Epidemiological study of antibiotic-resistant Helicobacter pylori in Brazil a meta-analysis

Authors

  • Ana Carolina Messias de Souza Ferreira da Costa
  • Amina Kadja Martins Cahú
  • Amanda Reges de Sena
  • Allana Fernanda de Araújo Barroso Leite
  • Tonny Cley Campos Leite
  • Isis Filgueira Sampaio
  • Maria Clara Lorrete Laviola
  • Bruno Cavalcante Linhares
  • Camilla Thays Melquiades Tavares de Oliveira
  • José Vinicius Perminio Barbosa
  • Daniela Simões Velame

DOI:

https://doi.org/10.54033/cadpedv21n5-210

Keywords:

Antibiotic Resistance, Epidemiology, Clarithromycin, Prevalence, Brazil

Abstract

Objectives: To evaluate the proportion of Helicobacter pylori resistant to tetracyclines, amoxicilline, furazolidone, clarithromycin, fluoroquinolones and amoxicillin in Brazil and to present genotypic characteristics of strains. Methodology: Search in PubMed, SciELO, VHL and Medline. Twelve Brazilian studies on resistant Helicobacter pylori were selected, with a total of 2,038 patients. The options were performed with a confidence interval of 95% and an alpha of 0.05 using the software RStudio5.0. Results: low resistance rate for 04 antibiotics, being lower than the 15% threshold considered for empirical treatment. However, for metronidazole the rate of 43% and clarithromycin 16% macrolide and amoxicillin increased resistance when compared to previous years. The Southeast region had the highest rates. A clarithromycin ae A2147 in the 23s 23s RNA gene was the most prevalent conferring clear resistance. Conclusion: The increase in resistance to clarithromycin and amoxicillin resistance demonstrates that the factors that still increase for the acquisition of resistance still exist. Therefore, constant epidemiological surveillance is necessary so that we are aware of the resistance profile, performing assertive therapy.

References

ANSARI, S.; YAMAOKA, Y. Helicobacter pylori Virulence Factors Exploiting Gastric Colonization and its Pathogenicity. Toxins, v. 11, n. 11, p. 677, 2019. DOI: https://doi.org/10.3390/toxins11110677

BAJ, J. et al. Helicobacter pylori Virulence Factors-Mechanisms of Bacterial Pathogenicity in the Gastric Microenvironment. Cells, v. 10, n. 1, p. 27, 2020. DOI: https://doi.org/10.3390/cells10010027

BRASIL. Ministério da Saúde. Instituto Nacional de Câncer – INCA. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA, 2019. 120 p.

CAMARGO, M. C. et al. The problem of Helicobacter pylori resistance to antibiotics: a systematic review in Latin America. The American journal of gastroenterology, v. 109, n. 4, p. 485-95, 2014. DOI: https://doi.org/10.1038/ajg.2014.24

CHEY, W. D.; LEONTIADIS, G. I.; HOWDEN, C. W.; MOSS, S. F. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. The American Journal of gastroenterology,v. 112, n. 2, p. 212-239, 2017. DOI: https://doi.org/10.1038/ajg.2016.563

CHOI, J. M. et al. Effects of Helicobacter pylori eradication for metachronous gastric cancer prevention: a randomized controlled trial. Gastrointestinal endoscopy, v. 88, n. 3, p 475-485, 2018. DOI: https://doi.org/10.1016/j.gie.2018.05.009

EISIG, J. N. et al. Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option. Arquivos de Gastroenterologia, v. 48, n. 4, p. 261–264, 2011. DOI: https://doi.org/10.1590/S0004-28032011000400008

FALLONE, C.A. et al. The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults. Gastroenterology, v. 151, n. 1, p. 51-69, 2016. DOI: https://doi.org/10.1053/j.gastro.2016.04.006

FLORES-TREVIÑO, S. et al. Helicobacter pylori drug resistance: therapy changes and challenges. Expert review of gastroenterology & hepatology, v. 12, n. 8, p. 819–827, 2018. DOI: https://doi.org/10.1080/17474124.2018.1496017

GARCIA, G. T. et al. High prevalence of clarithromycin resistance and cagA, vacA, iceA2, and babA2 genotypes of Helicobacter pylori in Brazilian children. Journal of clinical microbiology v. 48, n. 11 p. 4266-8, 2010. DOI: https://doi.org/10.1128/JCM.01034-10

GLOBAL CANCER OBSERVATORY. Cancer Today. Lyon, France: International Agency for Research on Cancer. https://gco.iarc.fr/today/.

GODOY, A. P. O. et al. Analysis of antimicrobial susceptibility and virulence factors in Helicobacter pylori clinical isolates. BMC gastroenterology, v. 3, n. 20, 2003. DOI: https://doi.org/10.1186/1471-230X-3-20

HIGGINS, J.P.; THOMPSON, S. G.; DEEKS, J. J.; ALTMAN, D. G. Measuring inconsistency in meta-analyses. BMJ, v. 327, n.7414, p. 557-560, 2003. DOI: https://doi.org/10.1136/bmj.327.7414.557

HOOI, J. K. Y. et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. v. 153, n. 2, p. 420-429, 2017. DOI: https://doi.org/10.1053/j.gastro.2017.04.022

JAKA, H. et al. The magnitude of antibiotic resistance to Helicobacter pylori in Africa and identified mutations which confer resistance to antibiotics: systematic review and meta-analysis. BMC Infect Dis, v. 18, n. 193, 2018. DOI: https://doi.org/10.1186/s12879-018-3099-4

LEE, Y-C. et al. Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis. Gastroenterology, v. 150, n. 5, p. 1113-1124, 2016. DOI: https://doi.org/10.1053/j.gastro.2016.01.028

LEE, J. Y.; PARK, K. S. Optimal First-Line Treatment for Helicobacter pylori Infection: Recent Strategies. Gastroenterol Res Pract., v. 2016, 2016. DOI: https://doi.org/10.1155/2016/9086581

LINS, A. K.; LIMA, R. A.; MAGALHÃES, M. Clarithromycin-resistant Helicobacter pylori in Recife, Brazil, directly identified from gastric biopsies by polymerase chain reaction. Arq Gastroenterol. v. 47, n. 4, p. 379-382, 2010. DOI: https://doi.org/10.1590/S0004-28032010000400011

MAGALHÃES, P. P. et al. Helicobacter pylori primary resistance to metronidazole and clarithromycin in Brazil. Antimicrobial agents and chemotherapy, v. 46, n. 6, 2021-2023, 2002. DOI: https://doi.org/10.1128/AAC.46.6.2021-2023.2002

MAHMOUDI, S. et al. Antibiotic susceptibility of Helicobacter pylori strains isolated from Iranian children: High frequency of A2143G point mutation associated with clarithromycin resistance. Journal of global antimicrobial resistance, v. 10, p. 131-135, 2017. DOI: https://doi.org/10.1016/j.jgar.2017.04.011

MALFERTHEINER, P. et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut, v. 66, n. 1, p. 6-30, 2017. DOI: https://doi.org/10.1136/gutjnl-2016-312288

MARTINS, G. M. et al. Molecular Detection of Clarithromycin And Fluoroquinolones Resistance in Helicobacter Pylori Infection, Directly Applied To Gastric Biopsies, in an Urban Brazilian Population. Arquivos de Gastroenterologia, v. 53, n. 2, p. 113–117, 2016. DOI: https://doi.org/10.1590/S0004-28032016000200012

MENDONÇA, S. et al. Prevalence of Helicobacter pylori resistance to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone in Brazil. Helicobacter, v. 5, n.2 p. 79-83, 2000. DOI: https://doi.org/10.1046/j.1523-5378.2000.00011.x

MOHER, D. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine, v. 6, n.7, 2009. DOI: https://doi.org/10.1371/journal.pmed.1000097

NEJATI, S. et al. Influence of Helicobacter pylori virulence factors CagA and VacA on pathogenesis of gastrointestinal disorders. Microbial pathogenesis, v. 117, p. 43-48. 2018. DOI: https://doi.org/10.1016/j.micpath.2018.02.016

OGATA, S. K.; GALES, A. C.; KAWAKAMI, E. Antimicrobial susceptibility testing for Helicobacter pylori isolates from Brazilian children and adolescents: comparing agar dilution, E-test, and disk diffusion. Brazilian Journal of Microbiology, v. 45, n. 4, p. 1439–1448, 2014. DOI: https://doi.org/10.1590/S1517-83822014000400039

PICOLI, S. U. et al. Resistance to amoxicillin, clarithromycin and ciprofloxacin of Helicobacter pylori isolated from southern Brazil patients. Revista do Instituto de Medicina Tropical de São Paulo, v. 56, n. 3, p. 197–200, 2014. DOI: https://doi.org/10.1590/S0036-46652014000300003

RIBEIRO, M. L. et al. Mutations in the 23S rRNA gene are associated with clarithromycin resistance in Helicobacter pylori isolates in Brazil. Annals of clinical microbiology and antimicrobials, v. 2 n. 11, 2003. DOI: https://doi.org/10.1186/1476-0711-2-11

SANCHES, B. S. et al. Detection of Helicobacter pylori resistance to clarithromycin and fluoroquinolones in Brazil: A national survey. World journal of gastroenterology, v. 22, n. 33, 2016. DOI: https://doi.org/10.3748/wjg.v22.i33.7587

SAVOLDI, A. et al. Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions. Gastroenterology, v. 155, n. 5, p. 1372-1382, 2018. DOI: https://doi.org/10.1053/j.gastro.2018.07.007

SCALETSKY, I. C. A. et al. Application of real-time PCR stool assay for Helicobacter pylori detection and clarithromycin susceptibility testing in Brazilian children. Helicobacter, v. 16, n.4, p. 311-315, 2011. DOI: https://doi.org/10.1111/j.1523-5378.2011.00845.x

SHOLEH, M. et al. The increasing antimicrobial resistance of Helicobacter pylori in Iran: A systematic review and meta-analysis. Helicobacter, v. 25, n. 5, 2020. DOI: https://doi.org/10.1111/hel.12730

WHO. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. https://remed.org/wp-content/uploads/2017/ 03/lobal-priority-list-of-antibiotic-resistant-bacteria-2017.pdf.

XU, C.; SOYFOO, D. M.; WU, Y.; XU, S. Virulence of Helicobacter pylori outer membrane proteins: an updated review. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology, v. 39, n. 10, p. 1821–1830, 2020. DOI: https://doi.org/10.1007/s10096-020-03948-y

ZAMANI, M. et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Alimentary pharmacology & therapeutics, v. 47, n. 7, p. 868-876, 2018. DOI: https://doi.org/10.1111/apt.14561

Downloads

Published

2024-05-29

How to Cite

Costa , A. C. M. de S. F. da, Cahú, A. K. M., Sena, A. R. de, Leite, A. F. de A. B., Leite, T. C. C., Sampaio, I. F., Laviola, M. C. L., Linhares, B. C., Oliveira, C. T. M. T. de, Barbosa, J. V. P., & Velame, D. S. (2024). Epidemiological study of antibiotic-resistant Helicobacter pylori in Brazil a meta-analysis. Caderno Pedagógico, 21(5), e4568. https://doi.org/10.54033/cadpedv21n5-210

Issue

Section

Articles