Keywords
drug resistance, microbial
stomach diseases
beta-lactamases
amoxicillin
Colombia Helicobacter pylori
farmacorresistencia microbiana
gastropatías
beta-Lactamasas
amoxicilina
Colombia
How to Cite
Abstract
Introduction: Helicobacter pylori exhibit variations in antibiotic resistance in America and Colombia. Despite the use of various treatment regimens containing amoxicillin in the department of Antioquia, Colombia, as well as in several countries across the continent, the pattern of genotypic and phenotypic susceptibility to this antibiotic remains unknown. Objective: To determine the frequency of H. pylori infection by detecting the ureA gene and amoxicillin susceptibility through beta-lactamases in H. pylori isolates from patients with gastroduodenal diseases in Antioquia-Colombia. Methods: Cross-sectional analytical study with 179 patients attending endoscopy units of seven healthcare institutions. Sociodemographic and risk factor data were collected. Moreover, biopsies from the antrum and body were taken for microbiological isolation and molecular detection of H. pylori. The sociodemographic data were assessed through frequency analysis and bivariate statistics. DNA obtained from the biopsies was amplified by PCR for the ureA gene, and beta-lactamase production was evaluated using the nitrocefin test as well as the amplification of the TEM and SHV genes. Results: It was found that 61 % (109 / 179) of patients tested positive for H. pylori; out of 84 isolates obtained by culture, none tested positive for the nitrocefin test. Significant differences were found in socioeconomic status, healthcare system, and geographical location in patients positive for the ureA gene. Two patients tested positive for molecular detection of beta-lactamases from biopsies; however, SHV and TEM genes were not found in any isolate. Conclusions: The frequency of H. pylori for ureA-gene detection is higher than previous studies and similar to other reports in other Colombian regions; consequently, this will become a good diagnostic test in the country. Finally, none of the H. pylori isolates tested positive for beta-lactamases TEM and SHV.
References
Ansari, S., & Yamaoka, Y. (2022). Helicobacter pylori infection, its laboratory diagnosis, and antimicrobial resistance: A perspective of clinical relevance. Clinical Microbiology Reviews, 35(3), e0025821. https://doi.org/10.1128/cmr.00258-21
Atehortua-Rendon, J. D., Martínez, A., & Pérez-Cala, T. (2020). Descripción de la resistencia de Helicobacter pylori a seis antibióticos de uso frecuente en colombia. Revista Colombiana de Gastroenterología, 35(3), 351–361. https://doi.org/10.22516/25007440.493
Baltrus, D. A., Amieva, M. R., Covacci, A., Lowe, T. M., Merrel, D. S., Ottemann, K. M., Stein, M., Salama, N. R., & Guillemin, K. (2009). The complete genome sequence of Helicobacter pylori strain G27. Journal of Bacteriology, 191(1), 447–448. https://doi.org/10.1128/jb.01416-08
Bedoya-Gómez, I. J., Alvarez-Aldana, A., Moncayo-Ortiz, J. I., Guaca-González, Y. M., Santacruz-Ibarra, J. J., Arturo-Arias, B. L., Castañeda-Chávez, L. J., Leon Rodriguez, D. A., & Beltrán-Angarita, L. (2020). Surveillance of the antimicrobial resistance rates of Helicobacter pylori ten years later in the Western Central Region, Colombia. Digestive Diseases, 38(3), 196–203.
Boyanova, L., Kandilarov, N., Hadzhiyski, P., Gergova, R., Gergova, G., & Markoska, R. (2022). Increase in amoxicillin resistance in Helicobacter pylori from Bulgarian patients over 15 years. Diagnostic microbiology and infectious disease, 104(1), 115746.
Bravo, L. E., Cortés, A., Carrascal, E., Jaramillo, R., García, L. S., Bravo, P. E., Baldes, A., & Bravo, P. A. (2003). Helicobacter pylori: Patología y prevalencia en biopsias gástricas en Colombia. Colombia Médica, 34(3), 124–131.
Bustamante-Rengifo, J. A., Matta, A. J., Pazos, A. J., & Bravo L. E. (2013). In vitro effect of amoxicillin and clarithromycin on the 3’ Region of CagA gene in Helicobacter pylori isolates. World Journal of Gastroenterology, 19(36), 6044–6054.
Cámara de Comercio de Medellín para Antioquia. (2021). Perfiles socioeconómicos de las subregiones de Antioquia 2021 [Informe técnico]. Anuario estadístico de Antioquia.
Camargo, M. C., García, A., Riquelme, A., Otero, W., Camargo, C. A., Hernandez-García, T., Candia, R., Bruce, M. G., & Rabkin, C. S. (2014). The problem of Helicobacter pylori resistance to antibiotics: A systematic review in Latin America. American Journal of Gastroenterology, 109(4), 485–495.
Chahuán, J., Pizarro, M., Días, L. A., Villalón, A., & Riquelme, A. (2020). Métodos de diagnóstico para la detección de la infección por Helicobacter pylori. Revista Gastroenterología Latinoamericana, 31(2), 98–106. https://doi.org/10.46613/gastrolat202002-08
Choi, Y. I., Jeong, S. H., Chung, J. W., Park, D. K., Kim, K. O., Kwon, K. A., Kim, Y. J., So, S., Lee, J. H., Jeong, J. Y., & Lee, S. M. (2019). Rifabutin and furazolidone could be the candidates of the rescue regimen for antibiotic-resistant H. pylori in Korea. Canadian Journal of Infectious Diseases and Medical Microbiology, 2019, 9351801. https://doi.org/10.1155/2019/9351801
Edaptative Technologies LLC. (2022). M100 Performance standards for antimicrobial susceptibility testing (32nd ed.) [Base de datos]. CLSI. http://em100.edaptivedocs.net/dashboard.aspx
Elshair, M., Ugai, T., Oze, I., Kasugai, Y., Koyanagi, Y. N., Hara, K., Ito, H., & Matsuo, K. (2022). Impact of socioeconomic status and sibling number on the prevalence of Helicobacter pylori infection: A cross-sectional study in a Japanese population. Nagoya Journal of Medical Science, 84(2), 374–387.
Figueroa, M., Cortés, A., Pazos, A., & Bravo, L. E. (2012). Sensibilidad in vitro a amoxicilina y claritromicina de Helicobacter pylori obtenido de biopsias gástricas de pacientes en zona de bajo riesgo para cáncer gástrico. Biomédica, 32, 32–42. https://doi.org/10.7705/biomedica.v32i1.454
Gobernación de Antioquia. (2022). Encuesta calidad de vida 2021 [Informe técnico]. Antioquia Datos. https://antioquia.gov.co/indice-de-calidad-de-vida-icv-vf
Ho, J. J. C., Navarro, M., Sawyer, K., Elfanagely, Y., & Moss, S. F. (2022). Helicobacter pylori antibiotic resistance in the United States between 2011 and 2021: A systematic review and meta-analysis. The American Journal of Gastroenterology, 117(8), 1221–1230.
IBM Corp. (2016). IBM SPSS Statistics for Windows (Version 24.0) [Software]. IBM Corp, Armonk, United States of America. https://www.ibm.com/products/spss-statistics
International Agency for Research on Cancer. (1994). Schistosomes, Liver Flukes and Helicobacter pylori (1a ed.). IARCPress.
Jiang, Z., Qian, X., Wang, Z., Dong, Y., Pan, Y., Zhang, Z., & Wang, S. (2022). Antibiotic resistance of Helicobacter pylori isolated from patients in Nanjing, China: A cross-section study from 2018 to 2021. Frontiers in Cellular and Infection Microbiology, 12, 970630. https://doi.org/10.3389/fcimb.2022.970630
Katelaris, P., Hunt, R., Bazzoli, F., Cohen, H., Fock, K. M., Gemilyan, M., Malfertheiner, P., Mégraud, F., Piscoya, A., Quach, D., Vakil, N., Vaz Coelho, L. G., LeMair, A., & Melberg, J. (2023). Helicobacter pylori world gastroenterology organization global guideline. Journal of Clinical Gastroenterology, 57(2), 111–126. https://doi.org/10.1097/MCG.0000000000001719
Kouitcheu, L., Eyoum, B., Tepap, C., Tali, L., & Leundji, H. (2019). Broad spectrum resistance in Helicobacter pylori isolated from gastric biopsies of patients with dyspepsia in cameroon and efflux-mediated multiresistance detection in MDR isolates. BMC Infectious Diseases, 19(1), 880. https://doi.org/10.1186/s12879-019-4536-8
Lantinga, M. A., Theunissen, F., Ter-Borg, P. C. J., Bruno, M. J., Ouwendijk, R. J. T., & Siersema, P. D.(2021). Impact of the COVID-19 pandemic on gastrointestinal endoscopy in the Netherlands: Analysis of a prospective endoscopy database. Endoscopy, 53(02), 166–170. https://doi.org/10.1055/a-1272-3788
Lin, Y., Shao, Y., Yan, J., & Ye, G. (2023). Antibiotic resistance in Helicobacter pylori: From potential biomolecular mechanisms to clinical practice. Journal of Clinical Laboratory Analysis, 37(7), e24885. https://doi.org/10.1002/jcla.24885
Matta A. J., Zambrano D. C., & Pazos A. J. (2018). Punctual mutations in 23S RRNA gene of clarithromycin-resistant Helicobacter pylori in Colombian populations. World Journal of Gastroenterology, 24(14), 1531–1539. https://doi.org/10.3748/wjg.v24.i14.1531
Matta, A. J., Zambrano D. C., Martínez Y. C., & Fernández., F.F. (2023). Mutaciones puntuales en el dominio transglicosilasa del gen pbp1a en aislados de Helicobacter pylori resistentes a amoxicilina. Revista de Gastroenterología de México, 88(2), 100–106. https://doi.org/10.1016/j.rgmx.2021.05.0080
Milenioscuro. (s.f.). Mapa de Antioquia con regiones representativas. [Imagen]. Licencia Creative Commons CC BY-SA 4.0. https://creativecommons.org/licenses/by-sa/4.0
Ministerio de Salud y Protección Social. (2018). Plan nacional de salud rural. Ministerio de Salud y Protección Social. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/PES/msps-plan-nacional-salud-rural-2018.pdf
Organización Mundial de la Salud. (2017). La OMS publica la lista de las bacterias para las que se necesitan urgentemente nuevos antibióticos [Comunicado de prensa]. http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/es/
Palamides, P., Jolaiya, T., Idowu, A., Loell, E., Onyekwere, C., Ugiagbe, R., Agbo, I., Lesi, O., Ndububa, D., Adekanle, O., Carranza, M., Ally, R., Njom, H., Adeleye, I. A., Harrison, U., Clarke, A., Fischer, W., Smith, S., & Haas, R. (2020). Helicobacter pylori patient isolates from South Africa and Nigeria differ in virulence factor pathogenicity profile and associated gastric disease outcome. Scientific Reports, 10(1), 11409. https://doi.org/10.1038/s41598-020-66128-0
Patel, S. (2023). Agar dilution MIC test for aerobic bacteria. En A. L. Leber & C. D. Burnham (Eds.), Clinical microbiology procedures handbook (5a ed., pp. 903–928). American Society for Microbiology Press.
Pitout, J. (2010). Infections with extended-spectrum β-Lactamase-producing Enterobacteriaceae. Drugs, 70(3), 313–333.
Rada, A. M., Hernández-Gómez, C., Restrepo, E., & Villegas, M. V. (2019). Distribución y caracterización molecular de Betalactamasas en bacterias Gram negativas en Colombia, 2001-2016. Biomédica, 39, 199–220.
Rajilic-Stojanovic, M., Figueiredo, C., Smet, A., Hansen, R., Kupcinskas, J., Rokkas, T., Andersen, L., Machado, J. C., Ianiro, G., Gasbarrini, A., Leja, M., Gisbert, J., & Hold, G. L. (2020). Systematic review: Gastric microbiota in health and disease. Alimentary Pharmacology & Therapeutics, 51, 582–602. https://doi.org/10.1111/apt.15650
Roldán, I. J., Castaño, R., & Navas, M. C. (2019). Mutaciones del gen ARN ribosómico 23S de Helicobacter pylori asociadas con resistencia a claritromicina en pacientes atendidos en una unidad de endoscopia de Medellín, Colombia. Biomédica, 39(Supplement 2), 117–129. https://doi.org/10.7705/biomedica.v39i4.4377
Salazar, B, Gómez-Villegas, S. I., Vélez, D. E., Ramírez, V., Pérez, T, & Martínez, A. (2023). Frequency of Helicobacter pylori infection in patients requiring GI endoscopy in seven units in three Antioquia subregions. Revista Colombiana de Gastroenterología, 38(3), 290–302. https://doi.org/10.22516/25007440.983
Salazar, B. E., Pérez-Cala, T., Gomez-Villegas, S. I., Cardona-Zapata, L., Pazos-Bastidas, S., Cardona-Estepa, A., Vélez-Gómez, D. E., Justinico-Castro, J. A., Bernal-Cobo, A., Dávila-Giraldo, H. A., Benítez-Guerra, J. C., Valencia-Cárdenas, J. T., Ospina, E. J., Castaño-Llano, R., Bravo, M. M., Cataño-Correa, J. C., Zabaleta, J., Trespalacios-Rangel, A. A., Cock-Botero, A. M., … Martínez, A. (2022). The OLGA-OLGIM staging and the interobserver agreement for gastritis and preneoplastic lesion screening: A cross-sectional study. Virchows Archiv, 480(4), 759–769. https://doi.org/10.1007/s00428-022-03286-8
Savoldi, A., Carrara, E., Graham, D. Y., Conti, M., & Tacconelli, E. (2018). Prevalence of antibiotic resistance in Helicobacter pylori: A systematic review and meta-analysis in World Health Organization regions. Gastroenterology, 155(5), 1372–1382.
Trespalacios, A., Otero, W., & Mercado, M. (2010). Resistencia de Helicobacter pylori a metronidazol, claritromicina y amoxicilina en pacientes colombianos. Revista Colombiana Gastroenterología, 25, 31–38.
Tseng, Y. S., Wu, D. C., Chang, C. Y., Kuo, C. H., Yang, Y. C., Jan, C. M., Su, Y. C., Kuo, F. C., & Chang, L. L. (2009). Amoxicillin resistance with Beta-Lactamase production in Helicobacter pylori. European Journal of Clinical Investigation, 39(9), 807–812.
Valladales-Restrepo, L. F., Correa-Sánchez Y., Aristizábal-Carmona, B. S., & Machado-Alba, J. E. (2022). Treatment regimens used in the management of Helicobacter pylori in Colombia. The Brazilian Journal of Infectious Diseases, 26(1), 102331. https://doi.org/10.1016/j.bjid.2022.102331
Zamani, M., Ebrahimtabar, F., Zamani, V., Miller, W. H., Alizadeh-Navaei, R., Shokri-Shirvani, J., & Derakhshan, M. H. (2018). Systematic review with meta-analysis: The worldwide prevalence of Helicobacter pylori infection. Alimentary Pharmacology & Therapeutics, 47(7), 868–876. https://doi.org/10.1111/apt.14618.
Zandian, H., Zahirian, T., Pourfarzi, F., Malekzadeh, R., Rezaei, S., & Ghorbani, S. (2023). Gastric troubles in Iran: The role of social and economic factors in Helicobacter pylori infection. Health Promotion Perspectives, 13(2), 120–128.
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