HIGH PREVALENCE OF HELICOBACTER-PYLORI METRONIDAZOLE RESISTANCE IN MIGRANTS TO EAST LONDON - RELATION WITH PREVIOUS NITROIMIDAZOLE EXPOSUREAND GASTRODUODENAL DISEASE

A high prevalence of metronidazole resistance in Helicobacter pylori i s reported in developing countries. This study examined whether migran ts referred for diagnostic gastroscopy at a United Kingdom centre (n=5 4), had a higher prevalence of metronidazole resistance than subjects born in the United Kingdom attending endoscopy (n=46). Records of nitr oimidazole treatment prescribed in the United Kingdom was obtained in 83 patients to find out if there was an association between H pylori m etronidazole resistance and previous ingestion of either metronidazole or tinidazole. The prevalence of metronidazole resistant isolates var ied according to country of birth: Bangladesh (90%, 27 of 30), other c ountries (67%, 16 of 24), and United Kingdom (37%, 17 of 46) (p<0.001) . Among those born in the United Kingdom, women were more likely to ha rbour resistant H pylori than men (54% v 18% respectively, p=0.01) and more likely to have a history of previous nitroimidazole ingestion (4 1% v 11% respectively, p=0.02). Patients previously exposed to either metronidazole or tinidazole were more likely to harbour resistant stra ins (84% (27 of 32) v 41% (21 or 51), p<0.0001). The distribution of g astroduodenal. disease, assessed endoscopically, was not affected by m etronidazole resistance status.