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  • IDDF2019-ABS-0213 Long-term changes of gut microbiota, antibiotic resistance, and metabolic parameters after helicobacter pylori eradication- a multicentre randomised trial

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Gut – IDDF Young Investigator Award
Clinical Gastroenterology
IDDF2019-ABS-0213 Long-term changes of gut microbiota, antibiotic resistance, and metabolic parameters after helicobacter pylori eradication- a multicentre randomised trial
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  1. Chieh-Chang Chen1,
  2. Jyh-Ming Liou1,
  3. Yu-Jen Fang2,
  4. Jaw-Town Lin3,
  5. Emad El-Omar4,
  6. Ming-Shiang Wu1
  1. 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taiwan
  2. 2Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Taiwan
  3. 3Digestive Medicine Center, China Medical University Hospital, Taiwan
  4. 4St George and Sutherland Clinical School, University of New South Wales, Australia

Abstract

Background We previously showed that the eradication rates of triple therapy for 14 days (T14), concomitant therapy for 10 days (C10), and bismuth quadruple therapy for 10 days (BQ10) were 83.7%, 85.9%, and 90.4% in the first-line treatment of Helicobacter pylori (H. pylori). The short-term and long-term impacts these therapies on the gut microbiota, antibiotic resistance, and metabolic parameters were assessed in the present study

Methods Patients with H. pylori infection (n=1620) were randomized in this multicenter, open-label trial to receive T14, C10, or BQ10 therapy. The long-term outcomes included reinfection rate, changes in the gut microbiota, antibiotic resistance and metabolic parameters. Fecal samples were collected before and 2 weeks, 2 months, and at least 1 year after eradication therapy and 16S rRNA amplicon sequencing were done to asses gut microbiota change. Susceptibility testing for fecal E. coli and Klebsiella Pneumoniae was done. This trial is registered with ClinicalTrials.gov, number NCT01906879.

Results Compared to baseline, α-diversity and β-diversity were significantly reduced 2 weeks after T14, C10, and BQ10. α-diversity and β-diversity were restored at week 8 and 1 year in patients treated with T14, but were not fully recovered in patients treated with C10 and BQ10 at week 8 and 1 year. The transient increase of the resistance rates of E. coli and Klebsiella Pneumoniae to penicillin derivatives, cefazolin, cefmetazole, fluoroquinolones, gentamicin, and trimethoprim-sulfamethoxazole after T14 and C10 at week 2 returned to the basal state at week 8 and 1 year. Although body weight and BMI slightly increased, there were significant improvements in metabolic parameters with a decrease in insulin resistance, triglycerides and low-density lipoprotein, and an increase in high-density lipoprotein. Overall, there was no significant change in the prevalence of metabolic syndrome at week 8 and 1 year, after T14, C10, and BQ10. (figure 1)

Abstract IDDF2019-ABS-0213 Figure 1
Abstract IDDF2019-ABS-0213 Figure 1

Gut microbiota changes after H. pylori Eradication

Conclusions Eradication of H. pylori infection has minimal disruption of the microbiota, no effect on antibiotic resistance of E. coli and some positive effects on metabolic parameters. These collectively lend support to the long-term safety of H. pylori eradication therapy

https://doi.org/10.1136/gutjnl-2019-IDDFAbstracts.9

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