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In Africa, there are very little data concerning the susceptibility of\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      isolates to antibiotics. The purpose of this study was to evaluate the resistance prevalence of\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      strains circulating in Cameroon, and to assess overexpression of efflux pump as a possible multi-drug resistance mechanisms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 140\n                      <jats:italic>H. pylori<\/jats:italic>\n                      isolates were recovered from gastric biopsies of dyspeptic patients in two reference hospitals in Cameroon and analyzed for their antimicrobial susceptibility to amoxicillin, co-amoxiclav, ampicillin, penicillin, imipenem, metronidazole, rifabutin, erythromycin, clarithromycin, azithromycin, levofloxacin, ciprofloxacin, norfloxacin, tetracycline, doxycycline and minocycline. Antibiotic sensitivity was tested by disk diffusion method. Phe-Arg-naphthylamide (PA\u00dfN) was used as efflux pump inhibitor. INT broth microdilution method in supplemented Brain Heart Infusion broth was used to determine the MIC of ampicillin, amoxicillin, metronidazole, erythromycin, clarithromycin and doxycycline in the absence and the presence of PA\u00dfN against 32 selected MDR isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall\n                      <jats:italic>H. pylori<\/jats:italic>\n                      resistance rate was 100% to ampicillin, penicillin and co-amoxiclav; 97.14% to amoxicillin, 97.85% to metronidazole, 47.85% to erythromycin, 13.57% to clarithromycin; 5, 2.86 and 0.71% to doxycycline, tetracycline and minocycline respectively. No resistance to azithromycin, rifabutin, imipenem, ciprofloxacin, norfloxacin and levofloxacin was detected among\n                      <jats:italic>H. pylori<\/jats:italic>\n                      isolates. Seventy percent (70%) of the tested isolates elicited a multiple drugs resistance pattern; 42.57% double, 15.71% triple and 5.71% quadruple drugs resistance. Metronidazole and amoxicillin were more concerned with double resistance pattern (86.76%). The spectrum of activity recorded with metronidazole, doxycycline, clarithromycin and erythromycin ranged from 0 to 100% in the absence to the presence of PA\u00dfN against the tested MDR isolates. An 8 to 128-fold increase in potency was also noticed with these antibiotics in the presence of PA\u00dfN.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      With regard to the high resistance rate to both amoxicillin and metronidazole, these drugs should be avoided as components of triple therapy in our milieu. In contrast, ciprofloxacin, norfloxacin, levofloxacin and tetracyclines could be used to achieve a better eradication rate and to reduce the risk of selection of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      resistant strains.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4536-8","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T06:22:05Z","timestamp":1571811725000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Broad spectrum resistance in Helicobacter pylori isolated from gastric biopsies of patients with dyspepsia in Cameroon and efflux-mediated multiresistance detection in MDR isolates"],"prefix":"10.1186","volume":"19","author":[{"given":"Laure Brigitte","family":"Kouitcheu Mabeku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Eyoum Bille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cromwell","family":"Tepap Zemnou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel Danny","family":"Tali Nguefack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Leundji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,22]]},"reference":[{"issue":"36","key":"4536_CR1","first-page":"5962","volume":"9","author":"M Sirous","year":"2011","unstructured":"Sirous M, Mehrabadi JF, Daryani NE, Eshraghi S, Hajikhani S, Shirazi MH. 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The collection of biopsy specimen from dyspeptic patients was performed after obtaining an ethical approval from Laquintinie Hospital management board (Protocol number 425\/ AR\/ MINSANTE\/ HLD\/SCM\/CR) and from the National Ethical Committee on Human Health Research in Cameroon (Ethical clearance N<sup>0<\/sup> 2014\/03\/425\/L\/CNESRH\/SP). Participation was voluntary and each subject involved in the study gave a written consent. Children were enrolled after their parents or legal guardians received an information notice and oral explanation of the study and provided a written consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"880"}}