Antimicrobial Resistance of <i>Helicobacter pylori</i> in Gastric Biopsy Samples from Lima/Peru

<b><i>Background:</i></b> <i>Helicobacter pylori</i> prevalence and gastric cancer rates are remarkably high in Peru. Effective antimicrobial regimens are essential for successful <i>H. pylori</i> eradication. We aimed at assessing antimicrobial resistance rates to first- and second-line therapeutic agents in <i>H. pylori</i> strains detected in gastric biopsy samples. <b><i>Materials and Methods:</i></b> Gastric biopsy samples (antrum and corpus) were collected from therapy-naive patients (<i>n</i> = 154). <i>H. pylori</i> presence in the samples was confirmed by histopathology. Genotypic resistance to clarithromycin and quinolones was determined by real-time PCR. <b><i>Results:</i></b> Histology results were 100% concordant with PCR results (97/154; 63% <i>H. pylori</i>-positive in both). In 6% (6/97) of the patients, we found discordant results of <i>H. pylori</i> infection in antrum and corpus samples from the same patient. Resistance rates to clarithromycin and quinolone were 34% (33/97) and 68% (56/82), respectively. Antimicrobial resistance to both antimicrobials was 30% (25/82). <b><i>Conclusion:</i></b> Antimicrobial resistance rates of <i>H. pylori</i> to clarithromycin and quinolones are very high in Lima, Peru. Many first- and second-line, empiric eradication regimens may not be recommended for Peruvian patients.