Evolution of resistance to metronidazole and clarithromycin in Helicobacter pylori clinical isolates from Spain

López-Brea, M; Domingo, Diego; Sánchez, Isabel Martínez; Alarcón, Teresa

doi:10.1093/jac/40.2.279

Cited by 66 publications

(39 citation statements)

References 7 publications

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“…These Tc r determinants are often associated with transmissible genetic elements such as plasmids, transposons and integrons (8). In the case of H. pylori, Tc r is not observed as frequently as in other species (17,19,23). However, tetracycline-resistant H. pylori isolates have started to emerge, and their prevalence is increasing, especially in Asian countries such as China, Korea, and Japan (15,16,26).…”

mentioning

confidence: 99%

16S rRNA Mutations That Confer Tetracycline Resistance inHelicobacter pyloriDecrease Drug Binding inEscherichia coliRibosomes

Nonaka¹,

Connell

Taylor

2005

J Bacteriol

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Tetracycline resistance in clinical isolates of Helicobacter pylori has been associated with nucleotide substitutions at positions 965 to 967 in the 16S rRNA. We constructed mutants which had different sequences at 965 to 967 in the 16S rRNA gene present on a multicopy plasmid in Escherichia coli strain TA527, in which all seven rrn genes were deleted. The MICs for tetracycline of all mutants having single, double, or triple substitutions at the 965 to 967 region that were previously found in highly resistant H. pylori isolates were higher than that of the mutant exhibiting the wild-type sequence of tetracycline-susceptible H. pylori. The MIC of the mutant with the 965TTC967 triple substitution was 32 times higher than that of the E. coli mutant with the 965AGA967 substitution present in wild-type H. pylori. The ribosomes extracted from the tetracycline-resistant E. coli 965TTC967 variant bound less tetracycline than E. coli with the wild-type H. pylori sequence at this region. The concentration of tetracycline bound to the ribosome was 40% that of the wild type. The results of this study suggest that tetracycline binding to the primary binding site (Tet-1) of the ribosome at positions 965 to 967 is influenced by its sequence patterns, which form the primary binding site for tetracycline.

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mentioning

confidence: 99%

16S rRNA Mutations That Confer Tetracycline Resistance inHelicobacter pyloriDecrease Drug Binding inEscherichia coliRibosomes

Nonaka¹,

Connell

Taylor

2005

J Bacteriol

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“…In adults, the rate of resistance of H. pylori to clarithromycin before treatment is largely less, amounting to 0 to 10% in European and North American countries, averaging 1% in The Netherlands, 3.5% in Spain, 5% in Ireland, and 6% in the United States, with the highest rate (10%) occurring in France (3,12,20). This disparity in resistance rates seems to be correlated to the national level of macrolide consumption, since a crossover resistance mechanism among different types of macrolides develops rapidly (3).…”

mentioning

confidence: 99%

High Levels of Resistance to Metronidazole and Clarithromycin in Helicobacter pylori Strains in Children

Kalach¹,

Bergeret

Benhamou³

et al. 2001

J Clin Microbiol

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The aim of the study was to evaluate the prevalence of resistance to amoxicillin, metronidazole, and clarithromycin before treatment of Helicobacter pylori infection in children and to assess the evolution of resistance with time. The study was carried out between 1994 and 1999 with 150 H. pylori-positive children through gastric culture (antimicrobial susceptibility) and histology. All cultured H. pylori strains were sensitive to amoxicillin, 64 (43%) were resistant to metronidazole, 32 (21%) were resistant to clarithromycin, and 14 (9%) were resistant to both metronidazole and clarithromycin. The overall prevalence of resistance to metronidazole and clarithromycin did not change significantly with time. The study highlights the generalized high-level and stable metronidazole and clarithromycin resistance of H. pylori strains from children.The role of Helicobacter pylori in the colonization of the stomach in adults and children with chronic gastritis, peptic ulcer, and possibly gastric carcinoma is now documented (16). Eradication of the bacterium has a great effect on prevention of peptic ulcer relapses in both adults (9) and children (23; N. Kalach, J. Raymond, P. H. Benhamou, M. Bergeret, and C. Dupont, Letter, Clin. Microbiol. Infect. 5:235-236, 1999).The great jump in the understanding of the diseases mentioned above was accompanied by progressive evidence of the antibiotic resistance phenomenon, first reported for clarithromycin (21), a macrolide that partially carries crossover resistance to other antibiotics belonging to the same class (6). Resistance now involves antibiotics previously devoid of any resistance issues for that bacterium, such as amoxicillin, to which resistance sometimes occurs at a high level (4), largely challenging physicians at the present time (8). One important point is that antibiotic treatment of H. pylori involves drugs largely in use for other kinds of infections. For that reason, analysis of the resistance phenomenon must probably take into account a half century of coexistence between antibiotic habits and this parasitic bacterium, emphasizing the importance of analyzing both geographical variations and evolution with time (7).The purpose of our study was to evaluate the prevalence of resistance to amoxicillin, metronidazole, and clarithromycin before treatment of H. pylori infection in children and to assess the evolution of resistance with time compared to those from reference studies with both adults and children.A prospective study was carried out from January 1994 to July 1999 with 150 H. pylori-positive children (76 girls and 74 boys) aged 11.25 Ϯ 3.9 years (mean Ϯ 1 standard deviation [SD]; range, 1.75 to 18 years). Infection was proved by upper gastrointestinal endoscopy for retrieval of gastric antral biopsy specimens in the course of diagnostic evaluation of clinical gastritis, manifested by recurrent abdominal pain for at least 3 months, nausea, and vomiting. Informed consent from the parents was obtained. Children who had already suffered gastric H. pylori infect...

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“…Furthermore, in many reports, study populations are too small, both overall and for each year examined, to allow meaningful conclusions to be reached. This is the case for many studies that show possible increased rates of CLA resistance [2][3][4]. While some larger studies have also demonstrated increasing trends in CLA resistance in Europe [5] and the USA [6], others showed no such increase [7,8].…”

Section: In October 2005 Robert Warren and Barrymentioning

confidence: 97%

From Nobel to no cure: a case for monitoring antibiotic resistance in the gastric pathogenHelicobacter pylori

Chisholm¹,

Owen²

2006

Expert Review of Anti-infective Therapy

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Evolution of resistance to metronidazole and clarithromycin in Helicobacter pylori clinical isolates from Spain

Cited by 66 publications

References 7 publications

16S rRNA Mutations That Confer Tetracycline Resistance inHelicobacter pyloriDecrease Drug Binding inEscherichia coliRibosomes

16S rRNA Mutations That Confer Tetracycline Resistance inHelicobacter pyloriDecrease Drug Binding inEscherichia coliRibosomes

High Levels of Resistance to Metronidazole and Clarithromycin in Helicobacter pylori Strains in Children

From Nobel to no cure: a case for monitoring antibiotic resistance in the gastric pathogenHelicobacter pylori

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