Первичная резистентность Helicobacter pylori к антибиотикам в санкт-петербурге

Substantially the result of eradication therapy depends on the clarithromycin resistance of Helicobacter pylori. Using the molecular-genetic method the clinically significant 40% rate of resistance to clarithromycin was reported in Saint-Petersburg, which is much higher than the rate in other regions of Russia. Nevertheless there is still no data of primary antibiotic resistance to Helicobacter pylori in Saint-Petersburg by using the cultural method. We studied the prevalence of clarithromycin resistance to Helicobacter pylori in Saint-Petersburg by means of disk diffusion method. Forty-nine dyspeptic Helicobacter pylori -positive patients with endoscopical features of chronic gastritis were enrolled. Helicobacter pylori examination was determined by the rapid urease test (Biohit-test, Finland).The main exclusion criteria was the prior use of clarithromycin, amoxicillin, levofloxacin, metronidazole, nifuratel or tinidazole. Susceptibility to antibiotics was determined by disk diffusion method. Twenty-six strains of Helicobacter pylori were identified. The highest resistance rate was for metronidazole (69.2%) and levofloxacin (42.3%), whereas only two isolates (7.7%) were resistant to clarithromycin and there was no observed resistance to amoxicillin (table). Among the isolates 65.4% were sensitive to nifuratel, 46.2% to tinidazole. Thus, acording to disk diffusion method the prevalence of primary clarithromycin resistance in Saint-Petersburg is 7.7%, that allows using this antimicrobial in first-line therapy for Helicobacter pylori infection. The revealed essential distinctions in sensitivity of Helicobacter pylori to medicines of the same the pharmacological group: metronidazole and tinidazole needs further more large-scale researches.