Helicobacter pylori: Prevalence and antibiotic susceptibility among Kenyans

Abstract

Background. Helicobacter pylori infection in Kenya is
staggeringly high. Evidence links infection of the gastric
mucosa by H. pylori with subsequent development of gastric
pathologies.
Aim. We investigated the prevalence of H. pylori in dyspeptic patients, its relationship with gastric pathologies, and associated antibiotic susceptibility profiles, and compared two media to find the appropriate medium that enhances growth and expedites culture and isolation.
Methods. Rapid urease and histological tests were used to
screen for H. pylori. Culture was performed to test ensitivity
and evaluate media. Selective and nutritional supplements
were added to culture media (Colombia blood agar and brainheart infusion agar) for growth enhancement. E-test strips for metronidazole, amoxicillin and clarithromycin were used for susceptibility testing.
Results. The prevalence of H. pylori infection in children was 73.3%, and 54.8% in adults. All the H. pylori investigated in this study were largely sensitive to clarithromycin (100%, minimum inhibiting concentration (MIC) <2 μg/ml), amoxicillin (100%, MIC <2 μg/ml) and metronidazole (95.4%, MIC <8 μg/ml). There was, however, occasional resistance to metronidazole (4.6%, MIC >8 μg/ml). Both Colombia blood and brain-heart infusion agar, with the supplements, effectively supported H. pylori growth. Growth was achieved in an average of 36 hours for primary isolations and 24 hours for subcultures.
Conclusion. The media described here reduce the time
required to culture and isolate bacteria and perform
susceptibility testing. Despite the high prevalence of H.
pylori infection, the associated pathology is low and does not parallel H. pylori prevalence in the population.