Helicobacter pylori Virulence Factors and Clarithromycin Resistance-Associated Mutations in Mexican Patients

Alarcón‐Millán, Judit; Bonilla-Delgado, José; Fernández‐Tilapa, Gloria; Nieto-Velázquez, Nayeli Goreti; Sierra-Martínez, Mónica; Alvarado-Castro, Víctor Manuel; Cortés-Malagón, Enoc Mariano

doi:10.3390/pathogens12020234

Cited by 4 publications

(3 citation statements)

References 61 publications

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“…Additionally, several point mutations in the 23 s rRNA gene of H. pylori are associated with CLA resistance 38–40 . Through Sanger sequencing, we identified a high rate (98.4%) of a unique mutation at the A2143G nucleotide position.…”

Section: Discussionmentioning

confidence: 96%

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Antibiotic resistance and heteroresistance in Helicobacter pylori isolates from symptomatic Vietnamese children: A prospective multicenter study

Nguyen

Pham

et al. 2023

Helicobacter

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BackgroundAntibiotic resistance of Helicobacter pylori (H. pylori) is increasing worldwide, with geographical variations, impacting the treatment outcomes. This study assessed the antibiotic resistance patterns of H. pylori in Vietnamese children.Materials and MethodsSymptomatic children undergoing gastroduodenoscopy at two tertiary Children's Hospitals in Ho Chi Minh City were recruited. Antral and corpus biopsies were obtained and cultured separately. Susceptibility to amoxicillin (AMO), clarithromycin (CLA), metronidazole (MET), levofloxacin (LEV), and tetracycline (TET) was determined using E‐test. Polymerase chain reaction was performed on another antral biopsy to detect the urease gene, cytotoxin‐associated gene A (cagA), vacuolating cytotoxin A (vacA) genotypes, and 23S rRNA mutations conferring CLA resistance.ResultsAmong 123 enrolled children, a high primary resistance rate was found for CLA (68.5%, 61/89), followed by LEV (55.1%), MET (31.5%), AMO (25.8%), and TET (1.1%). Secondary resistance rates were 82.1% (7/28), 71.4%, 53.6%, and 3.6% for CLA, LEV, MET, and TET, respectively. Multidrug resistance was frequent (67.7%), with common patterns including CLA + LEV (20.3%) and CLA + MTZ + LEV (15.2%). Heteroresistance was detected in eight children (6.5%). The A2143G mutation was detected in 97.5% (119/122) of children. 86.1% of children had positive cagA strains and 27.9% had multiple vacA genotypes. No factor was significantly associated with antibiotic resistance.ConclusionsThe alarming rate of antibiotic resistance for H. pylori, especially for CLA, with emerging multi‐ and hetero‐resistant strains, pose a major treatment challenge that precludes CLA use as empirical therapy. Biopsies from both antrum and corpus can improve H. pylori culture, allowing tailored treatment based on antimicrobial susceptibility.

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Section: Discussionmentioning

confidence: 96%

“…Additionally, several point mutations in the 23 s rRNA gene of H. pylori are associated with CLA resistance. [38][39][40] TA B L E 1 Characteristics of the H. pylori-infected patients with and without antimicrobial susceptibility testing results.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance and heteroresistance in Helicobacter pylori isolates from symptomatic Vietnamese children: A prospective multicenter study

Nguyen

Pham

et al. 2023

Helicobacter

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“…The prevalence of mutations associated with resistance to clarithromycin was more than 15%. Between the mutation A2142G and the vacA s1m1/cagA+ genotype, a significant association (p < 0.05) was found [30]. Medical practice errors in diagnosis and prescribing eradication treatment are another important risk factor for increased antibiotic resistance.…”

Section: Risk Factors For the Resistance Of Helicobacter Pylori To An...mentioning

confidence: 98%

Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review)

Mladenova

2023

Antibiotics

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Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide and one of the main etiological factors of chronic gastritis, peptic ulcer disease, and stomach neoplasms. The mass application of antibiotics without testing, especially during the last years of the pandemic of SARS-CoV-2, could lead to a dramatic increase in antibiotic resistance and reduced effectiveness of eradication regimens for H. pylori infection. The epidemiology of H. pylori resistance to antibiotics still has unclear mechanisms. Antibiotic policy should be intensified to optimize treatment, and regular monitoring of resistance of H. pylori in different geographical regions should be conducted. Individualized treatment according to susceptibility testing is strongly advisable, and the best treatment regimens should be selected. The mutations in the genes encoding the antibiotic target protein are significant risk factors for H. pylori resistance. Iatrogenic errors in diagnosis and prescribing treatment for the failure of H. pylori eradication are other important risk factors. The low level of awareness and compliance with the correct treatment influence the rate of H. pylori resistance. Epidemiological surveillance of antibiotic resistance and the adoption of new treatment strategies are needed. The discovery of an efficient vaccine against H. pylori could reduce the pressure of the world’s growing antibiotic resistance.

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Factors associated with treatment failure, and possible applications of probiotic bacteria in the arsenal againstHelicobacter pylori

Miri

Kamankesh

Rad‐Malekshahi

et al. 2023

Expert Review of Anti-infective Therapy

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Helicobacter pylori Virulence Factors and Clarithromycin Resistance-Associated Mutations in Mexican Patients

Cited by 4 publications

References 61 publications

Antibiotic resistance and heteroresistance in Helicobacter pylori isolates from symptomatic Vietnamese children: A prospective multicenter study

Antibiotic resistance and heteroresistance in Helicobacter pylori isolates from symptomatic Vietnamese children: A prospective multicenter study

Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review)

Factors associated with treatment failure, and possible applications of probiotic bacteria in the arsenal againstHelicobacter pylori

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