HELICOBACTER PYLORI RESISTANCE PATTERN OVER LAST 14 YEARS IN A UNIVERSITY TEACHING HOSPITAL

Aims:

To investigate H. Pylori resistance patterns in patients having gastroscopy with culture & sensitivity (C&S) at St. James's Hospital, over last 14 years.

Methods:

This is a retrospective study, evaluating H. Pylori C&S sent over the last 14 years. Resistance patterns were analysed for the positive C&S.

Results:

Out of a total of 1228 C&S sent for H. pylori, 643 (52.36%) were positive while, 585 (47.64%) were negative for the bacteria. Within positive C&S, 402 (62.52%) were female, with the mean age of 42.69 years. The sensitivity testing for amoxicillin and metronidazole were discontinued after 2010. Resistance rate for clarithromycin and metronidazole were 78.08% and 66.37% respectively. Comparing the period from 2004 – 2009 to 2010 – 2017, the resistance rate for clarithromycin was rising from 69.27% to 81.51%. Resistance rate for amoxicillin, tetracycline, and rifampicin were 3.44%, 0.31% and 1.09% respectively. 35.87% were resistant while 3.26% were intermediate sensitivity to levofloxacin.

Conclusions:

In the cohort of patients with previous H Pylori eradication failure, resistance to Clarithromycin and Metronidazole is common, with increasing resistance rate to clarithromycin over the years. Resistance pattern to levofloxacin is also on the rise. This further validates the use of H Pylori C&S to guide the antibiotic regimen in this cohort.