Genotypic determination of resistance and heteroresistance to clarithromycin in Helicobacter pylori isolates from antrum and corpus of Colombian symptomatic patients

Arévalo-Jaimes, Betsy Verónica; Rojas-Rengifo, Diana F.; Molano, Belén Mendoza de; Vera-Chamorro, José Fernando; Delgado, María del Pilar

doi:10.1186/s12879-019-4178-x

Cited by 15 publications

(14 citation statements)

References 22 publications

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“…H. pylori can cause peptic ulcer disease and chronic gastritis ( Vazirzadeh et al, 2020 ). Furthermore mucosa-associated lymphoid tissue and gastric cancer are associated with this microorganism ( Arévalo-Jaimes et al, 2019 ). For these reasons, the WHO has announced H. pylori to be a class I carcinogen.…”

Section: Introductionmentioning

confidence: 99%

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods

Hussein

Al-Ouqaili

Majeed

2022

Saudi Journal of Biological Sciences

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Background and objectives Peptic ulcer disease, chronic gastritis, and stomach cancer are all caused by H. pylori . The most notable drug for the treatment is the antibiotic clarithromycin, which is currently the drug of choice. H. pylori clarithromycin resistance has been associated with point mutations in 23srRNA, the most prominent of which are A2143 and A2144G . In H. pylori bacteria, methylase synthesis, macrolide-inactivating enzyme activity, and active efflux have all been found to be resistance mechanisms. The goal of the study is to determine how resistant H. pylori is to clarithromycin and what the minimum inhibitory concentration is for various antimicrobials. Furthermore, gastro-endoscopy will be performed on Iraqi patients to detect the presence of A2143G and A2144G point mutations in Helicobacter pylori infections, as diagnosed from the pyloric region and other anatomical regions. Methods One hundred fifteen samples were collected from patients strongly suspected of H. pylori infection presented for upper gastrointestinal endoscopy at Ramadi Teaching Hospitals and Private Clinics for the period from January 2020 until February 2021. Specimens were cultured on brain heart infusion agar containing various antibiotics and were incubated at 37 °C under microaerophilic conditions. For identification of H. pylori, isolates of the biochemical tests and RT-PCR assay were applied. The Epsilometer test was used in the antibiotic susceptibility testing as dependent on the CLSI standard. The Restriction Fragment Length Polymorphism technique was used to determine point mutations. Results In total, 55 (47.8%) Helicobacter pylori isolates were cultured from the 115 biopsy specimens, among which 16 (29.1%), 38 (69.1%), 20 (36.4%), and 40 (72.7%) revealed some degree of resistance to levofloxacin, clarithromycin, ciprofloxacin, and metronidazole, respectively. The frequency of A2144G and A2143 point mutations were 23 (60.5%) and 19 (50%), respectively. Conclusions According to our results , Helicobacter pylori showed high resistance to clarithromycin. Our results demonstrate the requirement for antibiotic susceptibility testing and molecular methods in selecting drug regimens.

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Section: Introductionmentioning

confidence: 99%

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods

Hussein

Al-Ouqaili

Majeed

2022

Saudi Journal of Biological Sciences

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“…In the case of untreated and prolonged infection, H. pylori can cause peptic ulcer disease (PUD) and chronic gastritis (CG). Furthermore, neoplastic processes such as mucosa-associated lymphoid tissue (MALT) and gastric cancer (GC) are associated with this microorganism [3,4]. The International Agency for Research on Cancer classified H. pylori as class I carcinogen in 1994 [5].…”

Section: Introductionmentioning

confidence: 99%

Molecular Assessment of Resistance to Clarithromycin in Helicobacter pylori Strains Isolated from Patients with Dyspepsia by Fluorescent In Situ Hybridization in the Center of Iran

Vazirzadeh

Falahi

Moghim

et al. 2020

BioMed Research International

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Background and Aims. Helicobacter pylori is a common infectious bacterium mostly found in gastroduodenal diseases. The increased prevalence of clarithromycin-resistant H. pylori strains is a major challenge in the successful treatment of infections caused by this organism. The present study is aimed at detecting the clarithromycin resistance pattern of H. pylori strains isolated from gastric biopsies and evaluating point mutations of the 23S rRNA gene. Patients and methods. In the present descriptive cross-sectional study, 165 patients with gastrointestinal disorders, who were referred to the Endoscopy Center of Dr. Shariati Hospital of Isfahan, Iran, were enrolled from April to July 2018. H. pylori infection was diagnosed by culture, and susceptibility of the isolates to clarithromycin was assessed by the E-test. Minimum inhibitory concentration (MIC) values were obtained based on EUCAST recommendations. Also, fluorescence in situ hybridization (FISH) was used to determine point mutations associated with clarithromycin resistance. Results. By using culturing, H. pylori was isolated from 50.3% (83/165) gastric biopsy specimens. The overall frequency of resistance to clarithromycin was 25.3% (21/83) by the E-test. In the resistance genotypic analysis, 19 isolates had mutations. The prevalence of A2143G and A2144G mutations was 68.4% (13/19) and 31.5% (6/19), respectively. A2143C mutation was not tracked in any isolate. Two isolates with MIC > 0:5 μg/mL had no mutations that could be related to other mechanisms of resistance. Conclusion. As presented in the study, the high prevalence of clarithromycin-resistant H. pylori due to point mutations of the 23S rRNA gene indicates the necessity of revising the standard treatment regimen based on antibiotic susceptibility pattern of each region.

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“…По результатам 13-летнего ретроспективного исследования на севере Испании первичная устойчивость бактерии к кларитромицину составляет на уровне 19% [31], а у колумбийских симптомных больных -38,1%. Авторы судили об устойчивости бактерии по наличию мутаций в гене рРНК НР 23S при исследовании 126 биоптатов из антрального отдела и тела желудка [32].…”

Section: Discussionunclassified

Experience of Chita the program of the Scientific Society of Gastroenterologists of Russia and Russian Scientific Medical Society of Internal Medicine “Physicians without helicobacteriosis”

Luzina

Лазебник

Lareva

et al. 2020

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Objective. To determine the prevalence of Helicobacter pylori (HP) in doctors in Chita, to identify clinical manifestations of infection, endoscopic, ultrasound and morphological changes in the stomach, to conduct eradication treatment with an assessment of its effectiveness, to determine the resistance of HP to clarithromycin and to develop treatment tactics for HP-associated diseases in the region.Material and methods. 70 doctors of Chita were examined, including 55 women and 15 men, average age 47.04±12.76 years (20 persons were 39 years and younger, 33 persons were 40–59 years, 17 people were 60 years and older; 27 persons were gastroenterologists, 17 — therapists, 11 — pediatricians, 5 — surgeons and 10 persons were doctors of other specialties). All doctors underwent antigen (AH) of HP determination in feces, a survey on the original questionnaire to assess clinical manifestations. Ultrasound examination of the stomach was performed in 47 doctors. Endoscopy of the upper gastrointestinal tract (GI) was performed in 35 persons. During endoscopy, in 29 doctors biopsy material of the mucous membrane from 5 points of the stomach were taken. A histological examination of biopsy samples was performed with an assessment using the OLGA system. The resistance of HP to clarithromycin was determined by the molecular genetic method in biopsy samples of gastric biopsy. 44 doctors conducted eradication with different schemes. Adverse events (AE) and treatment tolerance were evaluated. Control of eradication was carried out 6–8 weeks after the end of therapy by determining AH of HP in the feces. Statistical processing was carried out using the method of descriptive statistics, criterion of Student and criterion x2 (Biostatprogramm).Results. A positive AH of HP in feces was registered in 71.4% of the doctors examined: 73.3% of men and 70.9% of women, 75% of people under the age of 39 years, 72.7% of those aged 40–59 years and 64.7% are over 60 years old. Gastroenterologists were infected in 63%, therapists in 70.6%, pediatricians in 72.7%, surgeons in 80%, another specialists in 90% of cases. In the presence of HP, 81.6% of the examined showed symptoms from the digestive organs, 3 times more often a hereditary history of stomach cancer was determined. The wall thickness of the stomach during ultrasound in the infected was recorded 0.21–0.18 mm more than in the group of HP-negative individuals. A histological examination of III–IV degree of activity of inflammation in the stomach was diagnosed in 86.1%, stage III atrophy and colonic metaplasia in 20.7% of the examined doctors. The desire to conduct eradication treatment was expressed by 78% of doctors, 44 people completed the therapy. Non-compliance with the eradication regimen was noted in 9 people. AE were registered in 76.6% of cases. The efficacy of all regimens was 71.4%: when using the regimen with clarithromycin — 73%, with josamycin — 100%, with tetracycline and metronidazole — 33%, with levofloxacin — 100%. HP DNA was detected in 27 samples of gastric. In 10 cases, mutations A2142G and A2143G in the HP genome were detected, providing resistance to clarithromycin, which amounted to 37%.Conclusion1. 71.4% of doctors in Chita are infected with HP, among which the bacterium is most often detected at a young age (39 years and younger).2. Infected doctors are more likely to have gastrointestinal symptoms, a history of gastric damage, and hereditary gastric cancer.3. In 20.7% of doctors, histological examination revealed colonic metaplasia and dysplasia, which confirms the need for treatment and requires further observation.4. Only 78% of Chita doctors expressed their readiness to eradicate HP, and 20.4% of those who started treatment did not comply with the treatment regimen. This fact requires further educational activities.5. The efficacy of eradication by all schemes was 71.4%. Genotypic resistance of HP to clarithromycin was found in 37% of doctors. Further studies are needed to identify the characteristics of the macro- and microorganism (genetic polymorphism of enzymes, HP mutations) in groups, both among doctors and other categories of patients who do not have professional contacts with microorganisms and antibiotics in order to develop recommendations on the use of HP eradication schemes in region.

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Genotypic determination of resistance and heteroresistance to clarithromycin in Helicobacter pylori isolates from antrum and corpus of Colombian symptomatic patients

Cited by 15 publications

References 22 publications

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods

Molecular Assessment of Resistance to Clarithromycin in Helicobacter pylori Strains Isolated from Patients with Dyspepsia by Fluorescent In Situ Hybridization in the Center of Iran

Experience of Chita the program of the Scientific Society of Gastroenterologists of Russia and Russian Scientific Medical Society of Internal Medicine “Physicians without helicobacteriosis”

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