Antimicrobial Susceptibility Profile of Helicobacter Pylori Isolated From Patients With Dyspepsia in Two Tertiary Hospitals in Nairobi, Kenya

Abstract

Background: Helicobacter pylori infection is a global problem with prevalence remaining high in developing countries. It has been implicated in the causation of a wide spectrum of gastric pathologies. The emergence of multi-drug resistant Helicobacter pylori strains poses a major challenge in the management of the associated diseases in a resource-limited country like Kenya. Therefore, there is a need for local surveillance of antimicrobial resistance, to guide clinicians in their choice of therapy. Study objective: To determine the current antimicrobial susceptibility profiles of Helicobacter pylori isolated from dyspeptic patients at Kenyatta National Hospital and The Nairobi Hospital. Design: Cross-sectional descriptive study Method: Participants aged 18years and above with dyspepsia referred for endoscopy at the KNH and TNH endoscopy units were enrolled. Endoscopy was performed and five biopsy samples collected from each patient taken for culture. Antimicrobial susceptibility testing was performed for the samples that tested positive using E-test strips. MIC values > 1 for amoxicillin and clarithromycin, > 8 for metronidazole and >1 were considered resistant. Results: A total of 158 patients with dyspepsia at KNH (n=82) and TNH (n=76) were enrolled in the study. These Patients were aged between 18 years and 77 years with a mean age of 43.5 years (SD 13.9). Eighty-five (53.8%) were females. Gastritis was the most common endoscopic finding (79.4%). All the isolates were sensitive to amoxicillin (MIC range 0.016- 0.75ug/ml), 66(97.1%) isolates were sensitive to levofloxacin (MIC range 0.012-2ug/ml) and ciprofloxacin (MIC range 0.016-3ug/ml). Nine (13.2%) isolates were resistant to clarithromycin (MIC range