Gastroenterologie
a hepatologie

Outcome of treatment of Helicobacter pylori infection based on microbiological susceptibility testing following the unsuccessful second-line eradication treatment

Lukáš Králíček¹, Radek Kroupa ^{Orcid.org  2}, Alena Ševčíková³, Magdalena Otrubová¹, Vít Kulhánek¹

+ Affiliation
¹ Endoskopické centrum, Nemocnice Milosrdných bratří, p. o., Brno
² Department of Gastroenterology, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
³ Oddělení klinické mikrobiologie, LF MU a FN Brno

Summary

Introduction: Helicobacter pylori is the etiological factor of several illnesses and its eradication is a key factor in treatment. Due to increasing resistance to antibiotics, it is necessary to monitor the development of the H. pylori infection and adjust the course of treatment depending on the antibiotic sensitivity of the H. pylori in a given population. The goal of this paper was to evaluate the effects of third-line eradication treatment, based on microbiological examinations and assessments of H. pylori antibiotic sensitivity. Patients and Methods: The data were collected on a retrospective and non-selective basis from all patients who had been treated at our department using third-line eradication treatment between 2011 and 2015. Antibiotics were selected based on the results of in vitro antibiotic susceptibility tests on biopsy samples of the stomach mucous lining. The effect of the treatment was assessed by performing a biopsy or determining the H. pylori antigen in stool samples. Results: Third-line eradication was carried out on 38 patients. H. pylori cultivation and assessment of H. pylori antibiotic susceptibility were successful in 31 cases; 23 patients were treated and examined. Eradication was achieved only in three patients, i.e. 7.9% of all cases examined (38). Conclusion: Third-line eradication treatment has so far been unsatisfactory, despite the use of targeted antibiotic treatment, indicating that efforts should be made to increase the effectiveness of the first or second line of eradication treatment.

Keywords

Helicobacter pylori, antibiotics, treatment outcome, microbial sensitivity tests

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users

Literature

1. Kopáčová M, Seifert B. Co je nového v léčbě infekce Helicobacter pylori? – komentář. Medicína po promoci 2015; 16 (4): 280–283.
2. Sýkora J. Helicobacter pylori a gastrointestinální projevy u dětí. Pediatr pro Praxi 2006; 7 (2): 74–79.
3. Bureš J, Kopáčová M, Koupil I et al. Significant decrease in prevalence of Helicobacter pylori in the Czech Republic. World J Gastroenterol 2012; 18 (32): 4412–4418. doi: 10.3748/wjg.v18.i32.4412.
4. Bureš J, Kopáčová M, Koupil I et al. Epidemiology of Helicobacter pylori infection in the Czech Republic. Helicobacter 2006; 11 (1): 56–65.
5. Bureš J, Dítě P, Fixa B et al. Infekce Helicobacter pylori. Doporučený postup České gastroenterologické společnosti ČLS JEP pro dospělé. [online]. Dostupné z: www.cgs-cls.cz/wp-content/uploads/2015/04/guidelines-infekce-helicobacter-pylori.pdf.
6. Malfertheiner P, Megraud F, O’Morain CA et al. Management of Helicobacter pylori infection: the Maastricht IV/Florence Consensus report. Gut 2012; 61 (5): 646–664. doi: 10.1136/gutjnl-2012-302084.
7. Falt P, Hanousek M, Kundrátová E et al. Prekancerózy žaludku. Klin Onkol 2013; 26 (Suppl): S22–S28.
8. Pročke M. Současný pohled na eradikaci Helicobacter pylori. Lékařské listy 2010; 59 (5): 5–7.
9. Rejchrt S. Prevalence a sociodemografická charakteristika dyspepsie v České republice. 1. vyd. Hradec Králové: Nucleus HK 2005: 96.
10. Fixa B, Komárková O, Nožička Z. Dlouhodobé sledování nemocných s funkční žaludeční dyspepsií. Závislost obtíží na infekci Helicobacter pylori? Čes a slov Gastroent a Hepatol 2002; 56 (5): 171–176.
11. Rejchrt S, Koupil I, Kopáčová M et al. Epidemiologie dyspepsie. Vnitř Lék 2014; 60 (7–8): 649–656.
12. Kopáčová M, Bureš J. Sekvenční léčba Helicobacter pylori. Folia Gastroenterol Hepatol 2009; 7 (2): 82–84.
13. Draeger S, Wüppenhorst N, Kist M et al.Outcome of second-and third-line Helicobacter pylori eradication therapies based on antimicrobial susceptibility testing. J Antimicrob Chemother 2015; 70 (11): 3141–3145. doi: 10.1093/jac/dkv223.
14. Wüppenhorst N, Draeger S, Stüger HP et al. Prospective multicentre study on antimicrobial resistence of Helicobacter pylori in Germany. J Antimicrob Chemother 2014; 69 (11): 3127–3133. doi: 10.1093/jac/dku243.
15. Sovinová H, Sadílek P, Csémy L. Vývoj prevalence kuřáctví v dospělé populaci ČR názory a postoje občanů ČR k problematice kouření (období 1997–2010). Výzkumná zpráva. Praha: Státní zdravotní ústav 2012. Dostupné z: http: //www.szu.cz/uploads/documents/czzp/zavislosti/koureni/zprava-kuractvi-2011.pdf.
16. Hlinka I, Hlinková B. Riziko skríženej alergie cefalosporíny u pacientov alergických na penicilíny. Alergie 2014; 16 (2): 22–23.
17. Gisbert JP, Barrio J, Modolell I et al.  Helicobacter pylori first-line and rescue treatments in the presence of penilillin allergy. Dig Dis Sci 2015; 60 (2): 458–464. doi: 10.1007/s10620-014-3365-2.
18. Graham DY, Lee YC a Wu MS. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence. Clin Gastroenterol Hepatol 2014; 12 (2): 177–186. doi: 10.1016/j.cgh.2013.05.028.
19. Murali MR, Naveen SV, Son CG. Current knowledge on alleviating Helicobacter pylori infections through the use of some commonly known natural products: bench to bedside. Integr Med Res 2014; 3 (3): 111–118.
20. Sovová M, Sova P. Farmaceutický význam Alliumsativum L. 2. Antibakteriální účinek. Ceska Slov Farm 2002; 51 (1): 11–16.
21. Boltin D. Probiotics in Helicobacter pylori-induced peptic ulcer disease. Best Pract Res Clin Gastroenterol 2016; 30 (1): 99–109. doi: 10.1016/j.bpg.2015.12.003.
22. Lu C, Sang J, He H et al. Probiotic supplementation does not improve eradication rate of Helicobacter pylori infection compared to placebo based on standard therapy: a meta-analysis. Sci Rep 2016; 6: 23522. doi: 10.1038/srep23522.
23. Danq Y, Reinhardt JD, Zhou X et al. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a meta-analysis. PLoS One 2014; 9 (11): e111030. doi: 10.1371/journal.pone.0111030.
24. Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther 2010; 32 (9): 1069–1079. doi: 10.1111/j.1365-2036.2010.04457.x.
25. Zhang MM, Qian W, Qin YY. Probiotics in Helicobacter pylori eradication therapy: a systematic review and meta-analysis. World J Gastroenterol 2015; 21 (14): 4345–4357. doi: 10.3748/wjg.v21.i14.4345.