Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea

Tae Jun Hwang, Nayoung Kim, Hong Bin Kim, Byoung Hwan Lee, Ryoung Hee Nam, Ji Hyun Park, Mi Kyoung Lee, Young Soo Park, Dong Ho Lee, Hyun Chae Jung, In Sung Song

Research output: Contribution to journalArticle

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Abstract

Background: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. Methods: H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. Results: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5% for the clarithromycin-sensitive strains, which was higher than the 67.9% for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100% in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23%) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. Conclusions: Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.

Original languageEnglish
Pages (from-to)536-543
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume44
Issue number8
DOIs
StatePublished - 1 Sep 2010

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Korea
Microbial Drug Resistance
Point Mutation
Helicobacter pylori
Clarithromycin
Mutation
Amoxicillin
Levofloxacin
Proton Pump Inhibitors
Metronidazole
Ciprofloxacin
Tetracycline
DNA Sequence Analysis
Agar
Stomach
Biopsy

Keywords

  • Helicobacter pylori
  • antibiotics
  • clarithromycin
  • mutation
  • point
  • resistance

Cite this

@article{bcc301f2be4d4ec3ab81f20ccbfab52c,
title = "Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea",
abstract = "Background: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. Methods: H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. Results: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5{\%} for the clarithromycin-sensitive strains, which was higher than the 67.9{\%} for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100{\%} in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23{\%}) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. Conclusions: Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.",
keywords = "Helicobacter pylori, antibiotics, clarithromycin, mutation, point, resistance",
author = "Hwang, {Tae Jun} and Nayoung Kim and Kim, {Hong Bin} and Lee, {Byoung Hwan} and Nam, {Ryoung Hee} and Park, {Ji Hyun} and Lee, {Mi Kyoung} and Park, {Young Soo} and Lee, {Dong Ho} and Jung, {Hyun Chae} and Song, {In Sung}",
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pages = "536--543",
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Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea. / Hwang, Tae Jun; Kim, Nayoung; Kim, Hong Bin; Lee, Byoung Hwan; Nam, Ryoung Hee; Park, Ji Hyun; Lee, Mi Kyoung; Park, Young Soo; Lee, Dong Ho; Jung, Hyun Chae; Song, In Sung.

In: Journal of Clinical Gastroenterology, Vol. 44, No. 8, 01.09.2010, p. 536-543.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea

AU - Hwang, Tae Jun

AU - Kim, Nayoung

AU - Kim, Hong Bin

AU - Lee, Byoung Hwan

AU - Nam, Ryoung Hee

AU - Park, Ji Hyun

AU - Lee, Mi Kyoung

AU - Park, Young Soo

AU - Lee, Dong Ho

AU - Jung, Hyun Chae

AU - Song, In Sung

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Background: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. Methods: H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. Results: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5% for the clarithromycin-sensitive strains, which was higher than the 67.9% for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100% in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23%) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. Conclusions: Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.

AB - Background: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. Methods: H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. Results: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5% for the clarithromycin-sensitive strains, which was higher than the 67.9% for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100% in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23%) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. Conclusions: Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.

KW - Helicobacter pylori

KW - antibiotics

KW - clarithromycin

KW - mutation

KW - point

KW - resistance

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U2 - 10.1097/MCG.0b013e3181d04592

DO - 10.1097/MCG.0b013e3181d04592

M3 - Article

C2 - 20179610

AN - SCOPUS:77955929313

VL - 44

SP - 536

EP - 543

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 8

ER -