High efficacy of gemifloxacin-containing therapy in Helicobacter Pylori eradication

Mahmoudi, Laleh; Farshad, Shohreh; Seddigh, Mehrdad; Mahmoudi, Paria; Ejtehadi, Fardad; Niknam, Ramin

doi:10.1097/md.0000000000004410

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…Our study revealed that 50.2% of our population were H. pylori positive, which was lower and at the same time higher compared to local and international studies. H. pylori infection causes a spectrum of both gastric and extra gastrointestinal diseases with acute and chronic gastritis, peptic ulcer disease, gastric atrophy, intestinal metaplasia, MALT lymphoma, and gastric adenocarcinoma 21…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori, Endoscopic, And Histologic Features Among Kidney Transplant Candidates In Southern Iran

Niknam¹,

Barfei²,

Mahmoudi³

2019

IDR

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BackgroundThe risks of gastrointestinal disorders and cancer are higher in chronic kidney disease (CKD) patients than the general population. There are only a few published reports on the association of helicobacter pylori (H. pylori) infection, endoscopic findings, and histology in these patients. This study was designed to address these controversial topics among kidney transplant candidates as the first study in southern Iran.Patients and methodsIn this cross-sectional study, patients undergoing renal transplantation in the largest center of southern Iran during 2016–2017 were evaluated for the frequency of H. pylori infection, endoscopic findings, and histology. Gastric endoscopic findings (normal, abnormal non-ulcerative, ulcerative) and histological findings of gastric biopsy (normal/non-significant, inflammation, premalignant lesions (PMLs), malignant lesions) were studied.ResultsIn total, 293 patients underwent endoscopy for transplant work up. The mean age (SD) was 47.37 (13.14) years. The most common endoscopic finding was abnormal gastric lesions. Overall, 78.8% patients had abnormal gastric histologic findings, of which 6.1% had PMLs. There was no significant association between laboratory data of patients with H. pylori infection. Of these, 147 (50.2%) patients were positive and the others were H. Pylori negative. Positive H. pylori infection was significantly associated with gastric ulcerative lesions. Positive H. pylori infection was also strongly associated with inflammation (P<0.01), but not significantly associated with PMLs (P=0.99) in gastric histology.ConclusionThe present study showed that abnormal endoscopic and histologic findings as well as positive H. pylori infection were observed in a large number of kidney transplant candidates, so upper endoscopy with biopsy is an acceptable procedure for these patients. However, further studies are recommended to determine the relationship of H. pylori with abnormal endoscopic and histologic findings considering other confounding factors in kidney transplant candidates as well as the efficacy of H. pylori eradication therapy to improve these abnormal findings.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori, Endoscopic, And Histologic Features Among Kidney Transplant Candidates In Southern Iran

Niknam¹,

Barfei²,

Mahmoudi³

2019

IDR

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“…In addition, it has been reported that stool antigen test is a sensitive and specific mean to diagnose and screen the H. pylori infection (15). Different therapeutic regimen for eradication of H. pylori has been suggested due to antibiotic resistance of this infection (6,16).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Helicobacter pylori in Southern Part of Iran

Niknam¹,

Fattahi²,

Sepehrimanesh³

et al. 2018

Jundishapur J Microbiol

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Background: There are clear variations between and within countries regarding the prevalence of Helicobacter pylori. In addition, there are no estimations of its prevalence in the general population in the south of Iran. Objectives: We aimed to evaluate the prevalence of H. pylori in the rural population of Kavar, a southern city of Iran. Methods: A random sample of 500 individuals were selected from the Kavar cohort study. Serum total IgG against H. pylori was checked. The serum positive patients recalled for stool sampling and the H. pylori stool antigen was checked using sandwich ELISA. Moreover, age and gender were recorded for all patients. Results: Among the remained 441 who participated, 254 patients (57.6%) were positive for serum IgG. A total of 14 patients (5.5%) gave up due to stool sampling unsatisfaction. Overall, the rate of H. pylori infection based on both serum IgG and stool Ag of H.

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“…In agreement with these findings, a high‐efficiency eradication rate (≥90% PP cure rate) is documented for gemifloxacin‐containing quadruple therapy regimens, which recommend it as a component of second‐line treatment. The abovementioned findings can be in part explained by our study, which demonstrated better overall interactions of MXN and GXN, in comparison with LVX, on mutated H pylori GyrA.…”

Section: Discussionmentioning

confidence: 99%

New insights into resistance of Helicobacter pylori against third‐ and fourth‐generation fluoroquinolones: A molecular docking study of prevalent GyrA mutations

et al. 2019

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Background: Fluoroquinolones hinder bacterial DNA replication by inhibiting DNA gyrase. However, mutations, in the QRDR segment of its A subunit (GyrA), cause antibiotic resistance. Here, the interactions of levofloxacin (LVX), gemifloxacin (GXN), and moxifloxacin (MXN) with Helicobacter pylori GyrA, in LVX-resistant vs -sensitive strains, were studied. Methods: Levoflixacin-sensitive (n = 4) and -resistant (n = 9) H pylori strains, randomly selected from another antibiotic susceptibility study, underwent PCR amplification of gyrA gene, spanning the QRDR segment. The amplified gene fragments were sequenced and aligned. The homology model of H pylori GyrA was built based on that of Escherichia coli, and energy minimization was done. The interaction patterns of LVX, GXN, and MXN with GyrA were analyzed via molecular docking studies. Results: Sequence alignment of the 13 studied strains, created 5 categories of strains: (A) wild type-like (H pylori ATCC26695), (B) N87K-only, (C) D91N-only, (D) N87K + V94L, and (E) D91N + A97V mutations. The minimum inhibitory concentrations (MIC) for LVX-sensitive (category A) and -resistant (categories B-E) strains were <1 mg/L and ≥32 mg/L, respectively. The binding mode of GyrA in category A withLVX identified G35/N87/Y90/D91/V94/G114/S115/I116/D117/G118/D119, as key residues, some residing outside the QRDR segment. Category B strains lost only one interaction (G35), which led to elevated binding free energy (∆G) and full LVX resistance. Categories C-E lost more contacts, with higher ∆G and again full LVX resistance. GXN bound to GyrA of categories A and B via a different set of key residues, while MXN retained the lost contact (G35) in LVX-resistant, category B strains. Conclusion:Using molecular docking tools, we identified the key residues responsible for interaction of GyrA with LVX, GXN, and MXN. In the presence of N87K-only mutation, the loss of one of these contacts (ie, G35) led to full LVX resistance. Yet, GXN and MXN overcame this mutation, by retaining all key contacts with GyrA.

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High efficacy of gemifloxacin-containing therapy in Helicobacter Pylori eradication

Cited by 12 publications

References 31 publications

<p><em>Helicobacter pylori</em>, Endoscopic, And Histologic Features Among Kidney Transplant Candidates In Southern Iran</p>

<p><em>Helicobacter pylori</em>, Endoscopic, And Histologic Features Among Kidney Transplant Candidates In Southern Iran</p>

Prevalence of Helicobacter pylori in Southern Part of Iran

New insights into resistance of Helicobacter pylori against third‐ and fourth‐generation fluoroquinolones: A molecular docking study of prevalent GyrA mutations

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