Maria Teresa Mascellino
Sapienza University of Rome, Italy
Biography:
Maria Teresa Mascellino has completed her MD at the age of 25 years in Rome during the period of 1980 and specialization studies in Microbiology and Infectious Diseases from Sapienza University of Rome (Italy). She works as aggregate professor in the Department of Public Health and Infectious Diseases. She has published other than 100 papers in reputed journals and has been serving as an editorial board member of repute. She is editor of the book “Bacterial and Mycotic infections in immune-compromised hosts”” from OMICS Group and of the book “Salmonella: a re-emerging pathogen” from InTech. She is a reviewer for many important scientific international Journals and Research Projects from Ministry of University and Scientific Research. She has attended national and international Conferences as speaker presenting relevant research topics
Abstract:
Aim of study was to evaluate the antibiotic resistance and the eradication rate in 40 patients who failed first line therapy, with gastric symptoms that required assessing with diagnostic endoscopy. The histological and endoscopic data are reported in the table.
The patients all positive to urease test, were treated with the quadruple therapy PPI-bismuth-metronidazole (MZ)-TE for 14 days consistently to the high CLA-resistance level. Eradication status was determined by the 13C-urea breath test.
The resistance to CLA and MZ resulted to be very high (50% and 65% respectively) due to their large use. Amoxicillin, TE and levofloxacin showed 3%, 5% and 25% of resistance respectively. Mixed Hp infections were demonstrated by the presence of different antimicrobial susceptibility patterns contemporarily.. The overall eradication rate resulted to be 82% strictly depending for each patient on the number (1 or 2 or 3) of gastric districts colonized by Hp. The CLA-resistance levels and mainly the local susceptibility, resulted to be crucial in order to establish a correct therapy. The genotypic-resistance is useful in case of absence of live bacteria, contamination and mainly for identifying mixed infections that represent a real problem possibly leading to a resistance underestimation. The real-time PCR detected the resistant population at a very low concentration not detectable by phenotypic tests which primarily show susceptible bacteria. The use of genotypic tests directly on the clinical specimens could predict the antibiotic resistance addressing changes in previous failure treatments. The bismuth quadruple therapy resulted to be effective in the Hp eradication rate.