Helicobacter pylori

Brief Original Article Antibiotic susceptibility of Helicobacter pylori isolates in Dakar, Senegal
Abdoulaye Seck1, Mouhamadou Mbengue2, Amy Gassama-Sow3, Lamine Diouf2, Mouhamadou Mourtalla Ka4, Cheikh Saad-Bouh Boye 5
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Laboratoire de Biologie Médicale, Institut Pasteur, Dakar Sénégal Service de Gastro-entérologie, Hôpital Arsitide Le Dantec, Dakar Sénégal 3 Laboratoire de BactériologieExpérimentale, Institut Pasteur de Dakar, Dakar Sénégal 4 Service de Médecine Interne, Hôpital Arsitide Le Dantec, Dakar Sénégal 5 Laboratoire de Bactériologie-virologie, Hôpital Arsitide Le Dantec, Dakar Sénégal

Abstract
Background: Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. A high frequency of H. pyloriinfection has been reported from resource-poor regions. H. pylori infection is curable with regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. In Africa, there are very little data concerning the susceptibility of H. pylori isolates to antibiotics. Methodology: H. pylori isolates from gastric biopsies from outpatients ≥ 18 years oldaffected by a gastro-duodenal ulcer were used in this study. Susceptibility testing was performed for amoxicillin, ciprofloxacin and metronidazole by using the Epsilometer test (E-test) method. Results: H. pylori strains were isolated from 40 patients of whom 36 were diagnosed as having duodenal ulcer, two with gastric ulcer, and two with gastro-duodenal ulcer. Thirty-six (90%) of the isolates wereresistant to metronidazole (MICs ≥ 8 µg/l), whereas all isolates were susceptible to amoxicillin (MICs ≤ 0. 5 µg/ml) and ciprofloxacin (MICs ≤ 1µg/ml). Conclusion: These data suggest that metronidazole should not be used therapeutically among Senegalese patients in first-line therapy, while ciprofloxacin could be recommended in association with amoxicillin and a proton pump inhibitor in Senegal.Keywords: Helicobacter pylori; antimicrobial susceptibility; Senegal J Infect Developing Countries 2009; 3(2):137-140.
Received 29 February 2008 - Accepted 3 September 2008 Copyright © 2009 Seck et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work isproperly cited.

Introduction The frequency of H. pylori infection is rising worldwide [1]. The problem is more acute in the resource-poor regions, particularly in Africa [2]. The hospital prevalence rate of H. pylori infection in Senegal is as high as 82% [3]. To date, the eradication of H. pylori infection is clearly indicated for healing gastro-duodenal ulcerous disease, not only because itmodifies the disease’s natural course [4], but because it also prevents long-term ulcer relapse [5]. The successful treatment for eradication of H. pylori infection requires a proton pump inhibitor (PPI) and a combination of two or more antibiotics, depending on the susceptibility of isolates to antibiotics [6]. As the treatment of the infection starts with a standard therapeutic regimen, it istherefore important to know in advance the resistance rates of isolates to antibiotics commonly used in the treatment. In Africa, there are very little data

concerning the susceptibility of H. pylori isolates to antibiotics, even considering that the resistance rates should be high [7]. The aim of this study was to assess the susceptibility of H. pylori strains isolated from gastric biopsies ofpatients with ulcer to antibiotics commonly used in therapeutic procedures. Materials and methods Patients and Bacterial isolates This is a prospective study including outpatients ≥ 18 years old selected between January 1999 and June 2000, and consulting at the gastroenterology department of the major teaching hospital Aristide Le Dantec in Dakar. This study involved patients with clinical symptoms...