Changing Antimicrobial Susceptibility Epidemiology of Helicobacter pylori Strains in Japan between 2002 and 2005

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2007
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Abstract
Surveillance of Helicobacter pylori antimicrobial susceptibility reflecting the general population in Japan is limited. The antimicrobial susceptibilities of 3,707 H. pylori strains isolated from gastric mucosa samples of previously untreated patients diagnosed with gastroduodenal diseases at 36 medical facilities located throughout Japan between October 2002 and September 2005 were evaluated. Using an agar dilution method for antimicrobial susceptibility testing of H. pylori , the MIC distributions and trends during the study period for clarithromycin, amoxicillin, and metronidazole were studied. While the MIC50 and MIC90 for clarithromycin did not change during the 3-year period, the MIC80 showed a 128-fold increase. Furthermore, the rate of resistance increased yearly from 18.9% (2002 to 2003) to 21.1% (2003 to 2004) and 27.7% (2004 to 2005). With a resistance rate of 19.2% among males compared to 27.0% among females, a significant gender difference was observed ( P < 0.0001). Our study shows that in Japan, there is an evolving trend towards increased resistance to clarithromycin with geographical and gender differences as well as between clinical disease conditions. No significant changes in resistance were observed for amoxicillin and metronidazole during the period. While the benefit of H. pylori antimicrobial susceptibility testing has been debated in Japan, current empirical regimens are not based on susceptibility data representative of the general population. The development of an effective H. pylori eradication regimen in Japan will require continued resistance surveillance as well as a better understanding of the epidemiology of resistance.
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Authors Intetsu Kobayashi;Kazunari Murakami;Mototsugu Kato;Seiichi Kato;Takeshi Azuma;Shin'ichi Takahashi;Naomi Uemura;Tsutomu Katsuyama;Yoshihiro Fukuda;Ken Haruma;Masaru Nasu;Toshio Fujioka;Intetsu Kobayashi;Kazunari Murakami;Mototsugu Kato;Seiichi Kato;Takeshi Azuma;Shin'ichi Takahashi;Naomi Uemura;Tsutomu Katsuyama;Yoshihiro Fukuda;Ken Haruma;Masaru Nasu;Toshio Fujioka;
Journal Journal of clinical microbiology
Year 2007
DOI
10.1128/JCM.00740-07
URL
https://dx.doi.org/10.1128/JCM.00740-07
Keywords
National Center for Biotechnology Information NCBI NLM MEDLINE humans pubmed abstract nih national institutes of health national library of medicine adult female male adolescent aged middle aged Child sex factors 80 and over drug resistance bacterial* microbial sensitivity tests anti-bacterial agents / pharmacology* helicobacter pylori / drug effects* japan / epidemiology amoxicillin / pharmacology* pmid:17942652 pmc2168569 doi:10.1128/jcm.00740-07 intetsu kobayashi kazunari murakami toshio fujioka clarithromycin / pharmacology* gastric mucosa / microbiology helicobacter infections / epidemiology helicobacter infections / microbiology* helicobacter pylori / isolation & purification metronidazole / pharmacology*

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