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Article

Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates

1
Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan
2
Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
3
Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia
4
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
5
Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya 60113, Indonesia
6
Department of Infectious Diseases, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
7
Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX 77030, USA
8
Global Oita Medical Advanced Research Center for Health (GO-MARCH), Yufu 879-5593, Japan
9
Borneo Medical and Health Research Centre, University Malaysia Sabah, Kota Kinabalu, Sabah 88400, Malaysia
*
Authors to whom correspondence should be addressed.
Received: 21 May 2020 / Revised: 8 July 2020 / Accepted: 20 July 2020 / Published: 24 July 2020
(This article belongs to the Special Issue Helicobacter pylori Toxins and Pathogenesis)
We evaluated biofilm formation of clinical Helicobacter pylori isolates from Indonesia and its relation to antibiotic resistance. We determined the minimum inhibition concentration (MIC) of amoxicillin, clarithromycin, levofloxacin, metronidazole and tetracycline by the Etest to measure the planktonic susceptibility of 101 H. pylori strains. Biofilms were quantified by the crystal violet method. The minimum biofilm eradication concentration (MBEC) was obtained by measuring the survival of bacteria in a biofilm after exposure to antibiotics. The majority of the strains formed a biofilm (93.1% (94/101)), including weak (75.5%) and strong (24.5%) biofilm-formers. Planktonic resistant and sensitive strains produced relatively equal amounts of biofilms. The resistance proportion, shown by the MBEC measurement, was higher in the strong biofilm group for all antibiotics compared to the weak biofilm group, especially for clarithromycin (p = 0.002). Several cases showed sensitivity by the MIC measurement, but resistance according to the MBEC measurements (amoxicillin, 47.6%; tetracycline, 57.1%; clarithromycin, 19.0%; levofloxacin, 38.1%; and metronidazole 38.1%). Thus, biofilm formation may increase the survival of H. pylori and its resistance to antibiotics. Biofilm-related antibiotic resistance should be evaluated with antibiotic susceptibility. View Full-Text
Keywords: Helicobacter pylori; antibiotic resistance; biofilm formation; biofilm-specific resistance; amoxicillin; clarithromycin; levofloxacin; metronidazole; tetracycline Helicobacter pylori; antibiotic resistance; biofilm formation; biofilm-specific resistance; amoxicillin; clarithromycin; levofloxacin; metronidazole; tetracycline
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MDPI and ACS Style

Fauzia, K.A.; Miftahussurur, M.; Syam, A.F.; Waskito, L.A.; Doohan, D.; Rezkitha, Y.A.A.; Matsumoto, T.; Tuan, V.P.; Akada, J.; Yonezawa, H.; Kamiya, S.; Yamaoka, Y. Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates. Toxins 2020, 12, 473. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12080473

AMA Style

Fauzia KA, Miftahussurur M, Syam AF, Waskito LA, Doohan D, Rezkitha YAA, Matsumoto T, Tuan VP, Akada J, Yonezawa H, Kamiya S, Yamaoka Y. Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates. Toxins. 2020; 12(8):473. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12080473

Chicago/Turabian Style

Fauzia, Kartika A., Muhammad Miftahussurur, Ari F. Syam, Langgeng A. Waskito, Dalla Doohan, Yudith A.A. Rezkitha, Takashi Matsumoto, Vo P. Tuan, Junko Akada, Hideo Yonezawa, Shigeru Kamiya, and Yoshio Yamaoka. 2020. "Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates" Toxins 12, no. 8: 473. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12080473

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