Phenotypic and Genotypic Antibiotic Resistance Patterns in Helicobacter pylori Strains From Ethnically Diverse Population in México

Abstract

Helicobacter pylori strains carry a range of mutations in genes that confer antimicrobial resistance and restrict the available options to treat the infection. Latin America is a region that conserve a large number of indigenous communities relatively isolated that practice a traditional medicine without consumption of drugs. We hypothesized that rates of antibiotic resistance are lower in these communities. Recent progress in whole-genome sequencing has allowed the study of drug susceptibility by searching for the known mutations associated with antibiotic resistance. The aim of this work was to study trends of antibiotic resistance over a 20-year period in Mexican H. pylori strains and to compare susceptibility between strains from Mexican mestizos and from indigenous population; we also aimed to learn the prevalence of mutational patterns in genes gyrA, gyrB, rdxA, frxA, rpsU, omp11, dppA, and 23S rRNA and its association with phenotypic tests. Resistance to clarithromycin, metronidazole, amoxicillin and levofloxacin was determined in167 H. pylori isolates by E-test, and the occurrence of mutational patterns in specific genes was determined by whole genome sequencing (WGS). The trend of resistance over 20 years in mestizo isolates showed significant resistant increase for clarithromycin and levofloxacin to frequencies that banned its clinical use. Resistance in H. pylori isolates of native communities was lower for all antibiotics tested. Phenotypic resistance showed good to moderate correlation with genotypic tests. Genetic methods for characterizing antibiotic resistance require further validation in each population.

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

“…The amoxicillin-resistant H. pylori proportion discovered in this study (25.7%) was similar to the finding by Saniee et al in Iran (27.1%; p = 0.423) in 2018 [ 23 ] but significantly higher than that in other studies, such as Zerbetto et al in Argentina (7.6%, p < 0.001) in 2017 [ 15 ], Manal et al in Egypt (18.3%; p = 0.035) in 2018 [ 24 ], Ortis et al in Central America (10%; p < 0.001) in 2019 [ 25 ], Azzaya et al in Mongolia (11.9%; p < 0.001), Aumpan et al in Cambodia (0%; p < 0.001) in 2020 [ 26 , 27 ], Calinga-Ponce et al in Mexico (1.8%; p < 0.001) and Li et al in China (0%; p < 0.001) in 2021 [ 28 , 29 ]. Compared to previous studies in Vietnam, the amoxicillin resistance proportion has been trending up significantly, for instance, from 0% ( p < 0.001) in 2013 [ 30 ], 1.1% ( p < 0.001) in 2015 [ 8 ], 10.4% ( p < 0.001) in 2016 [ 9 ], 15% ( p = 0.002) in 2019 [ 3 ] and to 25.7% in 2020 for this study.…”

Next-Generation Sequencing-Based Study of Helicobacter pylori Isolates from Myanmar and Their Susceptibility to Antibiotics

“…The remaining strains did not possess a mutation in the quinolone-determining region of gyrA (MMM37, 44, 47, and 149), but possessed other possible novel mutations such as D210N, K230Q, A524V, and A661T, which were not observed in the five sensitive strains. Although GyrB is also the target of quinolone, only one strain possesses a gyrB mutation that has been reported in a previous study (S479G) [24]. Hence, the resistance might be explained by novel mutations in gyrB, such as A584V, N679H, M676V, V614I, and several other variants.…”

Antibiotic resistance patterns of Helicobacter pylori in North Israel – A six‐year study

“…4 One of the main challenges in this bacterium eradication is its increasing antibiotic resistance. 5 For example, clarithromycin resistance was associated with approximately 70% decline in eradication rates. [6][7][8] Antibiotic resistance develops since most of the antibiotics prescribed to treat H. pylori infection are widely used for other infections.…”

“…One of the main challenges in this bacterium eradication is its increasing antibiotic resistance. 5 For example, clarithromycin resistance was associated with approximately 70% decline in eradication rates. 6 , 7 , 8 …”