TY - JOUR T1 - Multicenter survey of routine determinations of resistance of Helicobacter pylori to antimicrobials over the last 20 years (1990 to 2009) in Belgium36563 JF - J.Clin.Microbiol. Y1 - 2011 A1 - V.Y. Miendje Deyi A1 - Bontems,P. A1 - Jean Vanderpas A1 - E. De Koster A1 - Ntounda,R. A1 - Van den Borre,C. A1 - Cadranel,S. A1 - Burette,A. KW - 0 KW - 2009 KW - a KW - ADOLESCENT KW - Adult KW - adults KW - age KW - Age factors KW - Aged KW - Aged,80 and over KW - Agent KW - Agents KW - Amoxicillin KW - Anti-Bacterial Agents KW - Antimicrobial KW - Antimicrobial resistance KW - Antimicrobials KW - article KW - Belgium KW - Biology KW - Biopsy KW - Brussels KW - Bruxelles KW - Child KW - Child,Preschool KW - CHILDREN KW - Ciprofloxacin KW - Clarithromycin KW - Clinical KW - Consensus KW - CONSUMPTION KW - data KW - de KW - Digestive KW - disease KW - drug effects KW - Drug Resistance,Bacterial KW - electronic KW - EPIDEMIOLOGICAL KW - ethnic KW - factors KW - Female KW - Gastric Mucosa KW - Gender KW - Group KW - Helicobacter Infections KW - Helicobacter pylori KW - hospital KW - Humans KW - im KW - Infant KW - INFECTION KW - IS KW - isolation & purification KW - IT KW - journal KW - Logistic KW - logistic regression KW - Logistic-regression KW - Male KW - Metronidazole KW - Microbial Sensitivity Tests KW - microbiology KW - middle aged KW - Multivariate KW - need KW - observed KW - Patient KW - patients KW - period KW - pharmacology KW - POPULATION KW - RATES KW - regression KW - report KW - Research KW - Research Support KW - resistance KW - risk KW - Risk factor KW - Risk Factors KW - Risk-factor KW - Risk-factors KW - routine KW - SB - IM KW - sex factors KW - strain KW - study KW - survey KW - TESTING KW - Tetracycline KW - Tetracycline Resistance KW - Therapy KW - time KW - Universities KW - university KW - university hospital KW - WHO KW - Young adult AB - We analyzed the rates of antimicrobial resistance of Helicobacter pylori strains isolated from patients from 1990 to 2009 and identified risk factors associated with resistance. Gastric biopsy specimens were collected from several digestive disease centers in Brussels, Belgium. We routinely performed antimicrobial susceptibility testing for clarithromycin (CLR), metronidazole, amoxicillin, tetracycline, and ciprofloxacin. Evaluable susceptibility testing was obtained for 9,430 strains isolated from patients who were not previously treated for Helicobacter pylori infection (1,527 isolates from children and 7,903 from adults) and 1,371 strains from patients who were previously treated (162 isolates from children and 1,209 from adults). No resistance to amoxicillin was observed, and tetracycline resistance was very rare (<0.01%). Primary metronidazole resistance remained stable over the years, with significantly lower rates for isolates from children (23.4%) than for isolates from adults (30.6%). Ciprofloxacin resistance remained rare in children, while it increased significantly over the last years in adults. Primary clarithromycin resistance increased significantly, reaching peaks in 2000 for children (16.9%) and in 2003 for adults (23.7%). A subsequent decrease of resistance rates down to 10% in both groups corresponded to a parallel decrease in macrolide consumption during the same period. Multivariate logistic regression revealed that female gender, age of the patient of 40 to 64 years, ethnic background, the number of previously unsuccessful eradication attempts, and the different time periods studied were independent risk factors of resistance to clarithromycin, metronidazole, and ciprofloxacin. Our study highlights the need to update local epidemiological data. Thus, the empirical CLR-based triple therapy proposed by the Maastricht III consensus report remains currently applicable to our population VL - 49 CP - 6 U1 - 38300 M3 - http://dx.doi.org/10.1128/JCM.02642-10 ER -