Antimicrobial eradication rates for Helicobacter pylori have been decreasing and the reason for treatment failure was found to be resistance to one or more of the antibiotics. Clarithromycin resistance to H pylori was associated with point mutations in the 23S rRNA gene and the PCR-RFLP method can detect these point mutations. The aim of this study was to determine the molecular detection of genotypic clarithromycinresistant strains and its effect on the eradication rate of concomitant therapy in H pylori infection. The presence of H pylori DNA was confirmed by amplifying the UreC gene by polymerase chain reaction (PCR) and point mutations on 23S rRNA (A2142G and A2143G) were detected by PCR-RFLP. A total of 98 H pylori-infected patients were involved and among them, genotypic clarithromycin-sensitive strain was 93.9% and clarithromycin-resistant strain was 6.1%. All patients were found to have the A2143G point mutation but A2142G was not detected. Successful eradication rate of concomitant therapy was found to be 89.8% and unsuccessful rate was 10.2%.Among patients with the clarithromycin-resistant gene, only 16.7% had successful eradication and 83.3% had unsuccessful eradication. There was a statistically significant association between failure rate of concomitant therapy and detection of clarithromycin-resistant genes (P < 0.01). The presence of A2143G point mutation in the clarithromycin-resistant strain has a negative effect on the eradication rate of H pylori infection.How to cite this article: Nyi KN, Soe AM, Htut ZM. Molecular detection of genotypic clarithromycin-resistant strains and its effect on the eradication rate of concomitant therapy in
As Helicobacter pylori infection is highly prevalent estimated to be affecting more than 50% of the world's populations and implicated in the pathogenesis of several gastric diseases including gastric cancer, early detection of infection even before symptoms appears to be one of the most important strategies in management. This study was aimed to detect infection by 14 C urea breath test and to describe the risk factors in asymptomatic adults at Kanbauk village-tract, located in Southern Myanmar. It was a community-based, cross-sectional prevalence study conducted between 4 and 9 October 2019. After thorough history taking, physical examination, obtaining informed consent, and fasting for 5 h, H pylori infection was detected by 14 C urea breath testing. Among 149 volunteers, infection was detected in 68.46% of the study population. The prevalence of H pylori infection in male patients was 66.7% and in female patients was 75%. There was no statistically significant association between H pylori infection and gender (P = 0.36). The mean age of H pylori infected patients was 37.4 years (SD ± 9.14) and it did not differ significantly (P = 0.421). Subjects who never attended government school were found out to have a significant association with H pylori infection (P = 0.006). Other factors such as family income, household numbers, smoking, betel chewing habit, alcohol consumption, BMI and blood groups were found to be no significant risk factors for H pylori infection. The prevalence of H pylori in Kanbauk village tract was comparable to two different community studies conducted in Myanmar.
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