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Antibiotics
Special Issues
Helicobacter pylori Infection and Antibiotic Resistance: The Emerging Eradication Strategies
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Helicobacter pylori Infection and Antibiotic Resistance: The Emerging Eradication Strategies

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 2357

Special Issue Editors

Prof. Dr. Tomica Milosavljevic

E-Mail Website
Guest Editor
Euromedik Hospital Belgrade, Belgrade, Serbia
Interests: endoscopy; helicobacter infections; gastric cancer
Dr. László Herszényi

E-Mail Website
Guest Editor
2nd Department of Medicine, Semmelweis University, H-1088 Budapest, Hungary
Interests: colorectal cancer; acute; cystocolic fistula; peritoneum lavage

Special Issue Information

Dear Colleagues,

In light of the growing prevalence of Helicobacter pylori (H. pylori), its eradication has been recognized as high priority. Despite efforts to control this pathogen, several factors have hindered its successful eradication. Antibiotic resistance has been recognized as the main driving factor in the treatment failure process.

The indiscriminate use of antibiotics in both clinical and community settings has played a significant role in fueling this problem, selecting for resistant strains and promoting their proliferation. H. pylori has developed an impressive repertoire of resistance mechanisms, rendering traditional antibiotic therapies less effective and highlighting the urgent need for a tailored therapy approach. Repetitive eradication attempts promote further antibiotic resistance, poor patient compliance, and contribute to point mutations while simultaneously weakening host immune systems and potentially leading to yeast co-infection, all of which have been recognized as additional predictors of treatment failure.

The impact of H. pylori antibiotic resistance is multifold, impacting both individual patients and public health. Several mechanisms have been proposed to meet the challenge of eradicating H. pylori, some of which have been implemented in global guidelines and consensus statements.

By fostering an interdisciplinary approach, implementing stringent antibiotic stewardship programs, and promoting tailored treatment approaches, we can strive toward successful H. pylori treatment outcomes.

Prof. Dr. Tomica Milosavljevic
Dr. László Herszényi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Helicobacter pylori
  • eradication therapy
  • antibiotic resistance

Published Papers (2 papers)

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Research

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11 pages, 688 KiB  
Article
Exploring the Molecular Mechanisms of Macrolide Resistance in Laboratory Mutant Helicobacter pylori
by Meltem Ayaş, Sinem Oktem-Okullu, Orhan Özcan, Tanıl Kocagöz and Yeşim Gürol
Antibiotics 2024, 13(5), 396; https://doi.org/10.3390/antibiotics13050396 - 26 Apr 2024
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Abstract
Resistance to clarithromycin, a macrolide antibiotic used in the first-line treatment of Helicobacter pylori infection, is the most important cause of treatment failure. Although most cases of clarithromycin resistance in H. pylori are associated with point mutations in 23S ribosomal RNA (rRNA), the [...] Read more.
Resistance to clarithromycin, a macrolide antibiotic used in the first-line treatment of Helicobacter pylori infection, is the most important cause of treatment failure. Although most cases of clarithromycin resistance in H. pylori are associated with point mutations in 23S ribosomal RNA (rRNA), the relationships of other mutations with resistance remain unclear. We examined possible new macrolide resistance mechanisms in resistant strains using next-generation sequencing. Two resistant strains were obtained from clarithromycin-susceptible H. pylori following exposure to low clarithromycin concentrations using the agar dilution method. Sanger sequencing and whole-genome sequencing were performed to detect resistance-related mutations. Both strains carried the A2142G mutation in 23S rRNA. Candidate mutations (T1495A, T1494A, T1490A, T1476A, and G1472T) for clarithromycin resistance were detected in the Mutant-1 strain. Furthermore, a novel mutation in the gene encoding for the sulfite exporter TauE/SafE family protein was considered to be linked to clarithromycin resistance or cross-resistance, being identified as a target for further investigations. In the Mutant-2 strain, a novel mutation in the gene that encodes DUF874 family protein that can be considered as relevant with antibiotic resistance was detected. These mutations were revealed in the H. pylori genome for the first time, emphasizing their potential as targets for advanced studies. Full article
(This article belongs to the Special Issue Helicobacter pylori Infection and Antibiotic Resistance: The Emerging Eradication Strategies)
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Review

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36 pages, 7783 KiB  
Review
Sequential versus Standard Triple Therapy for First-Line Helicobacter pylori Eradication: An Update
by Olga P. Nyssen, Belén Martínez, Francis Mégraud, Vincenzo Savarino, Carlo A. Fallone, Franco Bazzoli and Javier P. Gisbert
Antibiotics 2024, 13(2), 136; https://doi.org/10.3390/antibiotics13020136 - 30 Jan 2024
Cited by 1 | Viewed by 1310
Abstract
Background: non-bismuth sequential therapy (SEQ) was suggested as a first-line anti-Helicobacter pylori treatment alternative to standard triple therapy (STT). Methods: We conducted a systematic review with a meta-analysis of randomized controlled trials (RCTs) comparing the efficacy of 10-day SEQ vs. STT (of [...] Read more.
Background: non-bismuth sequential therapy (SEQ) was suggested as a first-line anti-Helicobacter pylori treatment alternative to standard triple therapy (STT). Methods: We conducted a systematic review with a meta-analysis of randomized controlled trials (RCTs) comparing the efficacy of 10-day SEQ vs. STT (of at least 7 days) using bibliographical searches up to July 2021, including treatment-naïve adult or children. The intention-to-treat (ITT) eradication rate and the risk difference (RD) were calculated. Results: Overall, 69 RCTs were evaluated, including 19,657 patients (9486 in SEQ; 10,171 in STT). Overall, SEQ was significantly more effective than STT (82% vs. 75%; RD 0.08; p < 0.001). The results were highly heterogeneous (I2 = 68%), and 38 studies did not demonstrate differences between therapies. Subgroup analyses suggested that patients with clarithromycin resistance only and all geographical areas but South America could benefit more from SEQ. Both therapies have evolved over the years, showing similar results when STT lasted 14 days; however, a tendency toward lower SEQ efficacy was noted from 2010 onwards. Conclusions: Prior to 2010, SEQ was significantly more effective than STT, notably when 7-day STT was prescribed. A tendency toward lower differences between SEQ and STT has been noted, especially when using 10-day STT. None of the therapies achieved an optimal efficacy and therefore cannot be recommended as a valid first-line H. pylori treatment. Full article
(This article belongs to the Special Issue Helicobacter pylori Infection and Antibiotic Resistance: The Emerging Eradication Strategies)
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