The <i>Helicobacter pylori</i> Resistance Rate to Clarithromycin in Iran

Raftar, Shahrbanoo Keshavarz Azizi; Moniri, Rezvan; Saffari, Mahmood; Zadeh, Mohsen Razavi; Arj, Abbas; Mousavi, Seyed Gholam Abbas; Kalayeh, Hamed Mirzaei Ghazi; Dastehgoli, Kamran

doi:10.1089/mdr.2014.0104

Cited by 20 publications

(9 citation statements)

References 23 publications

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“…The prevalence of H. pylori infection varies among different regions even in the same country (20,21). The rate of bacteria isolation in our study (31.4%) was similar to several other studies (22)(23)(24)(25). In this study, H. pylori frequency was higher in gastritis cases (63%) and there was a significant correlation with clinical outcome, but in two other studies this association was found with PUD (26,27).…”

Section: Discussionsupporting

confidence: 91%

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

Khashei

Dara

Bazargani

et al. 2016

APMIS

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This study aimed to investigate the clarithromycin resistance and its associated molecular mechanisms among Helicobacter pylori isolates from dyspeptic patients in Shiraz, Iran. From January to May 2014, 100 H. pylori strains were isolated from patients with gastroduodenal disorders. The resistance to clarithromycin was quantitatively evaluated, using Epsilometer (E-test) method. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed on all the isolates to detect A2143G and A2142G mutations in 23S rRNA gene. The H. pylori isolation rate was found to be 31.4%. E-test showed that 20% of isolates were resistant to clarithromycin (MIC ≥ 1 mg/L). MIC of clarithromycin ranged between 0.016 and 24 mg/L. Findings of PCR-RFLP showed that the A2142G was the most (90%) frequently point mutation, followed by the A2143G (10%). No statistically significant difference was found between H. pylori clarithromycin resistance point mutations and patients' gender or age. To the best of our knowledge, this is the first report of high frequency of A2142G point mutation in Iran and probably in other regions of the world. Considering the increasing trend of H. pylori resistance to clarithromycin due to these mutations, it is crucial to investigate the new therapeutic approaches against H. pylori infection.

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Section: Discussionsupporting

confidence: 91%

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

Khashei

Dara

Bazargani

et al. 2016

APMIS

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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%

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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“…This correlation was not confirmed in a similar study by Khademi et al (24). The clarithromycin MICs for the strains isolated in Iran were in the range of 0.016 µg to 256 µg (25). These values are apparently lower than those reported in other countries.…”

Section: Discussionmentioning

confidence: 54%

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

Bayati

Amirmozafari

Alebouyeh

et al. 2019

Arch Clin Infect Dis

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Background:The extent of antibiotic resistance among Helicobacter pylori strains influences current clinical therapeutic regimens in each region. Objectives: This cross-sectional study aimed to determine the resistance property and minimum inhibitory concentration (MIC50-90) of Helicobacter pylori strains toward metronidazole, clarithromycin, and ciprofloxacin in patients with distinct gastric histopathological changes in Tehran, Iran. Methods: This study was conducted on 170 patients suffering from gastric complications in three hospitals in Tehran from October 2014 until March 2015. Two separate biopsy samples were collected from each patient and used for pathological and microbiological examinations. Antimicrobial susceptibility tests were performed by agar dilution method according to the CLSI guidelines.The MIC values and susceptibility to varying concentrations of metronidazole (4 to 64 µg/mL), ciprofloxacin (0.5 to 16 µg/mL), and clarithromycin (0.25 to 16 µg/mL) were determined based on EUCAST recommendations. Results:Our results indicated the infection with H. pylori in a frequency of 32% (55/170) among the study patients (female, 51% and male, 49%). Endoscopic findings indicated that 42% of the patients suffered from peptic ulcers, 33% from duodenal ulcers, and 25% with a non-ulcer disease. Pathological findings indicated 58% of the patients had chronic gastritis, 33% had active chronic gastritis, and 9% suffered from intestinal metaplasia. In terms of antibiotic susceptibility, nearly 76.3%, 49%, and 45.5% of the strains were resistant to metronidazole, clarithromycin, and ciprofloxacin, respectively. The MIC values at which the growth of 50% and 90% of the strains was inhibited (MIC50-90) were 32 -64 µg/mL for metronidazole, 0.5 -16 µg/mL for clarithromycin, and 2 -16 µg/mL for ciprofloxacin. Conclusions: The overall resistance levels were relatively high among the study patients. Accordingly, the administration of other anti-Helicobacter drugs, as well as more appropriate therapeutic regimens based on laboratory results, is recommended in patients with a history of treatment failure. Patient Consent:All patients announced their agreement with this study by signing informed consent forms.

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The Helicobacter pylori Resistance Rate to Clarithromycin in Iran

Abstract: The resistance rate to clarithromycin in Iran is high. H. pylori clarithromycin-resistant strains were not associated with sex, age, and disease. The A2143G mutation in clarithromycin-resistant H. pylori strains was the predominant finding.

Cited by 20 publications

References 23 publications

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

High rate of A2142G point mutation associated with clarithromycin resistance among Iranian Helicobacter pylori clinical isolates

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

Antibiotic Resistance Among Helicobacter pylori Strains Isolated from Patients with Gastric Pathologies Towards Metronidazole, Clarithromycin, and Ciprofloxacin

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