RESUMEN
BACKGROUND: Increasingly, over time, antibiotic resistance is considered a problem for the efficacy of H. pylori eradication treatment. The aim of our study was to evaluate the changes in clarithromycin and levofloxacin resistance of H. pylori strains in Greek patients in two different time periods (in 2000 and in 2010). METHODS: Gastric biopsies of consecutive H. pylori-positive patients were investigated retrospectively. Mutations in H. pylori 23S rRNA and gyrA genes associated with resistance to clarithromycin and quinolones, respectively, were determined by allelic specific polymerase chain reaction. RESULTS: In the first time period (2000), H. pylori resistance patterns were evaluated in 50 and in the second period (2010) in 57 patients. During the first time period 30 and 0% of patients were infected with clarithromycin- or quinolone-resistant strains, respectively. In the second time period (2010), the percentage of patients infected with clarythromycin or quinolone resistance strains increased to 42 and 5.3%, respectively. CONCLUSIONS: Our study showed an increase in the prevalence of both clarithromycin and quinolones resistance of H. pylori. Although the resistance rate to quinolones increased over the years, it is relatively low justifying its use for the eradication of H. pylori infections.
Asunto(s)
Claritromicina , Girasa de ADN/genética , Farmacorresistencia Bacteriana/genética , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Levofloxacino , ARN Ribosómico 23S/genética , Frecuencia de los Genes , Grecia/epidemiología , Infecciones por Helicobacter/epidemiología , Humanos , Epidemiología Molecular , Mutación , Polimorfismo de Nucleótido Simple , Prevalencia , Estudios RetrospectivosRESUMEN
Strongyloides stercoralis is an endemic parasitic infection of tropical areas, but it is rare in Europe. Most infected immunocompetent patients are asymptomatic, but may present with abdominal pain and diarrhea even several years after acquiring the infection. However, in immunocompromized patients, hyperinfection syndrome has a high mortality rate. Risk factors for the hyperinfection syndrome are corticosteroids and infection with human T lymphotropic virus type 1. Diagnosis of strongyloidiasis is usually made by identifying the larvae in the stool or in duodenal biopsies. There are only four published cases of strongyloidiasis in Greek patients, three of them were immunocompromized. In our patient videocapsule endoscopy identified rhabditiform larvae suggestive of strongyloidiasis. This case report illustrates the difficulty in establishing a diagnosis of the disease in immunocompetent patients.
