Antibiotic resistance problems with Helicobacter pylori

Alarcón, Teresa; Domingo, Diego; López-Brea, M

doi:10.1016/s0924-8579(99)00051-5

Cited by 115 publications

(89 citation statements)

References 68 publications

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“…Según el consenso de Maastricht IV, si el cultivo y las pruebas de sensibilidad, como la de epsilometría o la dilución en agar, no están disponibles, las pruebas moleculares pueden utilizarse para determinar la resistencia de H. pylori en biopsias gástricas o muestras de materia fecal. Estas pruebas han sido desarrolladas recientemente y son tan sensibles que pueden detectar organismos resistentes aun cuando constituyan una muy pequeña proporción entre un grupo grande de bacterias sensibles (6,(23)(24)(25).…”

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Determinación de mutaciones de un solo nucleótido en el gen 23S rRNA de Helicobacter pylori relacionadas con resistencia a claritromicina en una población del departamento del Cauca, Colombia

2013

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Section: Discussionunclassified

Determinación de mutaciones de un solo nucleótido en el gen 23S rRNA de Helicobacter pylori relacionadas con resistencia a claritromicina en una población del departamento del Cauca, Colombia

2013

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“…While they can achieve eradication rates of 85 to 90%, the efficacy of these treatments is being eroded by the rise in frequency of antibiotic-resistant isolates. Although resistance to amoxicillin and tetracycline is rare, substantial and increasing rates of resistance to metronidazole and clarithromycin are a significant cause of treatment failure (1). A further concern is that the use of broad-spectrum drug combinations to treat this chronic infection may promote resistance in other pathogenic bacteria, thereby compromising their utility in the treatment of more serious infections.…”

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Systematic Identification of Selective Essential Genes in Helicobacter pylori by Genome Prioritization and Allelic Replacement Mutagenesis

et al. 2001

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A comparative genomic approach was used to identify Helicobacter pylori 26695 open reading frames (ORFs) which are conserved in H. pylori J99 but highly diverged in other eubacteria. A survey of selected pathways of central intermediary metabolism was also carried out, and genes with a potentially selective role in H. pylori were identified. Forty-five ORFs identified in these two analyses were screened using a rapid vector-free allelic replacement mutagenesis technique, and 33 were shown to be essential in vitro. Notably, 13 ORFs gave essentiality results which are unexpected in view of their known or proposed functions, and phylogenetic analysis was used to investigate the annotation of 7 such ORFs which are highly diverged. We propose that the products of a number of these H. pylori-specific essential genes may be suitable targets for novel anti-H. pylori therapies.

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“…Resistance to amoxicillin is very infrequent, despite the wide use of this antibiotic, either alone or combined with clavulanic acid, to treat H. pylori or respiratory tract infections in both children and adults, although resistance has appeared in some parts of the world (1,9). Mutations detected in the 28 clarithromycin-resistant strains are summarized in Table 3.…”

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Clarithromycin Resistance among Helicobacter pylori Strains Isolated from Children: Prevalence and Study of Mechanism of Resistance by PCR-Restriction Fragment Length Polymorphism Analysis

et al. 2003

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Clarithromycin and metronidazole resistance was 29.1 and 23.9%, respectively, in 96 Helicobacter pylori strains obtained from pediatric patients. No resistance to amoxicillin was observed. Resistance according to patients' ages to clarithromycin and metronidazole was 45.4 and 18.2% in 22 patients from 4 to 8 years old, 30.2 and 20.7% in 53 patients from 9 to 13 years old, and 9.5 and 38.1% in 21 patients from 14 to 18 years old, respectively. The A2143G mutation was the most prevalent (82.1%) among clarithromycin-resistant strains.Helicobacter pylori is a gram-negative microaerophilic rod found in the human gastric mucosa associated with different digestive diseases, such as peptic ulcer, gastritis, and mucosaassociated lymphoid tissue lymphoma (7), and it is considered a risk factor in the development of gastric cancer (24). H. pylori infection is frequently acquired during childhood, and symptoms such as vomiting and epigastric or recurrent abdominal pain are associated with H. pylori infection (6).Amoxicillin, tetracycline, metronidazole, and clarithromycin are frequently used, combined with proton pump inhibitors or bismuth salts, for the treatment of H. pylori infections (22). However, side effects, poor compliance, and resistance to antibiotics are causes of treatment failure (4, 16). Resistance to metronidazole and clarithromycin is population dependent, and several studies suggest that clarithromycin resistance is higher in strains obtained from children than in those from adults (9).The aim of this study was to determine the rate of resistance to clarithromycin in H. pylori strains obtained from pediatric patients according to the age of the patients. Metronidazole and amoxicillin resistance was also studied. The mutation involved in clarithromycin resistance was detected by PCR-restriction fragment length polymorphism analysis.Ninety-six pediatric patients, aged from 4 to 18 years (mean age Ϯ standard deviation, 10.86 Ϯ 3.3 years), attending the Gastroenterology Unit at the Hospital del Niño Jesus during 1999 and 2000, were included in this study. Patients were referred for endoscopy due to different symptoms, with epigastric pain (74.2%), vomiting (33.3%), and recurrent abdominal pain (25.8%) being the most prevalent. Parents signed an informed consent form for the endoscopy, and the Ethical Committee supervised the study. Patients previously treated for H. pylori infections were not included. Strains were grouped according to the age of the patient at the time of endoscopy.Only culture-positive patients were included. H. pylori clinical isolates were obtained from gastric biopsy specimens according to standard procedures.Clarithromycin was obtained from Abbott Laboratories SA, Madrid, Spain, and metronidazole and amoxicillin were obtained from Sigma-Aldrich, Madrid, Spain. MICs were determined by an agar dilution technique with Mueller-Hinton agar plus 7% horse blood according to NCCLS recommendations (17). Plates with twofold dilutions of each antibiotic were inoculated with 1 to 2 l of 10 9 CFU/ml ...

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Antibiotic resistance problems with Helicobacter pylori

Cited by 115 publications

References 68 publications

Determinación de mutaciones de un solo nucleótido en el gen 23S rRNA de Helicobacter pylori relacionadas con resistencia a claritromicina en una población del departamento del Cauca, Colombia

Determinación de mutaciones de un solo nucleótido en el gen 23S rRNA de Helicobacter pylori relacionadas con resistencia a claritromicina en una población del departamento del Cauca, Colombia

Systematic Identification of Selective Essential Genes in Helicobacter pylori by Genome Prioritization and Allelic Replacement Mutagenesis

Clarithromycin Resistance among Helicobacter pylori Strains Isolated from Children: Prevalence and Study of Mechanism of Resistance by PCR-Restriction Fragment Length Polymorphism Analysis

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