High primary resistance to metronidazole and levofloxacin, and a moderate resistance to clarithromycin in Helicobacter pylori isolated from Karnataka patients

Shetty, Vignesh; Lamichhane, Binit; Tay, Chin Yen; Pai, Girish K; Ramachandra, Lingadakai; Balaraju, Girisha; Shetty, Shiran; Ballal, Mamatha; Chua, Eng Guan

doi:10.1186/s13099-019-0305-x

Cited by 42 publications

(46 citation statements)

References 33 publications

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“…28 Moreover, the strategy employed by H pylori for clarithromycin resistance has been elucidated mainly due to mutations at nucleotide positions (A2142G, A2143G, A2142C, A2146, A2147G, and G2224A) in the 23S rRNA. [29][30][31] Despite high prevalence of H pylori in Bangladesh, little is known about the local lineages or the local prevalence of particular genotypes for cagA or vacA and babA genotypes and any associations with disease severity. 32 Therefore, this study was directed to evalu-…”

Section: Introductionmentioning

confidence: 99%

A comparative whole genome analysis of Helicobacter pylori from a human dense South Asian setting

et al. 2020

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Helicobacter pylori, a Gram‐negative bacterium, is associated with a wide range of gastric diseases such as gastritis, duodenal ulcer, and gastric cancer. The prevalence of H pylori and risk of disease vary in different parts of the world based on the prevailing bacterial lineage. Here, we present a contextual and comparative genomics analysis of 20 clinical isolates of H pylori from patients in Bangladesh. Despite a uniform host ethnicity (Bengali), isolates were classified as being part of the HpAsia2 (50%) or HpEurope (50%) population. Out of twenty isolates, eighteen isolates were cagA positive, with two HpEurope isolates being cagA negative, three EPIYA motif patterns (AB, AB‐C, and ABC‐C) were observed among the cagA‐positive isolates. Three vacA genotypes were observed with the s1m1i1dic1 genotype observed in 75% of isolates; the s1m2i1d1c2 and s2m2i2d2c2 genotypes were found to be 15% and 10% of isolates, respectively. The non‐virulent genotypes s2m2i2d2c2 was only observed in HpEurope population isolates. Genotypic analysis of oipA gene, present in all isolates, revealed five different patterns of the CT repeat; all HpAsia2 isolates were in “ON” while 20% of HpEurope isolates were genotypically “OFF.” The three blood group antigen binding adhesins encoded genes (bab genes) examined and we observed that the most common genotype was (babA/babB/‐) found in eight isolates, notably six were HpAsia2 isolates. The babA gene was found in all HpAsia2 isolates but present in only half of the HpEurope isolates. In silico antibiotic susceptibility analysis revealed that 40% of the strains were multi‐drug resistant. Mutations associated with resistance to metronidazole, fluoroquinolone, and clarithromycin were detected 90%, 45%, and 5%, respectively, in H pylori strain. In conclusion, it is evident that two populations of H pylori with similar antibiotic profiles are predominant in Bangladesh, and it appears that genotypically the HpAisa2 isolates are potentially more virulent than the HpEurope isolates.

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Section: Introductionmentioning

confidence: 99%

A comparative whole genome analysis of Helicobacter pylori from a human dense South Asian setting

et al. 2020

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“…An unprecedented number of studies last year reported on the important topic of antimicrobial resistance of H pylori strains 24‐60 . These are outlined in Table 1.…”

Section: Antibiotic Resistancementioning

confidence: 99%

Review – Treatment of Helicobacter pylori infection 2020

et al. 2020

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This review summarizes important studies regarding Helicobacter pylori therapy published from April 2019 to April 2020. The main themes that emerge involve studies assessing antibiotic resistance, and there is also growing momentum behind the utility of vonoprazan as an alternative to proton pump inhibitor (PPI) therapy and also bismuth‐based regimens as a first‐line regimen. Antibiotic resistance is rising wherever it is being assessed, and clarithromycin resistance in particular has reached a point where it may no longer be a viable therapy without previous testing in many regions of the world. The evidence for the efficacy of a bismuth‐based quadruple therapy as a first‐line therapy is now very clearly established, and there is substantial evidence that it is the best performing first‐line therapy. The utility of vonoprazan as an alternative to PPI therapy, especially in resistant and difficult‐to‐treat groups, has also been considered in great detail this year, and it may offer an opportunity in the near future to reduce the problem of antibiotic resistance.

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“…The resistance breakpoints of CLA and LEV were defined as >0.5 μg/mL and >1 μg/mL, as previously suggested. 27…”

Section: Mic Determinationmentioning

confidence: 99%

<p>Phenotype and Molecular Detection of Clarithromycin and Levofloxacin Resistance in <em>Helicobacter pylori</em> Clinical Isolates in Beijing</p>

Lok

Zhu

Wang

et al. 2020

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Introduction: Understanding drug resistance is important in drug selection for Helicobacter pylori (H. pylori) eradication, and drug resistance data are lacking in Beijing. Purpose: This cross-sectional study aimed to isolate H. pylori from patients with gastroduodenal diseases and to analyze drug resistance to clarithromycin (CLA) and levofloxacin (LEV), which are used frequently in China. Patients and Methods: One hundred and seventy-six patients with gastroduodenal diseases undergoing gastroduodenoscopy were selected by convenient sampling. Gastric mucosa samples were cultured and sub-cultured using a new medium broth. Active H. pylori strains were confirmed by microscopy observation as Gram-negative curved bacilli with positive test results for urease, oxidase, and catalase, and H. pylori 16S rRNA amplification by polymerase chain reaction (PCR). CLA and LEV resistance was identified by minimum inhibitory concentration (MIC) tests and sequencing of 23S rRNA, gyrA, and gyrB genes. Results: From the 176 clinical samples, 112 (112/176, 63.6%) were confirmed with H. pylori infection and 65 (65/176, 36.9%) active H. pylori strains were obtained and further confirmed by MIC assay. Overall, the rates of CLA-resistant and LEV-resistant mutations in the 112 samples were 50.9% and 33.0%, respectively. Mutation related to CLA resistance was A2143G in the 23S rRNA gene and mutations associated with LEV resistance were N87K, D91G, and D91Y in the gyrA gene. Of 112 samples, 22 (19.6%) presented dual resistance to CLA and LEV. Resistance of the H. pylori strains to CLA (r=0.846, P<0.001) and LEV (r=0.936, P<0.001) had a strong correlation in phenotypic and genotypic level. Conclusion: The results indicated that resistance of CLA and LEV is severe among patients with gastroduodenitis. A good consistency could be found as to drug resistance between genotypic or phenotypic assay, suggested extending the detection of H. pylori drug resistance from the MIC method to a genotypic assay.

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High primary resistance to metronidazole and levofloxacin, and a moderate resistance to clarithromycin in Helicobacter pylori isolated from Karnataka patients

Cited by 42 publications

References 33 publications

A comparative whole genome analysis of Helicobacter pylori from a human dense South Asian setting

A comparative whole genome analysis of Helicobacter pylori from a human dense South Asian setting

Review – Treatment of Helicobacter pylori infection 2020

<p>Phenotype and Molecular Detection of Clarithromycin and Levofloxacin Resistance in <em>Helicobacter pylori</em> Clinical Isolates in Beijing</p>

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