Clarithromycin-resistant Helicobacter pylori in Recife, Brazil, directly identified from gastric biopsies by polymerase chain reaction

Lins, Ana Kelly; Lima, Roberto A.; Magalhães, Marcelo

doi:10.1590/s0004-28032010000400011

Cited by 20 publications

(21 citation statements)

References 20 publications

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“…The global average mutation frequency for the A2143G and A2142G mutations are 69.8% and 11.7%, respectively (23). In many studies, the point mutations A2142G (13,18,23,24) and/or A2142C (4,13,21,24) were not found, and numerous investigations reported that A2143G was the only detected mutation or the most prevalent (4,5,13,17,18,(21)(22)(23)(24)(25). On the other hand, it has been found that the presence of the A2143G point mutation, but not of A2142G or A2142C, significantly lowered the H. pylori eradication rate (26,27).…”

Section: Discussionmentioning

confidence: 99%

“…However, resistance to antibiotics is a major problem in effective treatment (2). Clarithromycin is the most effective antimicrobial used for the treatment of H. pylori infection, and resistance to this drug is the major cause of treatment failure (3)(4)(5). The prevalence of clarithromycin resistance may vary in different geographical regions, and continuous monitoring of the clarithromycin resistance rate in each region is important for designing the most effective therapies (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran

Tajbakhsh

Falahi²,

Motamed³

et al. 2016

Avicenna J Clin Microbiol Infect

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Background: Resistance to clarithromycin in Helicobacter pylori has become one of the most important reasons for failure of antibiotic eradication therapies. This resistance is predominantly caused by point mutations in the peptidyl transferase region of 23S rRNA. Objectives: The aim of this study was to determine the prevalence of the A2143G, A2144G, and A2143C point mutations among H. pylori strains from gastric biopsy specimens in Bushehr, in the southwest of Iran. Patients and Methods: Gastric biopsy specimens were obtained from patients with upper gastrointestinal symptoms during endoscopy. Fluorescent in situ hybridization (FISH) using oligonucleotide probes was applied to detect the point mutations responsible for clarithromycin resistance in H. pylori. Results: Of the 135 H. pylori-positive specimens, two harbored strains with the A2143G mutation and nine contained strains with the A2144G mutation. Thus, the prevalences of the A2143G and A2144G point mutations were 1.5% and 6.7%, respectively. The A2143C point mutation was not found. Conclusions:The prevalences of the point mutations A2143G and A2144G were low in our geographic area. Based on the findings of this study, clarithromycin still seems to be a useful antibiotic for initial treatment regimens in Bushehr, Iran.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran

Tajbakhsh

Falahi²,

Motamed³

et al. 2016

Avicenna J Clin Microbiol Infect

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“…Its effectiveness basically depends on rates of resistance to clarithromycin and is not recommended in areas where these rates among the population are higher than 20%. The few Brazilian studies on clarithromycin resistance show rates below this value (45,78,123,160) . While not outstanding, in the last 10 years this regimen has shown eradication rates close to 80% among us (29,54,134,166) .…”

Section: Statement 27mentioning

confidence: 96%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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“…Clarithromycin resistance is also different depending on the area. In Brazil, stomach biopsy specimens positive for H. pylori were analyzed by PCR to detect the point mutation associated with clarithromycin resistance [34] . The results uncovered primary clarithromycin resistance in 16.5% patients.…”

Section: Current Antibiotic Resistance In Worldwidementioning

confidence: 99%

Antibiotic treatment forHelicobacter pylori: Is the end coming?

Kim

Choi

Chung

2015

WJGPT

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Infection with the Gram-negative pathogen Helicobacter pylori (H. pylori ) has been associated with gastroduodenal disease and the importance of H. pylori eradication is underscored by its designation as a group I carcinogen. The standard triple therapy consists of a proton pump inhibitor, amoxicillin and clarithromycin, although many other regimens are used, including quadruple, sequential and concomitant therapy regimens supplemented with metronidazole, clarithromycin and levofloxacin. Despite these efforts, current therapeutic regimens lack efficacy in eradication due to antibiotic resistance, drug compliance and antibiotic degradation by the acidic stomach environment. Core tip: This article reviews the recent literature describing antibiotic resistance and trends in Helicobacter pylori (H. pylori ) treatment. As there is no effective conventional therapy, new treatments are being developed and bismuth quadruple, sequential, concomitant therapies are recommended as a first-line regimen in regions with high levels of clarithromycin resistance. Quinolones have also been used for H. pylori treatment, although the cure rate has gradually reduced with this approach. New therapeutic directions include probiotic supplementation, tailored therapy, novel agents, and nanotechnology.

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Clarithromycin-resistant Helicobacter pylori in Recife, Brazil, directly identified from gastric biopsies by polymerase chain reaction

Abstract: -Context -Clarithromycin is the most effective drug used in the eradication of infection by Helicobacter pylori. Due to worldwide increase in resistance, pre-treatment susceptibility testing for clarithromycin is recommended.

Cited by 20 publications

References 20 publications

Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran

Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Antibiotic treatment forHelicobacter pylori: Is the end coming?

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