RAPID INCREASE IN THE PREVALENCE OF METRONIDAZOLE-RESISTANT HELICOBACTER-PYLORI IN THE NETHERLANDS

The prevalence of primary metronidazole resistance of Helicobacter pyl ori was studied in one Dutch hospital from 1993 to 1996 and in two add itional Dutch hospitals in 1993 and 1996. All cultures of antral biops y specimens yielding H. pylori in the study period were evaluated, exc ept those from patients who had received anti-H. pylori treatment; 1,0 37 H. pylori strains, all from different patients were included. Metro nidazole resistance was determined by disk diffusion in 1993 and by Ep ilipsometer-test in 1994 to 1996. Metronidazole resistance increased f rom 7% (18/245) in 1993 to 32% (161/509) in 1996. More patients with n onulcer dyspepsia and more non-Western European patients were seen in 1996 than in 1993, but age and sex differences were not observed. A co mparable increase in metronidazole resistance was observed in both non ulcer dyspepsia patients and peptic ulcer patients, and the prevalence of metronidazole resistance in Western Europeans increased from 5% in 1993 to 28% in 1996.