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Heteroresistance to clarithromycin and metronidazole in patients with a Helicobacter pylori infection: a systematic review and meta-analysis
E. Kouhsari, N. Sadeghifard, A. Khadiv, H. Sayadi, T. Amiriani, S. Ghafourian, H. Valadbeigi, M. Krutova
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, metaanalýza, přehledy, systematický přehled
NLK
BioMedCentral
od 2002-01-01
BioMedCentral Open Access
od 2002
Directory of Open Access Journals
od 2002
Free Medical Journals
od 2002
PubMed Central
od 2002
Europe PubMed Central
od 2002
ProQuest Central
od 2009-01-01
Open Access Digital Library
od 2002-01-01
Open Access Digital Library
od 2002-09-01
Open Access Digital Library
od 2002-01-01
Medline Complete (EBSCOhost)
od 2002-09-16
Health & Medicine (ProQuest)
od 2009-01-01
Public Health Database (ProQuest)
od 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2002
Springer Nature OA/Free Journals
od 2002-01-01
- MeSH
- amoxicilin farmakologie MeSH
- antibakteriální látky farmakologie terapeutické užití MeSH
- bakteriální léková rezistence genetika MeSH
- Helicobacter pylori * MeSH
- infekce vyvolané Helicobacter pylori * diagnóza farmakoterapie MeSH
- klarithromycin farmakologie terapeutické užití MeSH
- lidé MeSH
- metronidazol farmakologie terapeutické užití MeSH
- mikrobiální testy citlivosti MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
- systematický přehled MeSH
BACKGROUND: Antimicrobial resistance of H. pylori can lead to treatment failure. Importantly, several studies have reported on heteroresistance, i.e. the presence of resistant and susceptible H. pylori populations in the same sample and/or a difference in the susceptibility patterns between biopsy samples. This meta-analysis aims to provide comprehensive data on the prevalence of metronidazole and clarithromycin heteroresistance and the approaches to their detection. MATERIAL AND METHODS: A systematic review was performed after the search of MEDLINE, Scopus and Web of Science. The study outcomes were the weighted pooled prevalence of heteroresistance to clarithromycin and metronidazole in H. pylori positive samples and/or isolates with a subanalysis by continent. RESULTS: A total of 22 studies that had investigated 3852 H. pylori positive patients were included in the meta-analysis. Heteroresistance to clarithromycin was reported in 20 studies, with a weighted pooled prevalence of 6.8% (95% CI 5.1-8.6; 3654 H. pylori positive patients; the substantial heterogeneity I2 = 55.6%). Heteroresistance to metronidazole was reported in 12 studies, with a weighted pooled prevalence of 13.8% (95% CI 8.9-18.6; 1670 H. pylori positive patients; the substantial heterogeneity I2 = 60.9%). The weighted pooled prevalence of clarithromycin heteroresistance was similar in Asia and Europe (p = 0.174584), however, metronidazole heteroresistance was detected more often in Europe (p < 0.00001). Clarithromycin heteroresistance was detected more often by phenotype rather than by using genotyping methods (12 vs 8 studies), whereas heteroresistance to metronidazole was detected only by phenotype. CONCLUSION: The prevalence of heteroresistance to clarithromycin and/or metronidazole is not negligible and can be detected in approximately 7 and 14% of H. pylori positive samples, respectively. These findings highlight the need to raise the awareness of gastroenterologists and microbiologists to the heteroresistance to clarithromycin and metronidazole in patients with a H. pylori infection.
Clinical Microbiology Research Centre Ilam University of Medical Sciences Ilam Iran
Department of Microbiology Faculty of Medicine Ilam University of Medical Sciences Ilam Iran
Laboratory Sciences Research Centre Golestan University of Medical Sciences Gorgan Iran
Non Communicable Diseases Research Centre Ilam University of Medical Sciences Ilam Iran
Citace poskytuje Crossref.org
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