- Page navigation anchor for Obtaining the local Helicobacter pylori resistance rate is easier said than doneObtaining the local Helicobacter pylori resistance rate is easier said than done
I read with interest these guidances that suggested the use of local clarithromycin resistance rate of Helicobacter pylori isolates to determine the choice of therapy.<1,2> Working in a regional microbiology laboratory in Canada, I received questions from clinicians on where they would find this local data. The best data I could find was based on 20 H pylori isolates from gastric biopsies processed in Sudbury, Ontario.<3> Their antimicrobial minimum inhibitory concentration (MIC) breakpoints and antimicrobial susceptibility testing (AST) methods were based on European guidance and other published literatures. These breakpoints and testing methods were not yet fully established by the Clinical and Laboratory Standards Institute (CLSI), which is followed by most of the clinical diagnostic laboratories in North America. Currently, for H. pylori, the CLSI has only the clarithromycin MIC breakpoint and its AST method.<4>
Our regional microbiology laboratory, operating with the 18 acute hospitals in Eastern Ontario, Canada, also conducted an audit of all the requests for isolation of H. pylori on patients’ specimens from June 1, 2016 to May 31, 2021. We typically attempt to grow and isolate H. pylori in both chocolate and Mueller-Hinton with 5% sheep blood plates, incubated at microaerophilic condition in Campy jars, at 35C for 10 days. We received a total of 13 requests with the following outcomes:
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• 4 gastric biopsy specimens were found to have H...Competing Interests: The author (E.Y.H.Y) has been paid working as a pharmacist, physician, and microbiologist, but is not paid to write this article. Opinions expressed are solely his own and do not express the views or opinions of his employers.
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