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Infect Drug Resist. 2017 Mar 10;10:85-90. doi: 10.2147/IDR.S123798. eCollection 2017.

Antibiotic resistance among Helicobacter pylori clinical isolates in Lima, Peru.

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Department of Environmental Health Sciences, School of Public Health.
Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Departamento Académico de Clínicas Médicas, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú.
Cancer Research and Biostatistics, Seattle, WA, USA.
Dirección General de Salud Ambiental, Ministerio de Salud del Perú, Lima, Perú.



Gastric carcinoma is the most common cancer and cause of cancer mortality in Peru. Helicobacter pylori, a bacterium that colonizes the human stomach, is a Group 1 carcinogen due to its causal relationship to gastric carcinoma. While eradication of H. pylori can help prevent gastric cancer, characterizing regional antibiotic resistance patterns is necessary to determine targeted treatment for each region. Thus, we examined primary antibiotic resistance in clinical isolates of H. pylori in Lima, Peru.


H. pylori strains were isolated from gastric biopsies of patients with histologically proven H. pylori infection. Primary antibiotic resistance among isolates was examined using E-test strips. Isolates were examined for the presence of the cagA pathogenicity island and the vacA m1/m2 alleles via polymerase chain reaction.


Seventy-six isolates were recovered from gastric biopsies. Clinical isolates showed evidence of antibiotic resistance to 1 (27.6%, n=21/76), 2 (28.9%, n=22/76), or ≥3 antibiotics (40.8%). Of 76 isolates, eight (10.5%) were resistant to amoxicillin and clarithromycin, which are part of the standard triple therapy for H. pylori infection. No trends were seen between the presence of cagA, vacA m1, or vacA m2 and antibiotic resistance.


The rate of antibiotic resistance among H. pylori isolates in Lima, Peru, is higher than expected and presents cause for concern. To develop more targeted eradication therapies for H. pylori in Peru, more research is needed to better characterize antibiotic resistance among a larger number of clinical isolates prospectively.


H. pylori; Peru; amoxicillin; antibiotic resistance

Conflict of interest statement

Disclosure LHB receives personal fees from Teva Pharmaceutical Industries Ltd. and Morphotek, Inc., for consulting/advisory role and is outside of the submitted work. All other authors report no conflicts of interest in this work.

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