Multidrug resistance in Helicobacter pylori infection

Frontiers in Microbiology

Microbiology

Anca Daniela Stoica¹  Alexandra Bolocan²  Alexandru Constantinescu²  Dan Nicolae Păduaru²  Octavian Andronic³  Raluca Ioana Dascălu⁴  Magda Mihaela Mitache⁵ 

[1] Babeş-Bolyai University, Cluj-Napoca, Romania;National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania;Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;University Emergency Hospital of Bucharest, Bucharest, Romania;Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;University Emergency Hospital of Bucharest, Bucharest, Romania;Research Institute of the University of Bucharest, Bucharest, Romania;Emergency Clinical Hospital of Bucharest, Bucharest, Romania;Titu Maiorescu University, Bucharest, Romania;

关键词: Helicobacter pylori;    infection;    multidrug resistance;    antibiotic;    eradication;   

DOI  :  10.3389/fmicb.2023.1128497

 received in 2022-12-20, accepted in 2023-01-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

Helicobacter pylori (Hp), a well-known human pathogen, causes one of the most common chronic bacterial infections and plays an important role in the emergence of chronic progressive gastric inflammation and a variety of gastrointestinal diseases. The prevalence of Hp infection varies worldwide and is indirectly proportional to socio-economic status, especially during childhood. The response to the eradication therapy significantly depends on the antibiotic resistance specific to each geographical region; thus, currently, given the increasing prevalence of antimicrobial resistance (especially to clarithromycin, metronidazole, and levofloxacin), successful treatment for Hp eradication has become a real challenge and a critical issue. The most incriminated factors associated with multidrug resistance (MDR) in Hp proved to be the overuse or the improper use of antibiotics, poor medication adherence, and bacterial-related factors including efflux pumps, mutations, and biofilms. Up to 30% of first-line therapy fails due to poor patient compliance, high gastric acidity, or high bacteremia levels. Hence, it is of great importance to consider new eradication regimens such as vonoprazan-containing triple therapies, quintuple therapies, high-dose dual therapies, and standard triple therapies with probiotics, requiring further studies and thorough assessment. Strain susceptibility testing is also necessary for an optimal approach.

【 授权许可】

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Copyright © 2023 Dascălu, Bolocan, Păduaru, Constantinescu, Mitache, Stoica and Andronic.