H. pylori causes chronic gastritis, peptic ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. Eradication success rates have fallen in recent years, largely due to antibiotic resistance. International consensus guidelines recommend that regional treatment strategies are determined by the prevalence of H. pylori antibiotic resistance in a given population. However, national data on H. pylori antibiotic resistance are not available in Ireland, as H. pylori antimicrobial susceptibility testing (AST) is not routinely performed in the majority of Irish Hospitals. Building on our experience assessing resistance rates locally at Tallaght University Hospital, we now seek to assess the nationwide prevalence of antibiotic-resistant H. pylori infection by recruiting patients from 7 public and private hospitals located in rural and urban areas. Endoscopic biopsy samples will be collected to culture H. pylori and perform AST. Molecular testing will be carried out to detect clarithromycin resistance-mediating DNA mutations. Updated national clinical guidelines with the most appropriate strategy for the treatment of H. pylori infection will be developed based on the resistance rates detected. In addition, recommendations on diagnosing antibiotic resistant H. pylori infection will be provided.
