Phenotype and genotype analysis for Helicobacter pylori antibiotic resistance in outpatients: a retrospective study
To investigate the antibiotic resistance of Helicobacter pylori ( H. pylori ) in outpatients and to explore the consistency between genotype and phenotype of H. pylori antibiotic resistance. A retrospective study on outpatients screened with urea breath test for H. pylori infection in Nanjing First...
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Veröffentlicht in: | Microbiology spectrum 2023-09, Vol.11 (5), p.e0055023-e0055023 |
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Zusammenfassung: | To investigate the antibiotic resistance of
Helicobacter pylori
(
H. pylori
) in outpatients and to explore the consistency between genotype and phenotype of
H. pylori
antibiotic resistance. A retrospective study on outpatients screened with urea breath test for
H. pylori
infection in Nanjing First Hospital from April 2018 to January 2022. Patients who tested positive underwent a consented upper endoscopy, and the
H. pylori
infection was confirmed by rapid urease test (RUT) and
H. pylori
culture. For antibiotic resistance phenotype analysis, the
H. pylori
strains isolated from gastric biopsy were tested for antibiotic resistance phenotype by the Kirby-Bauer disk diffusion test. In addition, the antibiotic resistance genotype of isolated
H. pylori
was tested with a real-time polymerase chain reaction. A total of 4,399 patients underwent
H. pylori
infection screening, and 3,306
H. pylori
strains were isolated. The antibiotic resistance phenotype test revealed that the resistance rates of metronidazole (MTZ), clarithromycin (CLR), levofloxacin (LEV), amoxicillin (AMX), furazolidone (FR), and tetracycline (TE) were 74.58%, 48.61%, 34.83%, 0.76%, 0.27%, and 0.09%, respectively. Additionally, the antibiotic resistance genotype test revealed that rdxA gene mutation A610G (92.96%), A91G (92.95%), C92A (93.00%), and G392A (95.07%) were predominant in
H. pylori
with MTZ resistance; 23S rRNA gene mutation A2143G (86.47%) occurred in most
H. pylori
with CLR resistance; and gyrA gene mutation 87Ile/Lys/Tyr/Arg (97.32%) and 91Asn/Gly/Tyr (90.61%) were the most popular mutations in strains with LEV resistance. The phenotypic resistance and genotypic resistance to CLR (kappa value = 0.824) and LEV (kappa value = 0.895) were in good agreement. The history of eradication with MTZ, CLR, LEV, and AMX was correlated with
H. pylori
resistance. In short, this study demonstrated that drug resistance of
H. pylori
was mainly to MTZ, CLR, and LEV in local outpatients. Three drugs can be selected for increased MICs (Minimum Inhibitory Concentration) via single chromosomal mutations. In addition, the genotype could be used to predict the phenotypic
H. pylori
resistance to CLR and LEV.
Helicobacter pylori
is a key bacterium that causes stomach diseases. There was a high prevalence of
H. pylori
in the Chinese population. We analyzed the resistance phenotype and genotype characteristics of
H. pylori
in 4,399 outpatients at the First Hospital of Nanjing, China. We found a higher resistanc |
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ISSN: | 2165-0497 2165-0497 |
DOI: | 10.1128/spectrum.00550-23 |