Emergence of amoxicillin resistance and identification of novel mutations of the pbp1A gene in Helicobacter pylori in Vietnam

Tran, Trung; Nguyen, Anh Tuan; Quach, Duc Trong; Pham, D. A. K.; Cao, Nga; Nguyen, Uyen Thi-Hong; Dang, An Nguyen-Thanh; Tran, Minh Anh; Quach, Loc Huu; Tran, Kevin; Le, Nhan Quang; Ung, Viet Van; Vo, Minh Ngoc-Quoc; Nguyen, Danh Thanh; Ngo, Kha Dong; Tran, Le Trung; Nguyen, Vy

doi:10.1186/s12866-022-02463-8

Cited by 17 publications

(26 citation statements)

References 41 publications

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“…Codon substitutions of the PBP1A protein were identified in amoxicillin-resistant H. pylori in this study. Two out of five codon variants detected in amoxicillin resistance in this study, namely V374L and G595_V596InsG, were previously shown to confer resistance to amoxicillin in H. pylori isolated from Cambodia [ 22 ] and Vietnam [ 23 ]. The rest of the codon variants, namely V346L, Y604H, and N608S, detected in amoxicillin-resistant H. pylori in this study were not previously reported in the literature.…”

Section: Discussionmentioning

confidence: 89%

Multidrug-Resistant Helicobacter pylori Strains: A Five-Year Surveillance Study and Its Genome Characteristics

et al. 2022

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Background: The emergence of multidrug-resistant Helicobacter pylori has undermined eradication strategies to prevent the development of gastric cancer. This study was conducted to estimate the prevalence of secondary antibiotic resistance of H. pylori in urban multicultural areas in Malaysia. Methods: From January 2017 to December 2021, gastric biopsies from 218 patients with a history of H. pylori eradication failure were sent to our laboratory for antibiotic susceptibility testing. A minimal inhibitory concentration was determined for six antibiotics, namely metronidazole, clarithromycin, levofloxacin, amoxicillin, tetracycline, and rifampicin using the E-test method. Two multidrug-resistant H. pylori strains identified in this study were subjected to whole genome sequencing. Results: Eradication failure was observed to be significantly higher in the Malaysian Chinese patients than in the Malaysian Indian and Malay patients. H. pylori were successfully isolated from 51 patients (23.4%). Overall, the antibiotic resistance rates of H. pylori to metronidazole, clarithromycin, levofloxacin, and amoxicillin were 82.4% (42/51), 72.5% (37/51), 52.9% (27/51), and 3.9% (2/51), respectively. Resistance to tetracycline and rifampicin were not observed during the study period. Resistance to more than one antibiotic was observed in 82.4% (42/51) of the isolates, of which 42.2% (19/42) were resistant to three antibiotic classes. Resistance to both clarithromycin and metronidazole were most frequently observed in isolates with dual resistance (56.5%; 13/23). Codon substitutions in penicillin-binding protein 1A (V346L, V374L, G595_V596InsG, Y604H, and N608S) were detected in amoxicillin-resistance H. pylori strains. Herein, we report amoxicillin resistance in H. pylori isolated from Malaysian patients, and its resistance mechanism, for the first time. Conclusion: Our results show the increase trend in secondary multidrug resistance in H. pylori isolates, which warrants continuous surveillance.

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Section: Discussionmentioning

confidence: 89%

Multidrug-Resistant Helicobacter pylori Strains: A Five-Year Surveillance Study and Its Genome Characteristics

et al. 2022

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“…Previous studies in both hospitals and the community showed a high prevalence of H. pylori infection in Vietnam [ 8 , 9 , 10 ]. In addition, the rate of antibiotic resistance of H. pylori in the country is on the increase and dissimilar across geographical regions [ 11 ]. Therefore, the monitoring of H. pylori susceptibility in different regions helps clinicians to choose the optimal and effective initial treatment for patients.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance of Helicobacter pylori in Patients with Peptic Ulcer

Tran

et al. 2022

Medicina

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Background and Objectives: To determine the antibiotic resistance rate of H. pylori among patients with peptic ulcer. Materials and Methods: A cross-sectional monocentric study was conducted from January to December 2021 among patients aged from 16 years with gastrointestinal symptoms and esophagogastroduodenoscopy. Gastric mucosa biopsies were collected at the edges of the ulcer or at lesion sites for H. pylori culture. Five antibiotics (amoxicillin (AMX), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), and tetracycline (TET)) were selected for antibiotic susceptibility testing. Results: One hundred and twenty-five patients were included, and the sex ratio was 0.6. Their mean age was 47.3 ± 14.2 years. All of the participants had gastritis, and 24.0% had duodenitis. A total of 21.6% of patients had a duodenal ulcer, and 12.8% had an antral ulcer. A total of 40 specimens have grown in H. pylori culture. The proportion of resistance to AMX, CLR, MTZ, LEV, and TET was 27.5%, 50%, 67.5%, 35%, and 5%, respectively. The proportion of multidrug resistance was 22.5%. The proportion of double resistance to AMX + CLR was 20.0%, AMX + MTZ was 15.0%, AMX + LEV was 2.5%, CLR + MTZ was 32.5%, and TET + MTZ was 5.0%. Conclusions: Our research results show that the treatment with MTX-TET or LVX-AMOX has the highest sensitivity rate. Therefore, practitioners should refer to these regimes to eradicate H. pylori in patients with gastric and duodenal ulcers. The reports on H. pylori eradication from different geographic areas show heterogeneous results. Therefore, continuous monitoring of antibiotic resistance of H. pylori in each population is very important. Having evidence helps clinicians to treat patients most effectively, reduce treatment costs, and limit the rate of antibiotic resistance.

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“…Comments: The results of clinical trials conducted during the last 5 years in Vietnam showed that the primary resistance rates of clarithromycin and metronidazole were very high, up to 34.1 and 69.4%, respectively ( 4 , 38 ). Recent data also show that the resistance rates of amoxicillin and levofloxacin tend to increase significantly ( 39 , 40 ). More importantly, there is an emerging increase in multidrug-resistant H. pylori strains, which poses a considerable challenge for eradication therapy in clinical practice ( 41 , 42 ).…”

Section: Resultsmentioning

confidence: 99%

“…Evidence level: Moderate, Strength of recommendation: Strong, Consensus level: 100%, Comments: The results of clinical trials conducted during the last 5 years in Vietnam showed that the primary resistance rates of clarithromycin and metronidazole were very high, up to 34.1 and 69.4%, respectively (4,38). Recent data also show that the resistance rates of amoxicillin and levofloxacin tend to increase significantly (39, 40).…”

Section: Alarm Features In Patients With Dyspeptic Symptomsmentioning

confidence: 99%

Vietnam Association of Gastroenterology (VNAGE) consensus on the management of Helicobacter pylori infection

et al. 2023

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Helicobacter pylori (H. pylori) infection is prevalent and has a rapidly increasing antibiotic resistance rate in Vietnam. Reinfection is quite common, and gastric carcinoma remains one of the most common malignancies, which is not uncommon to develop after successful eradication. The purpose of this consensus is to provide updated recommendations on the management of H. pylori infection in the country. The consensus panel consisted of 32 experts from 14 major universities and institutions in Vietnam who were invited to review the evidence and develop the statements using the Delphi method. The process followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The consensus level was defined as ≥80% for agreement on the proposed statements. Due to the limited availability of high-quality local evidence, this consensus was also based on high-quality evidence from international studies, especially those conducted in other populations in the Asia–Pacific region. The panel finally reached a consensus on 27 statements after two voting rounds, which consisted of four sections (1) indications for testing and selection of diagnostic tests (2), treatment regimens, (3) post-treatment confirmation of H. pylori status, and (4) reinfection prevention methods and follow-up after eradication. Important issues that require further evidence include studies on third-line regimens, strategies to prevent H. pylori reinfection, and post-eradication follow-up for precancerous gastric lesions. We hope this consensus will help guide the current clinical practice in Vietnam and promote multicenter studies in the country and international collaborations.

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Emergence of amoxicillin resistance and identification of novel mutations of the pbp1A gene in Helicobacter pylori in Vietnam

Cited by 17 publications

References 41 publications

Multidrug-Resistant Helicobacter pylori Strains: A Five-Year Surveillance Study and Its Genome Characteristics

Multidrug-Resistant Helicobacter pylori Strains: A Five-Year Surveillance Study and Its Genome Characteristics

Antibiotic Resistance of Helicobacter pylori in Patients with Peptic Ulcer

Vietnam Association of Gastroenterology (VNAGE) consensus on the management of Helicobacter pylori infection

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