Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic
The prevalence of Helicobacter pylori resistance to levofloxacin and metronidazole was high in the Dominican Republic. We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutatio...
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| Veröffentlicht in: | PloS one 2019-03, Vol.14 (3), p.e0213868 |
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| description | The prevalence of Helicobacter pylori resistance to levofloxacin and metronidazole was high in the Dominican Republic. We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutations associated with the antibiotic resistance using next-generation sequencing. We revealed that all 63 strains were sensitive towards sitafloxacin, furazolidone, and rifabutin. In contrast, the prevalence of rifaximin and garenoxacin resistance were high (82.5% and 34.9%, respectively). Patients more than or equal to 60 years old had the highest risk of double-antibiotic resistance (7/9, 77.8%, OR = 31.5, P = 0.009) and garenoxacin resistances (8/9, 88.9%, OR = 45.33, P = 0.002) with an increasing risk simultaneously by age (P = 0.004, r = 0.357). Almost all rifaximin resistant strains possessed multiple mutations with more than three mutations within rpoB including the most frequent novel mutations of S352L, I2726L, and V2465A. There was a significant association between vacA genotype and rifaximin resistance (P = 0.042). Among 23 levofloxacin-resistant strains, 82.6% (19/23, P |
| doi_str_mv | 10.1371/journal.pone.0213868 |
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We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutations associated with the antibiotic resistance using next-generation sequencing. We revealed that all 63 strains were sensitive towards sitafloxacin, furazolidone, and rifabutin. In contrast, the prevalence of rifaximin and garenoxacin resistance were high (82.5% and 34.9%, respectively). Patients more than or equal to 60 years old had the highest risk of double-antibiotic resistance (7/9, 77.8%, OR = 31.5, P = 0.009) and garenoxacin resistances (8/9, 88.9%, OR = 45.33, P = 0.002) with an increasing risk simultaneously by age (P = 0.004, r = 0.357). Almost all rifaximin resistant strains possessed multiple mutations with more than three mutations within rpoB including the most frequent novel mutations of S352L, I2726L, and V2465A. There was a significant association between vacA genotype and rifaximin resistance (P = 0.042). Among 23 levofloxacin-resistant strains, 82.6% (19/23, P <0.001) were also resistant to garenoxacin, and 39.1% (9/23) had a high minimal inhibitory concentration ≥8 μg/mL with positive trend correlation (P = <0.001, r = 0.84). Among 19 garenoxacin resistant strains, 16 (84.2%) contained mutations at D91 and N87 of gyrA. In conclusion, sitafloxacin, rifabutin, and furazolidone might be considered as alternative antibiotics to be included in H. pylori eradication regimen in regions with high prevalence of levofloxacin and metronidazole resistance, such as the Dominican Republic.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0213868</identifier><identifier>PMID: 30917150</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibacterial agents ; Antibiotic resistance ; Antibiotics ; Antimicrobial agents ; Antiprotozoan agents ; Antiulcer agents ; Bacterial Proteins - genetics ; Biology and Life Sciences ; Biomedical research ; Cancer therapies ; Chemotherapy ; Deoxyribonucleic acid ; Dilution ; Disease prevention ; DNA ; DNA-Directed RNA Polymerases - genetics ; Dominican Republic - epidemiology ; Drug resistance ; Drug Resistance, Multiple, Bacterial - drug effects ; Drug Resistance, Multiple, Bacterial - genetics ; Female ; Furazolidone ; Garenoxacin ; Gastric cancer ; Gastroenterology ; Gene mutation ; Gene sequencing ; Genotypes ; Helicobacter Infections - diagnosis ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter pylori ; Helicobacter pylori - drug effects ; Helicobacter pylori - physiology ; Hepatology ; Humans ; Levofloxacin ; Levofloxacin - pharmacology ; Levofloxacin - therapeutic use ; Lung diseases ; Male ; Medicine and Health Sciences ; Metronidazole ; Metronidazole - pharmacology ; Metronidazole - therapeutic use ; Microbial drug resistance ; Microbial Sensitivity Tests ; Middle Aged ; Minimum inhibitory concentration ; Mutation ; Next-generation sequencing ; Novels ; People and places ; Prevalence ; Preventive medicine ; Rifabutin ; Rifamycins ; Rifaximin ; RNA polymerase ; RpoB protein ; Staphylococcus infections ; Stomach cancer ; Strains (organisms) ; Tetracyclines ; Tropical diseases ; Tuberculosis ; University faculty ; Virulence - genetics</subject><ispartof>PloS one, 2019-03, Vol.14 (3), p.e0213868</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Miftahussurur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Miftahussurur et al 2019 Miftahussurur et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c651t-c86567ed79a0a4560f7b5662dc072f703b6bca44cddf8de746a81b7e9c47be063</citedby><cites>FETCH-LOGICAL-c651t-c86567ed79a0a4560f7b5662dc072f703b6bca44cddf8de746a81b7e9c47be063</cites><orcidid>0000-0002-1222-5819</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436749/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436749/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30917150$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miftahussurur, Muhammad</creatorcontrib><creatorcontrib>Cruz, Modesto</creatorcontrib><creatorcontrib>Doohan, Dalla</creatorcontrib><creatorcontrib>Subsomwong, Phawinee</creatorcontrib><creatorcontrib>Abreu, José A Jiménez</creatorcontrib><creatorcontrib>Hosking, Celso</creatorcontrib><creatorcontrib>Waskito, Langgeng Agung</creatorcontrib><creatorcontrib>Yamaoka, Yoshio</creatorcontrib><title>Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The prevalence of Helicobacter pylori resistance to levofloxacin and metronidazole was high in the Dominican Republic. We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutations associated with the antibiotic resistance using next-generation sequencing. We revealed that all 63 strains were sensitive towards sitafloxacin, furazolidone, and rifabutin. In contrast, the prevalence of rifaximin and garenoxacin resistance were high (82.5% and 34.9%, respectively). Patients more than or equal to 60 years old had the highest risk of double-antibiotic resistance (7/9, 77.8%, OR = 31.5, P = 0.009) and garenoxacin resistances (8/9, 88.9%, OR = 45.33, P = 0.002) with an increasing risk simultaneously by age (P = 0.004, r = 0.357). Almost all rifaximin resistant strains possessed multiple mutations with more than three mutations within rpoB including the most frequent novel mutations of S352L, I2726L, and V2465A. There was a significant association between vacA genotype and rifaximin resistance (P = 0.042). Among 23 levofloxacin-resistant strains, 82.6% (19/23, P <0.001) were also resistant to garenoxacin, and 39.1% (9/23) had a high minimal inhibitory concentration ≥8 μg/mL with positive trend correlation (P = <0.001, r = 0.84). Among 19 garenoxacin resistant strains, 16 (84.2%) contained mutations at D91 and N87 of gyrA. In conclusion, sitafloxacin, rifabutin, and furazolidone might be considered as alternative antibiotics to be included in H. pylori eradication regimen in regions with high prevalence of levofloxacin and metronidazole resistance, such as the Dominican Republic.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotic resistance</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Antiprotozoan agents</subject><subject>Antiulcer agents</subject><subject>Bacterial Proteins - genetics</subject><subject>Biology and Life Sciences</subject><subject>Biomedical research</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Deoxyribonucleic acid</subject><subject>Dilution</subject><subject>Disease prevention</subject><subject>DNA</subject><subject>DNA-Directed RNA Polymerases - genetics</subject><subject>Dominican Republic - epidemiology</subject><subject>Drug resistance</subject><subject>Drug Resistance, Multiple, Bacterial - drug effects</subject><subject>Drug Resistance, Multiple, Bacterial - genetics</subject><subject>Female</subject><subject>Furazolidone</subject><subject>Garenoxacin</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gene mutation</subject><subject>Gene sequencing</subject><subject>Genotypes</subject><subject>Helicobacter Infections - diagnosis</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter pylori</subject><subject>Helicobacter pylori - drug effects</subject><subject>Helicobacter pylori - physiology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Levofloxacin</subject><subject>Levofloxacin - pharmacology</subject><subject>Levofloxacin - therapeutic use</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Metronidazole</subject><subject>Metronidazole - pharmacology</subject><subject>Metronidazole - therapeutic use</subject><subject>Microbial drug resistance</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Minimum inhibitory concentration</subject><subject>Mutation</subject><subject>Next-generation sequencing</subject><subject>Novels</subject><subject>People and places</subject><subject>Prevalence</subject><subject>Preventive medicine</subject><subject>Rifabutin</subject><subject>Rifamycins</subject><subject>Rifaximin</subject><subject>RNA polymerase</subject><subject>RpoB protein</subject><subject>Staphylococcus infections</subject><subject>Stomach cancer</subject><subject>Strains (organisms)</subject><subject>Tetracyclines</subject><subject>Tropical diseases</subject><subject>Tuberculosis</subject><subject>University faculty</subject><subject>Virulence - genetics</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNp1ksFu1DAQhiMEoqXwBggiIXHbxY4TO7kgVYXSSpWQEJytiT3ZeOW1F9tZUc48OF42rXYPnDzyfPPP7_EUxWtKlpQJ-mHtp-DALrfe4ZJUlLW8fVKc045VC14R9vQoPitexLgmpMkQf16cMdJRQRtyXvy5NjsswSbMYmkf36A1yveg8lW5vbc-mBJcMr3xyahYJl8qP7l9djSrsbS484P1v0AZl0FdbjAF74yG395iGTCamMApLHM-jVh-8hvjjAJXfsPt1OduL4tnA9iIr-bzovhx_fn71c3i7uuX26vLu4XiDU0L1fKGC9SiAwJ1w8kg-obzSisiqkEQ1vNeQV0rrYdWo6g5tLQX2Kla9Eg4uyjeHnS31kc5DzDKinYdoy2jdSZuD4T2sJbbYDYQ7qUHI_9d-LCSEPIYLEo2gBJU6appdA1IADTpiULo-7YaKMtaH-duU79BrdClAPZE9DTjzChXfid5zbiouyzwbhYI_ueEMf3H8kytILsybvBZTG1MVPKyaQkjNSdVpt4fUSPmHx-jt1My3sVTsD6AKvgYAw6PhimR-8V7MCH3iyfnxctlb44f-1j0sGnsLz192cc</recordid><startdate>20190327</startdate><enddate>20190327</enddate><creator>Miftahussurur, Muhammad</creator><creator>Cruz, Modesto</creator><creator>Doohan, Dalla</creator><creator>Subsomwong, Phawinee</creator><creator>Abreu, José A Jiménez</creator><creator>Hosking, Celso</creator><creator>Waskito, Langgeng Agung</creator><creator>Yamaoka, Yoshio</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1222-5819</orcidid></search><sort><creationdate>20190327</creationdate><title>Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic</title><author>Miftahussurur, Muhammad ; Cruz, Modesto ; Doohan, Dalla ; Subsomwong, Phawinee ; Abreu, José A Jiménez ; Hosking, Celso ; Waskito, Langgeng Agung ; Yamaoka, Yoshio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c651t-c86567ed79a0a4560f7b5662dc072f703b6bca44cddf8de746a81b7e9c47be063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibacterial agents</topic><topic>Antibiotic resistance</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Antiprotozoan agents</topic><topic>Antiulcer agents</topic><topic>Bacterial Proteins - genetics</topic><topic>Biology and Life Sciences</topic><topic>Biomedical research</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Deoxyribonucleic acid</topic><topic>Dilution</topic><topic>Disease prevention</topic><topic>DNA</topic><topic>DNA-Directed RNA Polymerases - genetics</topic><topic>Dominican Republic - epidemiology</topic><topic>Drug resistance</topic><topic>Drug Resistance, Multiple, Bacterial - drug effects</topic><topic>Drug Resistance, Multiple, Bacterial - genetics</topic><topic>Female</topic><topic>Furazolidone</topic><topic>Garenoxacin</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gene mutation</topic><topic>Gene sequencing</topic><topic>Genotypes</topic><topic>Helicobacter Infections - diagnosis</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter pylori</topic><topic>Helicobacter pylori - drug effects</topic><topic>Helicobacter pylori - physiology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Levofloxacin</topic><topic>Levofloxacin - pharmacology</topic><topic>Levofloxacin - therapeutic use</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Metronidazole</topic><topic>Metronidazole - pharmacology</topic><topic>Metronidazole - therapeutic use</topic><topic>Microbial drug resistance</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Minimum inhibitory concentration</topic><topic>Mutation</topic><topic>Next-generation sequencing</topic><topic>Novels</topic><topic>People and places</topic><topic>Prevalence</topic><topic>Preventive medicine</topic><topic>Rifabutin</topic><topic>Rifamycins</topic><topic>Rifaximin</topic><topic>RNA polymerase</topic><topic>RpoB protein</topic><topic>Staphylococcus infections</topic><topic>Stomach cancer</topic><topic>Strains (organisms)</topic><topic>Tetracyclines</topic><topic>Tropical diseases</topic><topic>Tuberculosis</topic><topic>University faculty</topic><topic>Virulence - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miftahussurur, Muhammad</creatorcontrib><creatorcontrib>Cruz, Modesto</creatorcontrib><creatorcontrib>Doohan, Dalla</creatorcontrib><creatorcontrib>Subsomwong, Phawinee</creatorcontrib><creatorcontrib>Abreu, José A Jiménez</creatorcontrib><creatorcontrib>Hosking, Celso</creatorcontrib><creatorcontrib>Waskito, Langgeng Agung</creatorcontrib><creatorcontrib>Yamaoka, Yoshio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miftahussurur, Muhammad</au><au>Cruz, Modesto</au><au>Doohan, Dalla</au><au>Subsomwong, Phawinee</au><au>Abreu, José A Jiménez</au><au>Hosking, Celso</au><au>Waskito, Langgeng Agung</au><au>Yamaoka, Yoshio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-03-27</date><risdate>2019</risdate><volume>14</volume><issue>3</issue><spage>e0213868</spage><pages>e0213868-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The prevalence of Helicobacter pylori resistance to levofloxacin and metronidazole was high in the Dominican Republic. We used two-fold agar dilution method to determine the minimum inhibitory concentration of five alternative antibiotics in 63 Dominican strains. We also assessed the genetic mutations associated with the antibiotic resistance using next-generation sequencing. We revealed that all 63 strains were sensitive towards sitafloxacin, furazolidone, and rifabutin. In contrast, the prevalence of rifaximin and garenoxacin resistance were high (82.5% and 34.9%, respectively). Patients more than or equal to 60 years old had the highest risk of double-antibiotic resistance (7/9, 77.8%, OR = 31.5, P = 0.009) and garenoxacin resistances (8/9, 88.9%, OR = 45.33, P = 0.002) with an increasing risk simultaneously by age (P = 0.004, r = 0.357). Almost all rifaximin resistant strains possessed multiple mutations with more than three mutations within rpoB including the most frequent novel mutations of S352L, I2726L, and V2465A. There was a significant association between vacA genotype and rifaximin resistance (P = 0.042). Among 23 levofloxacin-resistant strains, 82.6% (19/23, P <0.001) were also resistant to garenoxacin, and 39.1% (9/23) had a high minimal inhibitory concentration ≥8 μg/mL with positive trend correlation (P = <0.001, r = 0.84). Among 19 garenoxacin resistant strains, 16 (84.2%) contained mutations at D91 and N87 of gyrA. In conclusion, sitafloxacin, rifabutin, and furazolidone might be considered as alternative antibiotics to be included in H. pylori eradication regimen in regions with high prevalence of levofloxacin and metronidazole resistance, such as the Dominican Republic.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30917150</pmid><doi>10.1371/journal.pone.0213868</doi><orcidid>https://orcid.org/0000-0002-1222-5819</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-03, Vol.14 (3), p.e0213868 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2199318314 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotic resistance Antibiotics Antimicrobial agents Antiprotozoan agents Antiulcer agents Bacterial Proteins - genetics Biology and Life Sciences Biomedical research Cancer therapies Chemotherapy Deoxyribonucleic acid Dilution Disease prevention DNA DNA-Directed RNA Polymerases - genetics Dominican Republic - epidemiology Drug resistance Drug Resistance, Multiple, Bacterial - drug effects Drug Resistance, Multiple, Bacterial - genetics Female Furazolidone Garenoxacin Gastric cancer Gastroenterology Gene mutation Gene sequencing Genotypes Helicobacter Infections - diagnosis Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter pylori Helicobacter pylori - drug effects Helicobacter pylori - physiology Hepatology Humans Levofloxacin Levofloxacin - pharmacology Levofloxacin - therapeutic use Lung diseases Male Medicine and Health Sciences Metronidazole Metronidazole - pharmacology Metronidazole - therapeutic use Microbial drug resistance Microbial Sensitivity Tests Middle Aged Minimum inhibitory concentration Mutation Next-generation sequencing Novels People and places Prevalence Preventive medicine Rifabutin Rifamycins Rifaximin RNA polymerase RpoB protein Staphylococcus infections Stomach cancer Strains (organisms) Tetracyclines Tropical diseases Tuberculosis University faculty Virulence - genetics |
| title | Five alternative Helicobacter pylori antibiotics to counter high levofloxacin and metronidazole resistance in the Dominican Republic |
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