Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan
Objectives: Bhutan suffers from a high prevalence of Helicobacter pylori (H. pylori) infection and gastric cancer-related mortality. In preparation for a countrywide H. pylori eradication program, the antibiotic resistance patterns of H. pylori infection were surveyed in different geographical regio...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220303842 |
| _version_ | 1818992583070711808 |
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| author | Ratha-korn Vilaichone Natsuda Aumpan Thawee Ratanachu-ek Tomohisa Uchida Lotay Tshering Varocha Mahachai Yoshio Yamaoka |
| author_facet | Ratha-korn Vilaichone Natsuda Aumpan Thawee Ratanachu-ek Tomohisa Uchida Lotay Tshering Varocha Mahachai Yoshio Yamaoka |
| author_sort | Ratha-korn Vilaichone |
| collection | DOAJ |
| description | Objectives: Bhutan suffers from a high prevalence of Helicobacter pylori (H. pylori) infection and gastric cancer-related mortality. In preparation for a countrywide H. pylori eradication program, the antibiotic resistance patterns of H. pylori infection were surveyed in different geographical regions. Methods: Dyspeptic patients in 6 districts including Thimphu, Punakha, Wangdue, Trongsa, Bumthang, and Haa underwent upper gastrointestinal endoscopy during GASTROCAMP and were enrolled between December 2010 and April 2015. Gastric biopsies were obtained for rapid urease test, histopathology, and H. pylori culture. Antimicrobial susceptibility testing was later performed if the culture was positive. Results: A total of 1178 patients were surveyed. The overall H. pylori infection in Bhutan was 66.2%. Punakha had the highest prevalence of H. pylori infection (85.6%). Thimphu and Punakha (city areas) had higher prevalence of H. pylori infection than rural districts (73.5% vs 63.3%, OR = 1.61, 95% CI 1.22–2.13, p = 0.0008). There were 357 patients (30.3%) with positive H. pylori culture completed antimicrobial susceptibility testing. The mean age was 40.5 years with female predominance (57.1%). No amoxicillin resistant strains were found. Metronidazole resistance was 81% followed by levofloxacin resistance (8.1%). Clarithromycin (2%) and tetracycline (0.6%) resistance was rare except in Thimphu, the capital city (10%) vs 0% in rural areas, p < 0.001. The metronidazole resistance rate remained stable at approximately 80% during the past 5 years of study. Levofloxacin-resistant strains gradually rose from 5.3% in 2010 to 9.9% in 2015. Conclusions: Bhutan had a high prevalence of H. pylori infection. Metronidazole resistance was extremely high, whereas clarithromycin resistance was quite low in this specific area. Antibiotic resistance pattern could be good evidence for guiding a proper treatment regimen for H. pylori infection in Bhutan. |
| first_indexed | 2024-12-20T20:28:28Z |
| format | Article |
| id | doaj.art-c1c8060b49d340ce898103c585f6cb49 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-20T20:28:28Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-c1c8060b49d340ce898103c585f6cb492022-12-21T19:27:25ZengElsevierInternational Journal of Infectious Diseases1201-97122020-08-0197102107Population-based study of Helicobacter pylori infection and antibiotic resistance in BhutanRatha-korn Vilaichone0Natsuda Aumpan1Thawee Ratanachu-ek2Tomohisa Uchida3Lotay Tshering4Varocha Mahachai5Yoshio Yamaoka6Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand; Department of Medicine, Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand; Digestive Diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand; Corresponding author at: Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, ThailandDepartment of Surgery, Rajavithi Hospital, Bangkok, ThailandDepartment of Molecular Pathology, Oita University Faculty of Medicine, Yufu, JapanDepartment of Surgery, Jigme Dorji Wangchuk National Referral Hospital, Thimphu, BhutanDepartment of Medicine, Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand; Digestive Diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand; Gastrointestinal and Liver Center, Bangkok Hospital, Bangkok, ThailandDepartment of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, JapanObjectives: Bhutan suffers from a high prevalence of Helicobacter pylori (H. pylori) infection and gastric cancer-related mortality. In preparation for a countrywide H. pylori eradication program, the antibiotic resistance patterns of H. pylori infection were surveyed in different geographical regions. Methods: Dyspeptic patients in 6 districts including Thimphu, Punakha, Wangdue, Trongsa, Bumthang, and Haa underwent upper gastrointestinal endoscopy during GASTROCAMP and were enrolled between December 2010 and April 2015. Gastric biopsies were obtained for rapid urease test, histopathology, and H. pylori culture. Antimicrobial susceptibility testing was later performed if the culture was positive. Results: A total of 1178 patients were surveyed. The overall H. pylori infection in Bhutan was 66.2%. Punakha had the highest prevalence of H. pylori infection (85.6%). Thimphu and Punakha (city areas) had higher prevalence of H. pylori infection than rural districts (73.5% vs 63.3%, OR = 1.61, 95% CI 1.22–2.13, p = 0.0008). There were 357 patients (30.3%) with positive H. pylori culture completed antimicrobial susceptibility testing. The mean age was 40.5 years with female predominance (57.1%). No amoxicillin resistant strains were found. Metronidazole resistance was 81% followed by levofloxacin resistance (8.1%). Clarithromycin (2%) and tetracycline (0.6%) resistance was rare except in Thimphu, the capital city (10%) vs 0% in rural areas, p < 0.001. The metronidazole resistance rate remained stable at approximately 80% during the past 5 years of study. Levofloxacin-resistant strains gradually rose from 5.3% in 2010 to 9.9% in 2015. Conclusions: Bhutan had a high prevalence of H. pylori infection. Metronidazole resistance was extremely high, whereas clarithromycin resistance was quite low in this specific area. Antibiotic resistance pattern could be good evidence for guiding a proper treatment regimen for H. pylori infection in Bhutan.http://www.sciencedirect.com/science/article/pii/S1201971220303842Helicobacter pyloriAntibiotic resistanceBhutan |
| spellingShingle | Ratha-korn Vilaichone Natsuda Aumpan Thawee Ratanachu-ek Tomohisa Uchida Lotay Tshering Varocha Mahachai Yoshio Yamaoka Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan International Journal of Infectious Diseases Helicobacter pylori Antibiotic resistance Bhutan |
| title | Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan |
| title_full | Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan |
| title_fullStr | Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan |
| title_full_unstemmed | Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan |
| title_short | Population-based study of Helicobacter pylori infection and antibiotic resistance in Bhutan |
| title_sort | population based study of helicobacter pylori infection and antibiotic resistance in bhutan |
| topic | Helicobacter pylori Antibiotic resistance Bhutan |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220303842 |
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