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The Primary Resistance of Helicobacter pylori in Taiwan after the National Policy to Restrict Antibiotic Consumption and Its Relation to Virulence Factors—A Nationwide Study

Author

Listed:
  • Jyh-Ming Liou
  • Chi-Yang Chang
  • Mei-Jyh Chen
  • Chieh-Chang Chen
  • Yu-Jen Fang
  • Ji-Yuh Lee
  • Jeng-Yih Wu
  • Jiing-Chyuan Luo
  • Tai-Cherng Liou
  • Wen-Hsiung Chang
  • Cheng-Hao Tseng
  • Chun-Ying Wu
  • Tsung-Hua Yang
  • Chun-Chao Chang
  • Hsiu‐Po Wang
  • Bor-Shyang Sheu
  • Jaw-Town Lin
  • Ming-Jong Bair
  • Ming-Shiang Wu
  • Taiwan Gastrointestinal Disease and Helicobacter Consortium

Abstract

Objective: The Taiwan Government issued a policy to restrict antimicrobial usage since 2001. We aimed to assess the changes in the antibiotic consumption and the primary resistance of H. pylori after this policy and the impact of virulence factors on resistance. Methods: The defined daily dose (DDD) of antibiotics was analyzed using the Taiwan National Health Insurance (NHI) research database. H. pylori strains isolated from treatment naïve (N=1395) and failure from prior eradication therapies (N=360) from 9 hospitals between 2000 and 2012 were used for analysis. The minimum inhibitory concentration was determined by agar dilution test. Genotyping for CagA and VacA was determined by PCR method. Results: The DDD per 1000 persons per day of macrolides reduced from 1.12 in 1997 to 0.19 in 2008, whereas that of fluoroquinolones increased from 0.12 in 1997 to 0.35 in 2008. The primary resistance of amoxicillin, clarithromycin, metronidazole, and tetracycline remained as low as 2.2%, 7.9%, 23.7%, and 1.9% respectively. However, the primary levofloxacin resistance rose from 4.9% in 2000–2007 to 8.3% in 2008–2010 and 13.4% in 2011–2012 (p=0.001). The primary resistance of metronidazole was higher in females than males (33.1% vs. 18.8%, p

Suggested Citation

  • Jyh-Ming Liou & Chi-Yang Chang & Mei-Jyh Chen & Chieh-Chang Chen & Yu-Jen Fang & Ji-Yuh Lee & Jeng-Yih Wu & Jiing-Chyuan Luo & Tai-Cherng Liou & Wen-Hsiung Chang & Cheng-Hao Tseng & Chun-Ying Wu & Tsu, 2015. "The Primary Resistance of Helicobacter pylori in Taiwan after the National Policy to Restrict Antibiotic Consumption and Its Relation to Virulence Factors—A Nationwide Study," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-11, May.
    • Handle: RePEc:plo:pone00:0124199
    DOI: 10.1371/journal.pone.0124199
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    Cited by:

    1. Louise Devillers & Jonathan Sicsic & Angelique Delbarre & Josselin Le Bel & Emilie Ferrat & Olivier Saint Lary, 2018. "General Practitioner trainers prescribe fewer antibiotics in primary care: Evidence from France," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-12, January.

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