Phenotypic Resistance Pattern of Helicobacter pylori Isolates to Clarithromycin, Amoxicillin and Metronidazole in Sana'a City, Yemen

Abstract

Background: Helicobacter pylori is a common bacterium infecting about half of the world's population, with higher rates in developing countries. Many strains of H. pylori are becoming antibiotic-resistant, making it increasingly difficult to treat infections. This resistance can lead to serious health issues, including an increased risk of gastric cancer. This study aimed to assess antibiotic resistance patterns among H. pylori isolates from Yemeni patients undergoing gastroendoscopy at the University of Science and Technology Hospital in Sana’a City, Yemen. Methods: A prospective cross-sectional study was conducted on 116 isolates from gastric biopsy specimens. H. pylori was identified using rapid urease testing and histopathological examination of biopsy specimens. Positive samples were subsequently cultured on selective media to assess antibiotic susceptibility to clarithromycin (CLR), amoxicillin (AMX), and metronidazole (MTZ). Results: Out of the 116 specimens analyzed, H. pylori was isolated from 62 samples (53.4%). Antibiotic susceptibility testing revealed resistance rates of 38.7% for CLR, 30.6% for AMX, and 87.1% for MTZ. Conclusion: The rise in antibiotic resistance among H. pylori isolates from Yemeni patients emphasizes the critical need for regular resistance testing to inform treatment choices, improve patient care and minimize the risk of serious complications associated with H. pylori infections. Alternative regimens that exclude MTZ and CLR should be considered.