Efficacy of Clarithromycin Depends on the Bacterial Density in Clarithromycin-Heteroresistant Helicobacter pylori Infections: An In Situ Detected Susceptibility and Quantitative Morphometry-Based Retrospective Study
The global rise in clarithromycin (Cla) resistance is considered to be the main contributor of ( ) eradication failures. In nearly half of the Cla-resistant infections, Cla-susceptible bacteria are simultaneously present with the Cla-resistant ones (Cla-heteroresistance). The proportion of resistant...
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| Veröffentlicht in: | Pathology oncology research 2021-06, Vol.27, p.1609863-1609863 |
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| creator | Kim, Jewel Ju Ea Kocsmár, Ildikó Buzás, György Miklós Szirtes, Ildikó Rusz, Orsolya Diczházi, Csaba Szijártó, Attila Hritz, István Schaff, Zsuzsa Kiss, András Kocsmár, Éva Lotz, Gábor |
| description | The global rise in clarithromycin (Cla) resistance is considered to be the main contributor of
(
) eradication failures. In nearly half of the Cla-resistant
infections, Cla-susceptible bacteria are simultaneously present with the Cla-resistant ones (Cla-heteroresistance). The proportion of resistant bacteria in the bacterial population (R-fraction) and its predictive role for the use of Cla-based therapies in Cla-heteroresistant infections has not yet been investigated. Our retrospective study analyzed gastric biopsy samples of 62
-positive patients with Cla-heteroresistant infection. Fluorescence
Hybridization technique was used to visualize the coexistence of resistant and susceptible bacteria within one tissue sample. R-fraction was quantified on multichannel microimages by digital morphometry. Resistant bacteria had a patchy distribution within the whole bacterial population causing high diversity among the investigated areas. Patients were subdivided into two major groups according to whether a Cla-based eradication attempt was conducted before or after the biopsy sampling. R-fraction was significantly lower among cases having only one previous Cla-based eradication attempt vs. those that had multiple previous eradications, including at least one Cla-containing therapy (0.41 vs. 0.89,
= 0.0308). Majority of the patients without previous eradication attempt had successful eradication with Cla-containing regimen (59.26%), verified by a negative
C-urea breath test or control biopsy. Multivariable model indicated that the therapeutic outcome using Cla-based regimens depended on the bacterial density rather than the R-fraction. Our study raises the potential use of Cla-containing eradication therapies in certain Cla-heteroresistant
infections, taking into account the possible predictive role of bacterial density. |
| doi_str_mv | 10.3389/pore.2021.1609863 |
| format | Article |
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(
) eradication failures. In nearly half of the Cla-resistant
infections, Cla-susceptible bacteria are simultaneously present with the Cla-resistant ones (Cla-heteroresistance). The proportion of resistant bacteria in the bacterial population (R-fraction) and its predictive role for the use of Cla-based therapies in Cla-heteroresistant infections has not yet been investigated. Our retrospective study analyzed gastric biopsy samples of 62
-positive patients with Cla-heteroresistant infection. Fluorescence
Hybridization technique was used to visualize the coexistence of resistant and susceptible bacteria within one tissue sample. R-fraction was quantified on multichannel microimages by digital morphometry. Resistant bacteria had a patchy distribution within the whole bacterial population causing high diversity among the investigated areas. Patients were subdivided into two major groups according to whether a Cla-based eradication attempt was conducted before or after the biopsy sampling. R-fraction was significantly lower among cases having only one previous Cla-based eradication attempt vs. those that had multiple previous eradications, including at least one Cla-containing therapy (0.41 vs. 0.89,
= 0.0308). Majority of the patients without previous eradication attempt had successful eradication with Cla-containing regimen (59.26%), verified by a negative
C-urea breath test or control biopsy. Multivariable model indicated that the therapeutic outcome using Cla-based regimens depended on the bacterial density rather than the R-fraction. Our study raises the potential use of Cla-containing eradication therapies in certain Cla-heteroresistant
infections, taking into account the possible predictive role of bacterial density.</description><identifier>ISSN: 1532-2807</identifier><identifier>ISSN: 1219-4956</identifier><identifier>EISSN: 1532-2807</identifier><identifier>DOI: 10.3389/pore.2021.1609863</identifier><identifier>PMID: 34267605</identifier><language>eng</language><publisher>Switzerland: Frontiers Media SA</publisher><subject>Anti-Bacterial Agents - pharmacology ; Antibiotics ; Antimicrobial agents ; Bacteria ; Bacterial Load ; Biopsy ; Clarithromycin - pharmacology ; Cross-Sectional Studies ; Drug Resistance, Bacterial ; Ethics ; Female ; Follow-Up Studies ; Helicobacter Infections - drug therapy ; Helicobacter Infections - microbiology ; Helicobacter Infections - pathology ; Helicobacter pylori - drug effects ; Helicobacter pylori - growth & development ; Humans ; Hybridization ; Infections ; Male ; Middle Aged ; Mutation ; Pathology and Oncology Archive ; Patients ; Prognosis ; Retrospective Studies</subject><ispartof>Pathology oncology research, 2021-06, Vol.27, p.1609863-1609863</ispartof><rights>Copyright © 2021 Kim, Kocsmár, Buzás, Szirtes, Rusz, Diczházi, Szijártó, Hritz, Schaff, Kiss, Kocsmár and Lotz.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2021 Kim, Kocsmár, Buzás, Szirtes, Rusz, Diczházi, Szijártó, Hritz, Schaff, Kiss, Kocsmár and Lotz. 2021 Kim, Kocsmár, Buzás, Szirtes, Rusz, Diczházi, Szijártó, Hritz, Schaff, Kiss, Kocsmár and Lotz</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-87cf6fb544f60e82a733f3914387be9f53ebff21bd419583f03c3ad008c53efe3</citedby><cites>FETCH-LOGICAL-c427t-87cf6fb544f60e82a733f3914387be9f53ebff21bd419583f03c3ad008c53efe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275651/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275651/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34267605$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Jewel Ju Ea</creatorcontrib><creatorcontrib>Kocsmár, Ildikó</creatorcontrib><creatorcontrib>Buzás, György Miklós</creatorcontrib><creatorcontrib>Szirtes, Ildikó</creatorcontrib><creatorcontrib>Rusz, Orsolya</creatorcontrib><creatorcontrib>Diczházi, Csaba</creatorcontrib><creatorcontrib>Szijártó, Attila</creatorcontrib><creatorcontrib>Hritz, István</creatorcontrib><creatorcontrib>Schaff, Zsuzsa</creatorcontrib><creatorcontrib>Kiss, András</creatorcontrib><creatorcontrib>Kocsmár, Éva</creatorcontrib><creatorcontrib>Lotz, Gábor</creatorcontrib><title>Efficacy of Clarithromycin Depends on the Bacterial Density in Clarithromycin-Heteroresistant Helicobacter pylori Infections: An In Situ Detected Susceptibility and Quantitative Morphometry-Based Retrospective Study</title><title>Pathology oncology research</title><addtitle>Pathol Oncol Res</addtitle><description>The global rise in clarithromycin (Cla) resistance is considered to be the main contributor of
(
) eradication failures. In nearly half of the Cla-resistant
infections, Cla-susceptible bacteria are simultaneously present with the Cla-resistant ones (Cla-heteroresistance). The proportion of resistant bacteria in the bacterial population (R-fraction) and its predictive role for the use of Cla-based therapies in Cla-heteroresistant infections has not yet been investigated. Our retrospective study analyzed gastric biopsy samples of 62
-positive patients with Cla-heteroresistant infection. Fluorescence
Hybridization technique was used to visualize the coexistence of resistant and susceptible bacteria within one tissue sample. R-fraction was quantified on multichannel microimages by digital morphometry. Resistant bacteria had a patchy distribution within the whole bacterial population causing high diversity among the investigated areas. Patients were subdivided into two major groups according to whether a Cla-based eradication attempt was conducted before or after the biopsy sampling. R-fraction was significantly lower among cases having only one previous Cla-based eradication attempt vs. those that had multiple previous eradications, including at least one Cla-containing therapy (0.41 vs. 0.89,
= 0.0308). Majority of the patients without previous eradication attempt had successful eradication with Cla-containing regimen (59.26%), verified by a negative
C-urea breath test or control biopsy. Multivariable model indicated that the therapeutic outcome using Cla-based regimens depended on the bacterial density rather than the R-fraction. Our study raises the potential use of Cla-containing eradication therapies in certain Cla-heteroresistant
infections, taking into account the possible predictive role of bacterial density.</description><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Bacteria</subject><subject>Bacterial Load</subject><subject>Biopsy</subject><subject>Clarithromycin - pharmacology</subject><subject>Cross-Sectional Studies</subject><subject>Drug Resistance, Bacterial</subject><subject>Ethics</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - microbiology</subject><subject>Helicobacter Infections - pathology</subject><subject>Helicobacter pylori - drug effects</subject><subject>Helicobacter pylori - growth & development</subject><subject>Humans</subject><subject>Hybridization</subject><subject>Infections</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Pathology and Oncology Archive</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><issn>1532-2807</issn><issn>1219-4956</issn><issn>1532-2807</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdUstu1DAUjRCIlsIHsEGW2LDJ4EecOCyQ2qEwlYoQDKwtx7lmXGXsYDuV8qX9nTp0qFpWvvZ5-F77FMVrgleMifb96AOsKKZkRWrcipo9KY4JZ7SkAjdPH9RHxYsYrzDGTd3Wz4sjVtG6qTE_Lm7OjbFa6Rl5g9aDCjbtgt_P2jr0CUZwfUTeobQDdKZ0gmDVkAEXbZpR5jyWlBvIlNxVtDEpl9AGBqt991eJxnnwwaILZ0An6138gE5d3qKtTVM2TfkYerSdooYx2c4OyyXK9ej7lM1sUsleA_rqw7jze0hhLs9UzIofufZxXFwzvk1TP78snhk1RHh1WE-KX5_Pf6435eW3Lxfr08tSV7RJpWi0qU3Hq8rUGARVDWOGtaRioumgNZxBZwwlXV-RlgtmMNNM9RgLnSED7KT4eOc7Tt0eeg0uBTXIMdi9CrP0ysrHiLM7-dtfS0EbXnOSDd4dDIL_M0FMcm_z_MOgHPgpSso5Xb6WVpn69j_qlZ-Cy-NlVsMrkXkLi9yxdH6TGMDcN0OwXGIjl9jIJTbyEJusefNwinvFv5ywW07Zxlo</recordid><startdate>20210629</startdate><enddate>20210629</enddate><creator>Kim, Jewel Ju Ea</creator><creator>Kocsmár, Ildikó</creator><creator>Buzás, György Miklós</creator><creator>Szirtes, Ildikó</creator><creator>Rusz, Orsolya</creator><creator>Diczházi, Csaba</creator><creator>Szijártó, Attila</creator><creator>Hritz, István</creator><creator>Schaff, Zsuzsa</creator><creator>Kiss, András</creator><creator>Kocsmár, Éva</creator><creator>Lotz, Gábor</creator><general>Frontiers Media SA</general><general>Frontiers Media S.A</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>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210629</creationdate><title>Efficacy of Clarithromycin Depends on the Bacterial Density in Clarithromycin-Heteroresistant Helicobacter pylori Infections: An In Situ Detected Susceptibility and Quantitative Morphometry-Based Retrospective Study</title><author>Kim, Jewel Ju Ea ; Kocsmár, Ildikó ; Buzás, György Miklós ; Szirtes, Ildikó ; Rusz, Orsolya ; Diczházi, Csaba ; Szijártó, Attila ; Hritz, István ; Schaff, Zsuzsa ; Kiss, András ; Kocsmár, Éva ; Lotz, Gábor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-87cf6fb544f60e82a733f3914387be9f53ebff21bd419583f03c3ad008c53efe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Bacteria</topic><topic>Bacterial Load</topic><topic>Biopsy</topic><topic>Clarithromycin - pharmacology</topic><topic>Cross-Sectional Studies</topic><topic>Drug Resistance, Bacterial</topic><topic>Ethics</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - microbiology</topic><topic>Helicobacter Infections - pathology</topic><topic>Helicobacter pylori - drug effects</topic><topic>Helicobacter pylori - growth & development</topic><topic>Humans</topic><topic>Hybridization</topic><topic>Infections</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Pathology and Oncology Archive</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Jewel Ju Ea</creatorcontrib><creatorcontrib>Kocsmár, Ildikó</creatorcontrib><creatorcontrib>Buzás, György Miklós</creatorcontrib><creatorcontrib>Szirtes, Ildikó</creatorcontrib><creatorcontrib>Rusz, Orsolya</creatorcontrib><creatorcontrib>Diczházi, Csaba</creatorcontrib><creatorcontrib>Szijártó, Attila</creatorcontrib><creatorcontrib>Hritz, István</creatorcontrib><creatorcontrib>Schaff, Zsuzsa</creatorcontrib><creatorcontrib>Kiss, András</creatorcontrib><creatorcontrib>Kocsmár, Éva</creatorcontrib><creatorcontrib>Lotz, Gábor</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>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pathology oncology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Jewel Ju Ea</au><au>Kocsmár, Ildikó</au><au>Buzás, György Miklós</au><au>Szirtes, Ildikó</au><au>Rusz, Orsolya</au><au>Diczházi, Csaba</au><au>Szijártó, Attila</au><au>Hritz, István</au><au>Schaff, Zsuzsa</au><au>Kiss, András</au><au>Kocsmár, Éva</au><au>Lotz, Gábor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of Clarithromycin Depends on the Bacterial Density in Clarithromycin-Heteroresistant Helicobacter pylori Infections: An In Situ Detected Susceptibility and Quantitative Morphometry-Based Retrospective Study</atitle><jtitle>Pathology oncology research</jtitle><addtitle>Pathol Oncol Res</addtitle><date>2021-06-29</date><risdate>2021</risdate><volume>27</volume><spage>1609863</spage><epage>1609863</epage><pages>1609863-1609863</pages><issn>1532-2807</issn><issn>1219-4956</issn><eissn>1532-2807</eissn><abstract>The global rise in clarithromycin (Cla) resistance is considered to be the main contributor of
(
) eradication failures. In nearly half of the Cla-resistant
infections, Cla-susceptible bacteria are simultaneously present with the Cla-resistant ones (Cla-heteroresistance). The proportion of resistant bacteria in the bacterial population (R-fraction) and its predictive role for the use of Cla-based therapies in Cla-heteroresistant infections has not yet been investigated. Our retrospective study analyzed gastric biopsy samples of 62
-positive patients with Cla-heteroresistant infection. Fluorescence
Hybridization technique was used to visualize the coexistence of resistant and susceptible bacteria within one tissue sample. R-fraction was quantified on multichannel microimages by digital morphometry. Resistant bacteria had a patchy distribution within the whole bacterial population causing high diversity among the investigated areas. Patients were subdivided into two major groups according to whether a Cla-based eradication attempt was conducted before or after the biopsy sampling. R-fraction was significantly lower among cases having only one previous Cla-based eradication attempt vs. those that had multiple previous eradications, including at least one Cla-containing therapy (0.41 vs. 0.89,
= 0.0308). Majority of the patients without previous eradication attempt had successful eradication with Cla-containing regimen (59.26%), verified by a negative
C-urea breath test or control biopsy. Multivariable model indicated that the therapeutic outcome using Cla-based regimens depended on the bacterial density rather than the R-fraction. Our study raises the potential use of Cla-containing eradication therapies in certain Cla-heteroresistant
infections, taking into account the possible predictive role of bacterial density.</abstract><cop>Switzerland</cop><pub>Frontiers Media SA</pub><pmid>34267605</pmid><doi>10.3389/pore.2021.1609863</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Pathology oncology research, 2021-06, Vol.27, p.1609863-1609863 |
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| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Anti-Bacterial Agents - pharmacology Antibiotics Antimicrobial agents Bacteria Bacterial Load Biopsy Clarithromycin - pharmacology Cross-Sectional Studies Drug Resistance, Bacterial Ethics Female Follow-Up Studies Helicobacter Infections - drug therapy Helicobacter Infections - microbiology Helicobacter Infections - pathology Helicobacter pylori - drug effects Helicobacter pylori - growth & development Humans Hybridization Infections Male Middle Aged Mutation Pathology and Oncology Archive Patients Prognosis Retrospective Studies |
| title | Efficacy of Clarithromycin Depends on the Bacterial Density in Clarithromycin-Heteroresistant Helicobacter pylori Infections: An In Situ Detected Susceptibility and Quantitative Morphometry-Based Retrospective Study |
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