Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

Çağan-Appak, Yeliz; Gazi, Hörü; Ayhan, Semin; Cengiz-Özyurt, Beyhan; Kurutepe, Semra; Kasırga, Erhun

doi:10.24953/turkjped.2016.04.004

Cited by 6 publications

(2 citation statements)

References 18 publications

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“…23 H. pylori strains were found to carry A2143G, A2142G, A2147G and A2146G mutations that can lead to clarithromycin-resistance in Africa, Asia, South America, Europe and North America. [24][25][26][27][28][29][30] The T2183C and A2223G transformations have been frequently found to be the cause of observed clarithromycin resistance in Asian countries than those in Europe and North America, 31 but not be observed in our study. In addition to these mutations, other mutations in different positions have been found in other parts of the world to confer clarithromycin resistance in H. pylori strains (T2182C, T2190C, C2195T, A2223G, G2141A, C2694A, G2224A, C2245T, T2289C).…”

Section: Discussioncontrasting

confidence: 62%

Mutations in the Antibiotic Target Genes Related to Clarithromycin, Metronidazole and Levofloxacin Resistance in Helicobacter pylori Strains from Children in China

Zhang

Wen

Xiao

et al. 2020

IDR

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Purpose: This study aimed to characterize common mutations of antibiotic-resistant gene of clarithromycin, metronidazole and levofloxacin in Helicobacter pylori (H. pylori) and determine their association with antibiotic resistance of H. pylori for providing a strategy for eradication therapy of H. pylori infection in children. Patients and Methods: The antibiotic resistance to clarithromycin, metronidazole and levofloxacin for H. pylori strains isolated from children was determined by E-test. The mutation of domain V of 23S rRNA, rdxA and frxA genes, gyrA and gyrB genes was performed by PCR-based sequencing of DNA fragments. Results: Out of the 79 H. pylori strains examined, 66 (83.5%) were resistant to at least one of the tested antibiotics and 13 (16.5%) were fully sensitive. A total of 29 (36.7%) strains were resistant to clarithromycin. Analysis of the 23S rRNA gene showed that most mutations occurred at the A2143G and T2182C sites, showing a frequency of 82.8% (24/29) and 89.7% (26/29) respectively. In the 11 sensitive strains to clarithromycin, the frequency of A2143G mutation was only 45.5%, which was significantly lower than that in resistant strains (P<0.05). There were 54 strains (68.4%) resistant to metronidazole, with most mutations occurring at G47A and T184G in the rdxA gene. T184G mutation was recognized in metronidazole-sensitive strains, but no G47A mutation was identified. Twelve strains (15.2%) were resistant to levofloxacin. Position 91 mutation of the gyrA gene occurred only in resistant strains, whereas position 87 mutations were detected in both sensitive and resistant strains to levofloxacin. Conclusion: In H. pylori resistant strains isolated from children in China, most mutations occurred at A2143G of the 23S rRNA gene for clarithromycin; G47A mutation of rdxA gene for metronidazole; and at 91 mutation of gyrA gene for levofloxacin. It is suggested that susceptibility testing together with screening the mutation of antimicrobial-resistant gene prior to treatment is important for the eradication of H. pylori in children.

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Section: Discussioncontrasting

confidence: 62%

Mutations in the Antibiotic Target Genes Related to Clarithromycin, Metronidazole and Levofloxacin Resistance in Helicobacter pylori Strains from Children in China

Zhang

Wen

Xiao

et al. 2020

IDR

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“…In another Turkish study, Çagan-Appak et al [ 36 ] reported resistance to clarithromycin in gastric biopsies of 19/200 (9.5%) children with dyspepsia and abdominal pain; 10/19 (52.6%) had A2143G mutations, and 9/19 (47.4%) had A2142G mutations. There were no A2142C mutations.…”

Section: Discussionmentioning

confidence: 99%

Detection of A2143G, A2142C, and A2142G Point Mutations with Real-Time PCR in Stool Specimens from Children Infected with Helicobacter pylori

Gareayaghi

Kocazeybek

2022

Diagnostics

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Reports have indicated an increasing prevalence of clarithromycin resistance in children relative to adults. Thus, it is important to investigate primary clarithromycin resistance before therapy to avoid treatment failure. A2142G, A2143G, and A2142C point mutations in the peptidyltransferase region of the 23S ribosomal RNA (rRNA) of Helicobacter pylori (H. pylori) strains isolated from children with gastrointestinal symptoms and asymptomatic children were evaluated via real-time polymerase chain reaction (RT-PCR) using fecal DNA samples. The presence of H. pylori was determined using a fecal H. pylori antigen enzyme-linked immunosorbent assay (ELISA) kit from the stools of children (n = 543). A2143G, A2142C, and A2142G point mutations were detected via RT-PCR and confirmed by sequencing the 23S rDNA. Fecal H. pylori antigen testing was positive in 101 symptomatic (49) and asymptomatic (52) children. A significant difference was found between the 0–5- and 5–18-year-old groups in terms of the A2143G and A2142G point mutations (p = 0.001). The A2142C mutation was not detected. There was a significant difference in the A2143G mutation between the symptomatic and asymptomatic 5–18-year-old children (p = 0.019). Macrolides are frequently used to treat upper respiratory tract infections in children due to their selective pressure effect. We suggest that H. pylori strains carrying mutations in the 23S RNA subunit conferring clarithromycin resistance may lead to an intense inflammatory response in the gastric epithelial cells, allowing them to proliferate more rapidly and causing possible diarrhea, halitosis, or abdominal pain in children.

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Antibiotic Resistance of Helicobacter pylori in Turkey: A Systematic Review and Meta-Analysis

Ayas

Gürol

2023

Microbial Drug Resistance

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Clarithromycin resistance and 23S rRNA gene point mutations of Helicobacter pylori infection in children

Cited by 6 publications

References 18 publications

<p>Mutations in the Antibiotic Target Genes Related to Clarithromycin, Metronidazole and Levofloxacin Resistance in <em>Helicobacter pylori</em> Strains from Children in China</p>

<p>Mutations in the Antibiotic Target Genes Related to Clarithromycin, Metronidazole and Levofloxacin Resistance in <em>Helicobacter pylori</em> Strains from Children in China</p>

Detection of A2143G, A2142C, and A2142G Point Mutations with Real-Time PCR in Stool Specimens from Children Infected with Helicobacter pylori

Antibiotic Resistance of Helicobacter pylori in Turkey: A Systematic Review and Meta-Analysis

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