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Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy

Background: Helicobacter pylori (H. pylori) 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, H. pylori prevalence remains high in developing areas, mainly due to low socio-...

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Autores principales: Fiorini, Giulia, Saracino, Ilaria Maria, Zullo, Angelo, Pavoni, Matteo, Saccomanno, Laura, Lazzarotto, Tiziana, Cavallo, Rossana, Antonelli, Guido, Vaira, Berardino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288298/
https://www.ncbi.nlm.nih.gov/pubmed/32370005
http://dx.doi.org/10.3390/jcm9051299
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author Fiorini, Giulia
Saracino, Ilaria Maria
Zullo, Angelo
Pavoni, Matteo
Saccomanno, Laura
Lazzarotto, Tiziana
Cavallo, Rossana
Antonelli, Guido
Vaira, Berardino
author_facet Fiorini, Giulia
Saracino, Ilaria Maria
Zullo, Angelo
Pavoni, Matteo
Saccomanno, Laura
Lazzarotto, Tiziana
Cavallo, Rossana
Antonelli, Guido
Vaira, Berardino
author_sort Fiorini, Giulia
collection PubMed
description Background: Helicobacter pylori (H. pylori) 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, H. pylori 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 H. pylori 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 H. pylori infected immigrants living in Italy as compared to Italian patients. Aims: to evaluate the resistance pattern in H. pylori isolates from immigrant patients in Italy, and the success rate of first-line therapy in these patients. Materials and Methods: This retrospective study evaluated data of consecutive immigrant patients, diagnosed with H. pylori infection in a single center (Bologna, Italy) between January 2009 and January 2019. Patients underwent first-line therapy with either sequential or Pylera(®) (Allergan USA, Inc. Madison, NJ, USA) therapy. Results: A total of 609 immigrants were diagnosed with H. pylori 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(®) seems to achieve a good performance as first-line treatment in all naïve foreigner patients, except for Africans.
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spelling pubmed-72882982020-06-17 Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy Fiorini, Giulia Saracino, Ilaria Maria Zullo, Angelo Pavoni, Matteo Saccomanno, Laura Lazzarotto, Tiziana Cavallo, Rossana Antonelli, Guido Vaira, Berardino J Clin Med Article Background: Helicobacter pylori (H. pylori) 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, H. pylori 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 H. pylori 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 H. pylori infected immigrants living in Italy as compared to Italian patients. Aims: to evaluate the resistance pattern in H. pylori isolates from immigrant patients in Italy, and the success rate of first-line therapy in these patients. Materials and Methods: This retrospective study evaluated data of consecutive immigrant patients, diagnosed with H. pylori infection in a single center (Bologna, Italy) between January 2009 and January 2019. Patients underwent first-line therapy with either sequential or Pylera(®) (Allergan USA, Inc. Madison, NJ, USA) therapy. Results: A total of 609 immigrants were diagnosed with H. pylori 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(®) seems to achieve a good performance as first-line treatment in all naïve foreigner patients, except for Africans. MDPI 2020-05-01 /pmc/articles/PMC7288298/ /pubmed/32370005 http://dx.doi.org/10.3390/jcm9051299 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fiorini, Giulia
Saracino, Ilaria Maria
Zullo, Angelo
Pavoni, Matteo
Saccomanno, Laura
Lazzarotto, Tiziana
Cavallo, Rossana
Antonelli, Guido
Vaira, Berardino
Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title_full Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title_fullStr Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title_full_unstemmed Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title_short Antibiotic Resistance and Therapy for H. pylori Infection in Immigrant Patients Treated in Italy
title_sort antibiotic resistance and therapy for h. pylori infection in immigrant patients treated in italy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288298/
https://www.ncbi.nlm.nih.gov/pubmed/32370005
http://dx.doi.org/10.3390/jcm9051299
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