Molecular testing for H. pylori clarithromycin and quinolone resistance: a prospective Chinese study
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 40 (8), 1-10
- https://doi.org/10.1007/s10096-021-04188-4
Abstract
In China, there is a high prevalence of antibiotic-resistant Helicobacter pylori infections in the population. The aim of the study was to assess a new ARMS-PCR test for detection of H. pylori clarithromycin resistance (CR) and quinolone resistance (QR) mutations and evaluate the spectrum of antibiotic resistance in patients from three Chinese provinces. Sanger sequencing and multiplex ARMS-PCR were used to detect H. pylori CR and QR bacteria in gastric biopsy samples. Among the 1,182 patients enrolled with gastritis, 643 (54.4%) were positive for H. pylori. Of these, 371 (57.7%) had antibiotic-resistant strains, comprising 236 (63.6%) with a single drug antibiotic-resistant strain and 135 (36.4%) with multiple drug-resistant strains. Following Sanger sequencing analysis of 23S rRNA and gyrA gene for mutations (antibiotic resistance markers), rates of CR, QR, and multidrug resistance (CR and QR) were 19.9, 12.0, and 25.8%, respectively. The 23S rRNA CR mutation A2143G (286, 96.9%) and the gyrA QR mutations C261A (85, 31.5%) and G271A (71, 26.3%) were common. Benchmarking against Sanger sequencing results, multiplex ARMS-PCR test had a high diagnostic sensitivity and specificity for detection of CR (96 and 93%), QR (95 and 92%) and multidrug resistance (95 and 95%). Based on our findings, the high incidence of single and multiple antibiotic resistance requires the routine checking of antibiotic resistance in all patients with suspected H. pylori infections. Multiplex ARMS-PCR is a simple and rapid test that can be now used for more efficient treatment of H. pylori infections and reduces the misuse of antibiotics.Keywords
Funding Information
- Scientific Research Projects of Universities in Zhejiang Province (Y201430629)
- Huzhou Nonprofit Technological Application Research Project (2017GY39, 2018GYB320)
This publication has 32 references indexed in Scilit:
- Helicobacter pyloriresistance to antibiotics in Europe and its relationship to antibiotic consumptionGut, 2012
- Mutations of Helicobacter pylori Associated with Fluoroquinolone Resistance in KoreaHelicobacter, 2011
- Prevalence of Helicobacter pylori Infection and Identification of Risk Factors in Rural and Urban Beijing, ChinaHelicobacter, 2009
- Update on fluoroquinolone resistance in Helicobacter pylori: new mutations leading to resistance and first description of a gyrA polymorphism associated with hypersusceptibilityInternational Journal of Antimicrobial Agents, 2007
- H pylori antibiotic resistance: prevalence, importance, and advances in testingGut, 2004
- Real-Time PCR Assay for Rapid and Accurate Detection of Point Mutations Conferring Resistance to Clarithromycin in Helicobacter pyloriJournal of Clinical Microbiology, 2003
- Helicobacter pylori and macrolidesPublished by Springer Science and Business Media LLC ,2002
- Nucleotide sequence of the gyrA gene and characterization of ciprofloxacin-resistant mutants of Helicobacter pyloriAntimicrobial Agents and Chemotherapy, 1995
- The E test for antimicrobial susceptibility testing of Helicobacter pylonJournal of Antimicrobial Chemotherapy, 1993
- Analysis of any point mutation in DNA. The amplification refractory mutation system (ARMS)Nucleic Acids Research, 1989