Eradication failure of Helicobacter pylori infection could play a causal role in progression of gastric disorders. In this study, infection with H. pylori was followed in gastric biopsies of symptomatic adult patients at two phases during 1-year period. Analyses were done to show association of therapeutic regimens with the refractory infection, changes in sequence types (STs) and minimum inhibitory concentration (MIC) values, and progression of histopathological changes. Infection with H. pylori was confirmed in 32.3% (57/170) of the patients. Persistent infection with H. pylori was confirmed in 14 out of the 25 patients (56%) who participated at the second phase of the study. A difference between primary and secondary resistance rates to clarithromycin (49% vs 64.3%), metronidazole (76.36% vs 100%), and ciprofloxacin (45% vs 57.1%) was detected. Although the re-emerged strains in patients with refractory infection did not show alteration in STs, their MIC50 values showed twofold increases for clarithromycin and ciprofloxacin. While ciprofloxacin containing regimens were more successful, failure of metronidazole containing regimens was detected in 77% of the patients. Consequently, inappropriate medication has an impact on refractory H. pylori infection, which could cause to a rise in resistance levels to antibiotics and progression of pathological disorders.

中文翻译：

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难治性幽门螺杆菌感染的组织学变化及其与对抗生素和治疗方案耐药性增加的关系：一年的随访。

根除幽门螺杆菌感染可能在胃病的进展中起因果作用。在这项研究中，在有症状的成年患者的胃活检中，在1年的两个阶段中，对幽门螺杆菌进行了感染。进行了分析以显示治疗方案与难治性感染，序列类型（STs）和最小抑菌浓度（MIC）值的变化以及组织病理学变化的关系。在32.3％（57/170）的患者中确认感染了幽门螺杆菌。参与研究第二阶段的25例患者中有14例（56％）证实了持续感染幽门螺杆菌。检测到克拉霉素的一级和二级耐药率（49％比64.3％），甲硝唑（76.36％比100％）和环丙沙星（45％比57.1％）之间存在差异。尽管难治性感染患者中重新出现的菌株在STs中没有改变，但克拉霉素和环丙沙星的MIC50值却增加了两倍。尽管含环丙沙星的方案更为成功，但在77％的患者中检测到含甲硝唑的方案失败。因此，不适当的药物会对难治性幽门螺杆菌感染产生影响，这可能会导致对抗生素的耐药性水平升高以及病理性疾病的发展。