Characteristics of Helicobacter pylori Heteroresistance in Gastric Biopsies and Its Clinical Relevance.
Characteristics of Helicobacter pylori Heteroresistance in Gastric Biopsies and Its Clinical Relevance.
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DOI：
10.3389/fcimb.2021.819506
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发表时间：
2021
影响因子：
5.7
通讯作者：
Xie Y
中科院分区：
文献类型：
--
作者：
Wang YH;Gong XL;Liu DW;Zeng R;Zhou LF;Sun XY;Liu DS;Xie Y
抗生素敏感性试验（AST）在抗幽门螺杆菌治疗中起着至关重要的作用，但传统的AST方法难以检测出异质耐药，可能导致耐药菌株的流行和根除失败。目的探讨H. pylori感染，并研究其临床相关性。共选择704例胃活检组织进行23 SrRNA和gyrA基因测序，470 H.从这些活检中选择幽门螺杆菌分离株进行AST检测，并回顾患者的临床特征。在699例23 SrRNA基因阳性标本中，98例（14.0%）为异源耐药基因型，其中野生型（WT）和A2143 G基因型（86.7%）占绝大多数。在694例gyrA基因阳性的活检标本中，99例（14.3%）为异源耐药基因型，以WT +87 K（26.3%）或WT +91 N（23.2%）为主。根据E-test结果，克拉霉素和左氧氟沙星的异质耐药基因型样本的耐药率分别为36.2%和68.1%。根据突变位点的测序谱峰将异源耐药样本分组时，突变位点的突变峰沿着耐药率较高。此外，感染突变株或异源耐药株的患者的消化性溃疡检出率低于感染WT株的患者（p < 0.05）。克拉霉素和左氧氟沙星的异质耐药基因型在H.幽门。大多数异源耐药基因型病例显示克拉霉素敏感表型和左氧氟沙星耐药表型。感染异源耐药基因型菌株的患者消化性溃疡检出率低于感染WT菌株的患者。
Antimicrobial susceptibility testing (AST) plays a vital role in anti-Helicobacter pylori treatment, but the traditional AST method has difficulty detecting heteroresistance, which may cause an increased prevalence of resistant strains and eradication failure. To investigate the characteristics of heteroresistance in H. pylori in gastric biopsies and investigate its clinical relevance. A total of 704 gastric biopsies were selected for 23S rRNA and gyrA gene sequencing, 470 H. pylori isolates from these biopsies were selected for AST, and the clinical characteristics of the patients were reviewed. For the 699 biopsies that were positive for 23S rRNA gene, 98 (14.0%) showed a heteroresistance genotype, and a wild type (WT) combined with A2143G (86.7%) genotype was found in most samples. For the 694 biopsies that were positive for gyrA gene, 99 (14.3%) showed a heteroresistance genotype, and a WT combined with 87K (26.3%) or WT combined with 91N (23.2%) genotype was predominant. According to the E-test results, the resistance rates of heteroresistance genotype samples for clarithromycin and levofloxacin were 36.2% and 68.1%, respectively. When dividing the heteroresistance samples into different groups according to the sequencing profile peaks of the mutation position, the resistance rates were higher along with mutation peaks at the mutation position. In addition, patients infected with mutated or heteroresistant strains showed lower peptic ulcer detection rates than those infected with the WT strain (p < 0.05). Heteroresistance genotypes for clarithromycin and levofloxacin were not rare in H. pylori. Most cases with a heteroresistance genotype showed a susceptible phenotype for clarithromycin and a resistance phenotype for levofloxacin. Patients infected with heteroresistance genotype strains showed a lower peptic ulcer detection rate than those infected with the WT strain.
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影响因子：
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Kishk RM;Soliman NM;Anani MM;Nemr N;Salem A;Attia F;Allithy ANA;Fouad M
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通讯作者：
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