Helicobacter pylori: Resistencia múltiple en pacientes de Bogotá-Colombia

Introduction: Antibiotic resistance is the main cause of treatment failure for Helicobacter pylori (H. pylori) infection. Clarithromycin and metronidazole being the main responsible for antibiotic resistance. In Colombia, the primary resistance as consequence of these two antibiotics and the excessive use of levofloxacin is above the accepted limit (13.6%, 83% and 16%, respectively). Despite this fact, empirical therapies are used in patients with previous therapeutic failure that include the combination of these antibiotics. Objective: To determine antibiotic resistance in patients previously treated for H. pylori in Bogotá-Colombia. Materials and methods: Descriptive study that include 10 isolates obtained from 5 patients with 3 or 4 previous failed treatments for H. pylori. Antibiotic resistance to amoxicillin, clarithromycin, levofloxacin and metronidazole was investigated by agar dilution. Antibiotic resistance was confirmed by DNA sequencing (Magrogen - Korea). Results: Eight isolates were resistant to two or more antibiotics. All isolates were resistant to levofloxacin. Susceptibility patterns in isolates from the antrum and body of the stomach were different in 3 patients. Conclusion: This is the first evidence of multiple H. pylori resistance in Colombia in patients previously treated for H. pylori. The results demonstrate the consequences of using an ineffective antibiotic scheme. In addition, the need to assess antibiotic susceptibility in different anatomical sites of the stomach is highlighted. The consequences of multiple resistance decrease the antibiotics useful to eradicate H. pylori in the future.