Accurate Prediction of Macrolide Resistance in Helicobacter pylori by a PCR Line Probe Assay for Detection of Mutations in the 23S rRNA Gene: Multicenter Validation Study
Leen-Jan van Doorn,Youri Glupczynski,Johannes G. Kusters,Francis Mégraud,Peter Midolo,Nadia Maggi-Solcà,Dulciene M.M. Queiroz,Nathalie Nouhan,Els Stet,Wim Quint +9 more
TLDR
Although there was no significant association between 23S rDNA mutations and the vacA andcagA status, clarithromycin-susceptible strains more often contained mixed vacA genotypes, indicating the presence of multiple H. pylori strains.Abstract:
Helicobacter pylori strains from 299 patients were tested in six laboratories in different countries Macrolide susceptibility of the strains was determined by agar dilution (174%) or the epsilometer test (826%) Mutations in the 23S ribosomal DNA (rDNA) that are associated with macrolide resistance were analyzed by PCR and reverse hybridization (PCR-line probe assay [LiPA]) This method identifies A2115G, G2141A, A2142G, A2142C, A2142T, A2143G, and A2143C mutations in the 23S rDNA vacA s-region (s1a, s1b, s1c, and s2) and m-region (m1, m2a, and m2b) genotypes and cagA status were also determined using another PCR-LiPA system Of the 299 strains investigated by MIC testing, 130 (435%) were resistant and 169 (565%) were susceptible to clarithromycin Of the 130 resistant strains, 127 (977%) contained 23S rDNA mutations, whereas 167 (988%) of the 169 susceptible strains contained wild-type sequences The predominant mutations were A2143G (452%) and A2142G (333%) Twenty-eight (198%) strains contained multiple 23S rDNA mutations Only five resistant strains contained the A2142C mutation (three of these in combination with the A2142G mutation), and the A2115G, G2141A, A2142T, and A2143C mutations were not found MICs of clarithromycin for the A2142G mutant strains were significantly higher than MICs for the A2143G strains Although there was no significant association between 23S rDNA mutations and the vacA and cagA status, clarithromycin-susceptible strains more often contained mixed vacA genotypes, indicating the presence of multiple H pylori strains In conclusion, our data confirmed the very strong association between 23S rDNA mutations and macrolide resistance and showed that the PCR-LiPA permits accurate and reliable diagnosis of macrolide resistance in H pyloriread more
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Review article: the global emergence of Helicobacter pylori antibiotic resistance.
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Real-Time PCR Assay for Rapid and Accurate Detection of Point Mutations Conferring Resistance to Clarithromycin in Helicobacter pylori
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TL;DR: A real-time PCR that included a simultaneous detection of the amplicons by hybridization of two probes labeled with LC-Red and fluorescein by using the fluorescence resonance energy transfer (FRET) technology and melting curve analysis with the LightCycler thermocycler had an accuracy at least as satisfactory as that of the phenotypic tests and could be performed within 2 h.
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References
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TL;DR: This minireview concentrates on target site alteration, which for erythromycin is the 50S subunit of the ribosome, and on posttranscriptional modification of the 23S rRNA by an adenine-specific N-methyltransferase (methylase) specified by a class of genes bearing the name erm.
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TL;DR: VacA s1, cagA, and iceA1 are markers of H. pylori strains that are more likely to lead to ulcer disease that are associated with specific virulence-associated bacterial genotypes.
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Mutations in 23S rRNA are associated with clarithromycin resistance in Helicobacter pylori.
James Versalovic,D. Shortridge,K. Kibler,M. V. Griffy,J. Beyer,R. K. Flamm,S. K. Tanaka,David Y. Graham,Mae F. Go +8 more
TL;DR: This study is the first to report mutations in H. pylori associated with resistance to an antimicrobial agent used in established peptic ulcer treatment regimens and shows no polymorphisms in a conserved loop within domain V of 23S rRNA.
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A systematic review of Helicobacter pylori eradication therapy--the impact of antimicrobial resistance on eradication rates.
TL;DR: The overall eradication rates of currently advised Helicobacter pylori eradication regimens were determined and conflicting evidence on the impact of antimicrobial resistance on the eradications rates was resolved.
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Treatment of Helicobacter pylori Infection: A Review of the World Literature
TL;DR: The present article reviews the effectiveness of currently used antimicrobial regimens, aimed to cure H. pylori infection.