Éva Kocsmár1, Mihály Kramer1, Gergely Röst2, György Miklós Buzás3, László Bene4, Attila Szijártó5, Ildikó Szirtes1, Zsófia Kramer1, Ildikó Kocsmár1, Petra Fadgyas-Freyler6, Gábor Urbán6, András Kiss1, Zsuzsa Schaff1, Gábor Lotz1
1 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
2 Bolyai Institute, University of Szeged, Szeged, Hungary
3 Department of Gastroenterology, Ferencváros Health Centre, Budapest, Hungary
4 1st Department of Medicine, Péterfy Hospital, Budapest, Hungary
5 1st Department of Surgery, Semmelweis University, Budapest, Hungary
6 National Health Insurance Fund Administration, Budapest, Hungary
Introduction: Clarithromycin-resistance (Cla-res) is the leading cause of treatment failure of Helicobacter pylori (HP) infections.
Aims: Our aim was to examine the prevalence of clarithromycin-resistant HP-infection and its connection to gender and age in a monocentric cohort.
Method: 4744 HP-positive adults were examined (2708 females; 57.1%, 2036 males; 42.9%). HP-positive gastric mucosal tissue slides were investigated by a bacterial rRNA-targeted FISH-test (BactFISH Helicobacter Combi Kit) detecting the clarithromycin-sensitive and -resistant HP-bacteria. HP eradication-related and -independent antibiotic consumption anamneses of these patients were collected in cooperation with the Hungarian National Health Insurance Fund.
Results: Overall Cla-res rate was 17.2%. Females showed significantly (p<0.0001) higher Cla-res rate (19.8%) than males (13.7%). Low Cla-res prevalence (12.9%) was found in the age group 70+. Cla-res rate reached 20% in females aged under 70, while it was less than 15% in males except ages 30-39 (15.3%). Cla-res prevalence was significantly lower (5.52%) in macrolide-naive patients than in the macrolide-treated group (30.5%; p<0.001). No significant difference was found between macrolide-naive females and males (6.4% vs. 4.6%; p=0.057).
Conclusion: Gender and age distribution of clarithromycin-resistance should be considered for HP-eradication treatments. Our results suggest that higher prevalence of clarithromycin-resistance in females is related to increased exposition to macrolide antibiotics.
Egyedi azonosító: ÚNKP_17-3-II-SE-3
Doctoral School: Pathological Sciences
Program: Alterations of Cells, Fibres and Extracellular Matrix and Diagnostic Pathomorphological Studies in the Course of Heart and Vascular Diseases and in Certain Tumours. Experimental and Diagnostic Pathomorphological Studies
Supervisor: Gabor Lotz