Molecular detection of mutations involved in Helicobacter pylori antibiotic resistance in Algeria

Bachir, Meryem; Allem, Rachida; Bénéjat, Lucie; Tifrit, A.; Medjekane, Meriem; Drici, Amine El-Mokhtar; Mégraud, Françis; Douidi, Kara Turki

doi:10.1093/jac/dky167

Cited by 29 publications

(15 citation statements)

References 33 publications

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“…The analysis revealed a high prevalence of clarithromycin resistance in the tested population and a particularly high percentage of mixed genotypes in resistant cases. 33 In the study by Blümel et al, the success rate of tailored, salvage eradication therapies guided by molecular testing of resistance to clarithromycin and eventually to levofloxacin after unsuccessful H. pylori eradication attempts was disappointing. 30 Bazin et al analyzed the impact of PPI medication on the H. pylori positivity of histology, immunohistochemistry, culture, and an inhouse real-time PCR.…”

Section: Molecular Methodsmentioning

confidence: 99%

“…Thus, molecular detection of mutations associated with resistance proved to be an appropriate alternative to culture-based antimicrobial susceptibility testing in this population. 33 In the study by Blümel et al, the success rate of tailored, salvage eradication therapies guided by molecular testing of resistance to clarithromycin and eventually to levofloxacin after unsuccessful H. pylori eradication attempts was disappointing. Even though current guidelines recommend susceptibility testing to be performed only after two treatment failures, the authors conclude that it may be reasonable to perform susceptibility testing as early as possible, since tailored first-line treatments are superior to empiric ones and may also be cost-effective.…”

Section: Molecular Methodsmentioning

confidence: 99%

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Review: Diagnosis of Helicobacter pylori infection

et al. 2019

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Endoscopic imaging of the stomach is improving. In addition to narrow band imaging, other methods, for example, blue light imaging and linked color imaging, are now available and can be combined with artificial intelligence systems to obtain information on the gastric mucosa and detect early gastric cancer. Immunohistochemistry is only recommended as an ancillary stain in case of chronic active gastritis without Helicobacter pylori detection by standard staining, and recommendations to exclude false negative H. pylori results have been made. Molecular methods using real‐time PCR, droplet digital PCR, or amplification refractory mutation system PCR have shown a high accuracy, both for detecting H. pylori and for clarithromycin susceptibility testing, and can now be used in clinical practice for targeted therapy. The most reliable non‐invasive test remains the 13C‐urea breath test. Large data sets show that DOB values are higher in women and that the cut‐off for positivity could be decreased to 2.74 DOB. Stool antigen tests using monoclonal antibodies are widely used and may be a good alternative to UBT, particularly in countries with a high prevalence of H. pylori infection. Attempts to improve serology by looking at specific immunodominant antigens to distinguish current and past infection have been made. The interest of Gastropanel® which also tests pepsinogen levels was confirmed.

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Section: Molecular Methodsmentioning

confidence: 99%

Section: Molecular Methodsmentioning

confidence: 99%

Review: Diagnosis of Helicobacter pylori infection

et al. 2019

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“…For determining variations in 23S rRNA and gyrA genes, all reads were aligned to the corresponding gene from the reference genome (NC_000915) followed by the identification of variants as described above for 16S. There is limited published data describing the clinical significance of a majority of variants for gyrA and 23S, and so only variants with a clear link to antibiotic resistance were considered clinically significant mutations (3,8,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Methodsmentioning

confidence: 99%

Helicobacter pylori Mutations Detected by Next-Generation Sequencing in Formalin-Fixed, Paraffin-Embedded Gastric Biopsy Specimens Are Associated with Treatment Failure

et al. 2019

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Helicobacter pylori antibiotic resistance is widespread and increasing worldwide. Routine detection of H. pylori mutations that invoke antimicrobial resistance may be a useful approach to guide antimicrobial therapy and possibly avert treatment failure. In this study, formalin-fixed, paraffin-embedded (FFPE) gastric biopsy specimens from a cohort of individuals from northern Ohio in the United States were examined using a next-generation sequencing (NGS) assay to detect H. pylori mutations that are known to confer resistance to clarithromycin, levofloxacin, and tetracycline. From January 2016 to January 2017, 133 H. pylori-infected gastric biopsy specimens were identified histologically and subsequently analyzed by NGS to detect mutations in gyrA, 23S rRNA, and 16S rRNA genes. The method successfully detected H. pylori in 126 of 133 cases (95% sensitivity). Mutations conferring resistance were present in 92 cases (73%), including 63 cases with one mutation (50%) and 29 cases with mutations in multiple genes (23%). Treatment outcomes were available in 58 cases. Sixteen of the 58 cases failed therapy (28%). Therapy failure correlated with the number of mutated genes: no failure in cases with no mutations (0/15), 19% (5/27) failure in cases with one gene mutation, and 69% (11/16) failure in cases with more than one mutated gene. Common 23S rRNA mutations (A2142G or A2413G) were present in 88% (14/16) of failed cases as opposed to in only 10% (4/42) of eradicated cases (P Ͻ 0.001). This NGS assay can be used on remnant specimens collected during standard-of-care testing to detect mutations that correlate with increased risk of treatment failure. A prospective study is needed to determine if the risk of treatment failure can be decreased by using this assay to guide antibiotic therapy.

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“…The individual studies detailing resistance are summarized in Table 1. [21][22][23][24][25][26][27][28][29][30][31][32]…”

Section: Antib I Oti C Re S Is Tan Cementioning

confidence: 99%

Review: Treatment of Helicobacter pylori Infection 2019

et al. 2019

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This review summarizes important studies regarding Helicobacter pylori therapy published from May 2018 to May 2019. The main themes that emerge involve studies assessing the efficacy of bismuth‐based regimens. While in recent years the efficacy of bismuth‐based quadruple therapy as a second‐line therapy has been clearly established, there is now substantial evidence that it is the best performing first‐line therapy. Antibiotic resistance was again intensely studied this year, and a clear and dramatic increase in resistance is noted for clarithromycin and levofloxacin; most notably, it may not be possible to support these therapies in most regions of the world much longer without testing. The utility of vonoprazan as an alternative to proton‐pump inhibitor therapy, especially in resistant and difficult to treat groups, has also been considered in greater detail this year, as well as means of supporting and enhancing adherence to therapy. Several studies showed that the diversity of gut microbiota was significantly altered shortly after H pylori eradication. However, the diversity was restored to pre‐treatment state after 2 months in patients treated with triple therapy. More studies are warranted to assess the long‐term changes of gut microbiota after H pylori eradication.

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Molecular detection of mutations involved in Helicobacter pylori antibiotic resistance in Algeria

Abstract: Local data regarding the primary resistance of H. pylori to clarithromycin, ciprofloxacin, tetracycline and rifampicin and the main genetic mutations involved in the resistance are necessary for a periodic evaluation of antibiotic consumption and new therapeutic strategies in Algeria.

Cited by 29 publications

References 33 publications

Review: Diagnosis of Helicobacter pylori infection

Review: Diagnosis of Helicobacter pylori infection

Helicobacter pylori Mutations Detected by Next-Generation Sequencing in Formalin-Fixed, Paraffin-Embedded Gastric Biopsy Specimens Are Associated with Treatment Failure

Review: Treatment of Helicobacter pylori Infection 2019

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