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National Helicobacter pylori antibiotic resistance surveillance to guide clinical practice

Helicobacter pylori infection is a public health issue. It remains one of the most common infections in adults in Ireland and is associated with significant disease as the main cause of stomach ulcers and stomach cancers. Infection is more common in lower socioeconomic groups and increases with age.
Despite significant work resulting in a better understanding of this bacterium (germ) and how it interacts with the human body, there has been an increase in treatment failure using standard therapies, which include a drug that controls stomach acid and two antibiotics that target the infection. Antibiotic resistance is one of the main reasons for H. pylori treatment failure.
International medical guidelines recommend that the choice of antibiotics used to treat H. pylori in a given population should be based on the pattern of antibiotic resistance in that region. However H. pylori antibiotic resistance testing is not routinely carried out in the majority of Irish Hospitals.
Building on the research team’s experience performing resistance testing at Tallaght University Hospital, this project plans to investigate the nationwide levels of antibiotic-resistant H. pylori infection by recruiting patients attending 7 public and private hospitals located in rural and urban areas around the country. Antibiotic resistance testing will be carried out by isolating the bacteria from patient samples and exposing the cultures to different antibiotics. In addition, bacterial DNA will be examined to detect changes that are known to lead to antibiotic resistance. Findings from this research will provide updated national guidelines for doctors in the most appropriate strategies to cure H. pylori infection and detect resistant infections.