Genotypic and phenotypic patterns of antimicrobial susceptibility of Helicobacter pylori strains among Egyptian patients

Abstract

Helicobacter pylori (H. pylori) is currently recognized as one of the most common chronic bacterial infections worldwide. Eradication of bacteria is effective in healing peptic ulcers, preventing ulcer relapses, and potentially decreasing the risk of progression to gastric carcinoma. For successful eradication of bacteria, it is imperative that the clinician be aware of the current antimicrobial susceptibility profiles of isolates within the region. Therefore, the aim of this study is to compare the phenotypic and genotypic patterns of antibiotics’ susceptibility to H. pylori strains among Egyptian patients.

60 symptomatic cases were enrolled. H. pylori infection was diagnosed by upper endoscopy as well as biopsy. Antimicrobial susceptibility to H. pylori strains was assessed in all subjects by disc diffusion and Ellipsometer testing (E-testing) methods. Further molecular characterization of genes encoding antimicrobial resistance of isolated strains was done by the polymerase chain reaction (PCR).

For metronidazole and ciprofloxacin, we compared the phenotypic and genotypic patterns of resistance as detected by PCR amplification of the resistance genes. Resistance rates by E-test were 100% and 25% for metronidazole and ciprofloxacin respectively from 16 isolated H. pylori strains.

Improving the knowledge of resistance mechanisms, the elaboration of rational and efficacious associations for the treatment H. pylori infection are of high importance especially in determining the therapeutic outcome. Further progress should ultimately focus on the establishment of a cheap, feasible and reliable laboratory test to predict the outcome of a therapeutic scheme.