: Marshall BJ, McCallum RW, Guerrant RL (ed):Helicobacter pylori in peptic ulceration and gastritis. Blackwell Scientific Publications, Boston, 1991, p. 81–91.
Glupczynski Y, Labbé M, Hansen W, Crokaert F, Yourassowsky E Evaluation of the E test for quantitative antimicrobial susceptibility testing ofHelicobacter pylori. Journal of Clinical Microbiology 1991, 29: 2072–2075.
National Committee for Clinical Laboratory Standards Methods for antimicrobial susceptibility testing of anaerobic bacteria. Approved standard M11-A2. NCCLS, Villanova, PA, 1990.
Kramer MS Statistical inference for categorical variables. In: Kramer MS (ed): Clinical epidemiology and biostatistics: a primer for clinical investigators and decision-makers. Springer Verlag, Berlin, 1988, p. 165–186.
Graham DY, Börsch GM The who's and when's of therapy forHelicobacter pylori. American Journal of Gastroenterology 1990, 85: 1552–1555.
Author information
Consortia
Additional information
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.
Rights and permissions
About this article
Cite this article
European Study Group on Antibiotic Susceptibility of Helicobacter pylori. Results of a multicentre European survey in 1991 of metronidazole resistance inHelicobacter pylori . Eur. J. Clin. Microbiol. Infect. Dis. 11, 777–781 (1992). https://doi.org/10.1007/BF01960875
Issue Date:
DOI: https://doi.org/10.1007/BF01960875