Brief Article
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World J Gastroenterol. Dec 7, 2010; 16(45): 5746-5751
Published online Dec 7, 2010. doi: 10.3748/wjg.v16.i45.5746
Antimicrobial susceptibility of Helicobacter pylori strains isolated from patients in Shiraz, Southern Iran
Shohreh Farshad, Abdolvahab Alborzi, Aziz Japoni, Reza Ranjbar, Kazem Hosseini Asl, Parisa Badiee, Maneli Amin Shahidi, Marziyeh Hosseini
Shohreh Farshad, Abdolvahab Alborzi, Aziz Japoni, Parisa Badiee, Maneli Amin Shahidi, Marziyeh Hosseini, Professor Alborzi Clinical Microbiology Research Centre, Shiraz University of Medical Sciences, Shiraz 71937-11351, Iran
Reza Ranjbar, Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran 19945-581, Iran
Kazem Hosseini Asl, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz 71345-1414, Iran
Author contributions: Farshad S, Alborzi A and Japoni A contributed equally to this work; Farshad S, Alborzi A, Japoni A and Ranjbar R designed the research; Badiee P, Amin Shahidi M and Hosseini M performed the research; Hosseini Asl K performed the sampling and pathologic diagnoses; Farshad S and Ranjbar R analyzed the data; Farshad S wrote the paper.
Supported by (in full) Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Grant No. 84-22
Correspondence to: Dr. Shohreh Farshad, PhD, Associate Professor of Medical Microbiology, Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz 71937-11351, Iran. farshads@sums.ac.ir
Telephone: +98-711-6474304 Fax: +98-711-6474303
Received: July 18, 2010
Revised: September 7, 2010
Accepted: September 14, 2010
Published online: December 7, 2010
Abstract

AIM: To improve our understanding of Iranian regional variation in Helicobacter pylori (H. pylori) antibiotic resistance rates to find the best antibiotic therapy for eradication of H. pylori infections.

METHODS: A total of 266 patients undergoing endoscopy in Shiraz, Southern Iran, were included in this study. H. pylori strains were isolated from antral biopsies by culture and confirmed by the rapid urease-test and gram staining. Antibiotic susceptibility of H. pylori isolates was determined by E-test.

RESULTS: A total of 121 H. pylori strains were isolated, 50 from male and 71 from female patients. Data showed that 44% (n = 53), 20% (n = 24), 5% (n = 6), and 3% (n = 4) of all strains were resistant to the antibiotics metronidazole, amoxicillin, clarithromycin, and tetracycline, respectively. When the antibiotics were considered together we found 11 sensitivity patterns for the strains. Resistance to metronidazole was significantly higher in female than in male patients (P < 0.05). In about 71% of the metronidazole-resistant isolates, the minimum inhibitory concentrations (MICs) exceeded 256 μg/mL.

CONCLUSION: We found a moderate rate of primary resistance to metronidazole. However, a high MIC (> 256 mg/L) which was found in 71% of the isolates is considerable. In the case of amoxicillin, an increased resistance rate of 20% is worrying. Resistance to clarithromycin and tetracycline is also emerging among the H. pylori strains in our region.

Keywords: Gastric disorders, Helicobacter pylori, Iran, Sensitivity, Treatment