Skip to main content

Advertisement

SpringerLink
Log in

Characterization of clarithromycin resistance in isolates of Helicobacter pylori from the UAE

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Clarithromycin therapy is effective in eradicating Helicobacter pylori. However, the resistance of H. pylori to clarithromycin is increasingly reported. The present study aimed to characterize the types of mutations present in the 23S rRNA genes of isolates of clarithromycin-resistant H. pylori from the UAE.

Methods

Clarithromycin susceptibility of H. pylori isolates (n = 26) was determined by E tests. Analyses for point mutations in domain V of the 23S rRNA genes in clarithromycin-resistant and-sensitive strains were performed by sequence analysis of amplified PCR products.

Results

Out of 100 gastric antral biopsy samples, 26 were positive for H. pylori by culture, and 29 were positive by PCR. Of the 26 culture isolates, five (19.2%) were resistant to clarithromycin and 24 were sensitive. The MIC of the resistant strains ranged from 3 to 24 μg/mL (median 24). All of the clarithromycin-resistant isolates had point mutations in the 23S rRNA gene. Two isolates had an A2142G 23S rRNA mutation, and three had A2143G mutations.

Conclusion

Clarithromycin resistance was common in this small collection of H. pylori isolates from the UAE. The A2142G and A2143G mutations were associated with clarithromycin resistance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Huang JQ, Hunt RH. Review article: Helicobacter pylori and gastric cancer—the clinicians’ point of view. Aliment Pharmacol Ther. 2000;14 Suppl 3:48–54.

    Article  PubMed  Google Scholar 

  2. Sipponen P, Kosunen TU, Valle J, Riihelä M, Seppälä K. Helicobacter pylori infection and chronic gastritis in gastric cancer. J Clin Pathol. 1992;45:319–23.

    Article  CAS  PubMed  Google Scholar 

  3. Megraud F. Epidemiology and mechanism of antibiotic resistance in Helicobacter pylori. Gastroenterology. 1998;115:1278–82.

    Article  CAS  PubMed  Google Scholar 

  4. de Boer WA, van Etten RJ, Schneeberger PM, Tytgat GN. A single drug for Helicobacter pylori infection: first results with a new bismuth triple monocapsule. Am J Gastroenterol. 2000;95:641–5.

    Article  PubMed  Google Scholar 

  5. Megraud F, Lehn N, Lind T, Bayerdorffer E, O’Morain C. Antimicrobial susceptibility testing of Helicobacter pylori in a large multicenter trial: the MACH 2 study. Antimicrob Agents Chemother. 1999;43:2747–52.

    CAS  PubMed  Google Scholar 

  6. Kato S, Fujimura S, Udagawa H, Shimizu T, Maisawa S, Ozawa K, et al. Antibiotic resistance of Helicobacter pylori strains in Japanese children. J Clin Microbiol. 2002;40:649–53.

    Article  CAS  PubMed  Google Scholar 

  7. Occhialini A, Urdaci M, Doucet-Populaire F, Bebear CM, Lamouliatte H, Megraud F. Macrolide resistance in Helicobacter pylori: rapid detection of point mutations and assays of macrolide binding to ribosomes. Antimicrob Agents Chemother. 1997;41:2724–8.

    CAS  PubMed  Google Scholar 

  8. Versalovic J, Shortridge D, Kibler K, et al. Mutations in 23S rRNA are associated with clarithromycin resistance in Helicobacter pylori. Antimicrob Agents Chemother. 1996;40:477–80.

    CAS  PubMed  Google Scholar 

  9. Hulten K, Gibreel A, Skold O, Engstrand L. Macrolide resistance in Helicobacter pylori: mechanism and stability in strains from clarithromycin-treated patients. Antimicrob Agents Chemother. 1997;41:2550–3.

    CAS  PubMed  Google Scholar 

  10. van Doorn LJ, Glupczynski Y, Kusters JG, et al. 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. Antimicrob Agents Chemother. 2001;45:1500–4.

    Article  PubMed  Google Scholar 

  11. Hammar M, Tyszkiewicz T, Wadström T, O’Toole PW. Rapid detection of Helicobacter pylori in gastric biopsy material by polymerase chain reaction. J Clin Microbiol. 1992;30:54–8.

    CAS  PubMed  Google Scholar 

  12. Alarcón T, Domingo D, Prieto N, López-Brea M. PCR using 3′-mismatched primers to detect A2142C mutation in 23S rRNA conferring resistance to clarithromycin in Helicobacter pylori clinical isolates. J Clin Microbiol. 2000;38:923–5.

    PubMed  Google Scholar 

  13. Mêgraud F. H. pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut. 2004;53:1374–84.

    Article  PubMed  Google Scholar 

  14. Toracchio S, Marzio L. Primary and secondary antibiotic resistance of Helicobacter pylori strains isolated in central Italy during the years 1998–2002. Dig Liver Dis. 2003;35:541–5.

    Article  CAS  PubMed  Google Scholar 

  15. Torres J, Camorlinga-Ponce M, Pérez-Pérez G, et al. Increasing multidrug resistance in Helicobacter pylori strains isolated from children and adults in Mexico. J Clin Microbiol. 2001;39:2677–80.

    Article  CAS  PubMed  Google Scholar 

  16. Versalovic J, Osato MS, Spakovsky K, et al. Point mutation in the 23S rRNA gene of Helicobacter pylori associated with different levels of clarithromycin resistance. J Antimicrob Chemother. 1997;40:283–6.

    Article  CAS  PubMed  Google Scholar 

  17. Stone GG, Shortridge D, Versalovic J, et al. PCR oligonucleotide ligation assay to determine the prevalence of 23S rRNA gene mutations in clarithromycin-resistant Helicobacter pylori. Antimicrob Agents Chemother. 1997;41:712–4.

    Google Scholar 

  18. Alarcon T, Domingo D, Prieto N, Lopez-Brea M. Clarithromycin resistance stability in Helicobacter pylori: influence of the MIC and type of mutation in the 23S rRNA. J Antimicrob Chemother. 2000;46:613–6.

    Article  CAS  PubMed  Google Scholar 

  19. Doorn LJ, Glupczynski Y, Kusters JG, et al. 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. Antimicrob Agents Chemother. 2001;45:1500–4.

    Article  PubMed  Google Scholar 

  20. Maeda S, Yoshida H, Matsunaga H, et al. Detection of clarithromycin-resistant Helicobacter pylori strains by a preferential homoduplex formation assay. J Clin Microbiol. 2000;38:210–4.

    CAS  PubMed  Google Scholar 

  21. Kato S, Fujimura S, Udagawa H, et al. Antibiotic resistance of Helicobacter pylori strains in Japanese children. J Clin Microbiol. 2002;40:649–53.

    Article  CAS  PubMed  Google Scholar 

  22. Pan ZJ, Su WW, Tytgat GNJ, Dankert H, Ende A. Assessment of clarithromycin-resistant Helicobacter pylori among patients in Shanghai and Guangzhou, China, by primer-mismatch PCR. J Clin Microbiol. 2002;40:259–61.

    Article  CAS  PubMed  Google Scholar 

  23. Versalovic J, Shortridge D, Kibler K, et al. Mutations in 23S rRNA are associated with clarithromycin resistance in Helicobacter pylori. Antimicrob Agents Chemother. 1996;40:477–80.

    CAS  PubMed  Google Scholar 

  24. Taylor DE, Ge Z, Purych D, Lo T, Hiratsuka K. Cloning and sequence analysis of two copies of a 23S rRNA gene from Helicobacter pylori and association of clarithromycin resistance with 23S rRNA mutations. Antimicrob Agents Chemother. 1997;41:2621–8.

    CAS  PubMed  Google Scholar 

  25. Fontana C, Favaro M, Minelli S, et al. New site of modification of 23S rRNA associated with clarithromycin resistance of Helicobacter pylori clinical isolates. Antimicrob Agents Chemother. 2002;46:3765–9.

    Article  CAS  PubMed  Google Scholar 

  26. Garrido L, Toledo H. Novel genotypes in Helicobacter pylori involving domain V of the 23S rRNA gene. Helicobacter. 2007;12:505–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Microbiology Division, Zayed Military Hospital, Abu Dhabi, United Arab Emirates (UAE)

    Mubarak S. Alfaresi & Abida A. Elkoush

Authors
  1. Mubarak S. Alfaresi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abida A. Elkoush
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mubarak S. Alfaresi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alfaresi, M.S., Elkoush, A.A. Characterization of clarithromycin resistance in isolates of Helicobacter pylori from the UAE. Indian J Gastroenterol 29, 116–120 (2010). https://doi.org/10.1007/s12664-010-0034-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-010-0034-z

Keywords

Search

Navigation