Mutations in 23S rRNA are associated with clarithromycin resistance in Helicobacter pylori

Abstract

Twelve clarithromycin-resistant Helicobacter pylori isolates (100% of resistant isolates examined) from seven different patients each contained an A-->G transition mutation within a conserved loop of 23S rRNA. A-->G transition mutations at positions cognate with Escherichia coli 23S rRNA positions 2058 and 2059 were identified. Clarithromycin-susceptible H. pylori isolates from 14 different patients displayed no polymorphisms in a conserved loop within domain V of 23S rRNA. The study is the first to report mutations in H. pylori associated with resistance to an antimicrobial agent used in established peptic ulcer treatment regimens.

In vitro and in vivo anti-Helicobacter pylori activity of Y-904, a new fluoroquinolone

“…In recent years, however, there have been reports of reduced bacterial clearance rates due to the appearance of bacteria resistant to clarithromycin 14 and metronidazole. 15 Research into new antibacterial treatments is therefore important.…”

Efficacy of metronidazole for the treatment of clarithromycin-resistant Helicobacter pylori infection in a Japanese population

“…At present, however, only AMOX and CLA are approved for the treatment of H. pylori infection in Japan, and resistance to CLA is easily acquired by H. pylori. 12 Although retreatment with first-line therapy for a period of 7-14 days was carried out after the failure of 1 week of this therapy, the eradication rate was not higher than that of the dual therapies of PPI and AMOX. 13 Because CLA-resistant strains have been increasing among Japanese H. pylori strains, the establishment of eradication therapy that does not contain CLA is required for patients who failed first-line therapy.…”

Influence of daily low-dose 14-membered-ring macrolide therapy on Helicobacter pylori infection in patients with chronic inflammatory disease of the airway

“…A single point mutation within domain V of 23SrRNA may be sufficient for conferring macrolide resistance to H. pylori. 4 This mutation would easily result from long-term and low-dose exposure to antibiotics. We performed gastroendoscopy and gastrobiopsy on three of the six patients in whom the urea breath test results were repeatedly positive.…”

“…The success rate of eradication is reportedly influenced by the degree of H. pylori resistance to clarithromycin. 4 Patients with chronic respiratory diseases who receive daily low-dose 14-membered-ring macrolide treatment may develop H. pylori infection. In such patients, clinicians are concerned with not only the eradication effects of this long-term monotherapy but also the occurrence of resistance against 14-memberedring macrolides.…”