High rates of clarithromycin and levofloxacin resistance of Helicobacter pylori in patients with chronic gastritis in the South East area of Vietnam

Abstract Objectives The increasing rates of CLR- and LVX-resistantH. pylori are the main causes of the considerable decrease in the eradication rates of triple therapy and LVX-based regimens. The aims of this study were to determine the rates of CLR- and LVX-resistant H. pylori by the Epsilometer test and to assess the risk factors for this antibiotic resistance among patients with chronic gastritis in the South East area of Vietnam. Methods Gastric biopsy specimens were obtained from 153 patients withH. pylori-positive chronic gastritis for use in culture and Epsilometer test to determine CLR and LVX susceptibilities. Results Rates ofH. pylori resistance to CLR and LVX were 72.6% and 40.5%, respectively. Dual-resistant H. pylori (to both CLR and LVX) accounted for 30.7%. The rates of high-level resistance to CLR and LVX were 18.9% and 83.9%, respectively. Multivariate analysis showed that age older than 30 years (OR = 3.80, 95%CI 1.61–8.97) and history of H. pylori treatment (OR = 8.72, 95%CI 1.90–39.91) were independent risk factors for CLR resistance, whereas only the age older than 35 years (OR = 2.42, 95%CI 1.23–4.76) was an independent risk factor for LVX resistance. Conclusions These results revealed high rates of resistance of H. pylori to CLR and LVX in patients with chronic gastritis in the South East area of Vietnam. This suggests that CLR-based triple therapy should not be used for the eradication treatment of H. pylori, and LVX susceptibility testing of H. pylori strains should be performed before choosing alternative regimens.