Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy
<i>Background</i>: <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is the leading cause of both peptic ulcers and gastric tumors, including low-grade MALT-lymphoma and adenocarcinoma. Although it is decreasing in developed countries, <i>H. pylori<...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1299 |
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| author | Giulia Fiorini Ilaria Maria Saracino Angelo Zullo Matteo Pavoni Laura Saccomanno Tiziana Lazzarotto Rossana Cavallo Guido Antonelli Berardino Vaira |
| author_facet | Giulia Fiorini Ilaria Maria Saracino Angelo Zullo Matteo Pavoni Laura Saccomanno Tiziana Lazzarotto Rossana Cavallo Guido Antonelli Berardino Vaira |
| author_sort | Giulia Fiorini |
| collection | DOAJ |
| description | <i>Background</i>: <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is the leading cause of both peptic ulcers and gastric tumors, including low-grade MALT-lymphoma and adenocarcinoma. Although it is decreasing in developed countries, <i>H. pylori</i> prevalence remains high in developing areas, mainly due to low socio-economic levels, and the potential consumption of contaminated water. Moreover, a different pattern of primary antibiotic resistance is expected in their <i>H. pylori</i> isolates, potentially affecting the efficacy of standard eradication therapies. Indeed, a previous study showed the eradication rate following triple therapy was distinctly lower in dyspeptic <i>H. pylori</i> infected immigrants living in Italy as compared to Italian patients. <i>Aims</i>: to evaluate the resistance pattern in <i>H. pylori</i> isolates from immigrant patients in Italy, and the success rate of first-line therapy in these patients. <i>Materials and Methods</i>: This retrospective study evaluated data of consecutive immigrant patients, diagnosed with <i>H. pylori</i> infection in a single center (Bologna, Italy) between January 2009 and January 2019. Patients underwent first-line therapy with either sequential or Pylera<sup>®</sup> (Allergan USA, Inc. Madison, NJ, USA) therapy. <i>Results</i>: A total of 609 immigrants were diagnosed with <i>H. pylori</i> infection during the study period, but 264 previously received an eradication therapy. Therefore, the study was focused on 294 out of 345 naïve patients with a successful bacterial culture with antibiogram. Latin America immigrants had the highest overall resistance rate. Levofloxacin resistance rate was significantly higher in Latin Americans and Asians as compared with Europeans. Based on resistance patterns, sequential therapy showed a clear decreasing trend in eradication rates. Conclusions: while antibiotic resistance rates are generally increasing worldwide, Pylera<sup>®</sup> seems to achieve a good performance as first-line treatment in all naïve foreigner patients, except for Africans. |
| first_indexed | 2024-03-10T20:06:37Z |
| format | Article |
| id | doaj.art-87f0de820a8b451bb9cc6743b3a097e0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T20:06:37Z |
| publishDate | 2020-05-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-87f0de820a8b451bb9cc6743b3a097e02023-11-19T23:15:56ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195129910.3390/jcm9051299Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in ItalyGiulia Fiorini0Ilaria Maria Saracino1Angelo Zullo2Matteo Pavoni3Laura Saccomanno4Tiziana Lazzarotto5Rossana Cavallo6Guido Antonelli7Berardino Vaira8Department of Medicine and Surgery Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medicine and Surgery Sciences, University of Bologna, 40138 Bologna, ItalyGastroenterology Unit, ‘Nuovo Regina Margherita’ Hospital, 00153 Rome, ItalyDepartment of Medicine and Surgery Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medicine and Surgery Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, ItalyMicrobiology and Virology Unit, University Hospital Città Della Salute e Della Scienza di Torino, 10126 Turin, ItalyDepartment of Molecular Medicine, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Medicine and Surgery Sciences, University of Bologna, 40138 Bologna, Italy<i>Background</i>: <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is the leading cause of both peptic ulcers and gastric tumors, including low-grade MALT-lymphoma and adenocarcinoma. Although it is decreasing in developed countries, <i>H. pylori</i> prevalence remains high in developing areas, mainly due to low socio-economic levels, and the potential consumption of contaminated water. Moreover, a different pattern of primary antibiotic resistance is expected in their <i>H. pylori</i> isolates, potentially affecting the efficacy of standard eradication therapies. Indeed, a previous study showed the eradication rate following triple therapy was distinctly lower in dyspeptic <i>H. pylori</i> infected immigrants living in Italy as compared to Italian patients. <i>Aims</i>: to evaluate the resistance pattern in <i>H. pylori</i> isolates from immigrant patients in Italy, and the success rate of first-line therapy in these patients. <i>Materials and Methods</i>: This retrospective study evaluated data of consecutive immigrant patients, diagnosed with <i>H. pylori</i> infection in a single center (Bologna, Italy) between January 2009 and January 2019. Patients underwent first-line therapy with either sequential or Pylera<sup>®</sup> (Allergan USA, Inc. Madison, NJ, USA) therapy. <i>Results</i>: A total of 609 immigrants were diagnosed with <i>H. pylori</i> infection during the study period, but 264 previously received an eradication therapy. Therefore, the study was focused on 294 out of 345 naïve patients with a successful bacterial culture with antibiogram. Latin America immigrants had the highest overall resistance rate. Levofloxacin resistance rate was significantly higher in Latin Americans and Asians as compared with Europeans. Based on resistance patterns, sequential therapy showed a clear decreasing trend in eradication rates. Conclusions: while antibiotic resistance rates are generally increasing worldwide, Pylera<sup>®</sup> seems to achieve a good performance as first-line treatment in all naïve foreigner patients, except for Africans.https://www.mdpi.com/2077-0383/9/5/1299<i>Helicobacter pylori</i>immigrantsresistancetherapy |
| spellingShingle | Giulia Fiorini Ilaria Maria Saracino Angelo Zullo Matteo Pavoni Laura Saccomanno Tiziana Lazzarotto Rossana Cavallo Guido Antonelli Berardino Vaira Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy Journal of Clinical Medicine <i>Helicobacter pylori</i> immigrants resistance therapy |
| title | Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy |
| title_full | Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy |
| title_fullStr | Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy |
| title_full_unstemmed | Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy |
| title_short | Antibiotic Resistance and Therapy for <i>H. pylori</i> Infection in Immigrant Patients Treated in Italy |
| title_sort | antibiotic resistance and therapy for i h pylori i infection in immigrant patients treated in italy |
| topic | <i>Helicobacter pylori</i> immigrants resistance therapy |
| url | https://www.mdpi.com/2077-0383/9/5/1299 |
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