Change of point mutations in Helicobacter pylori rRNA associated with clarithromycin resistance in Italy
Change of point mutations in Helicobacter pylori rRNA associated with clarithromycin resistance in Italy
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DOI：
10.1099/jmm.0.067942-0
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发表时间：
2014-03-01
影响因子：
3
通讯作者：
Vaira, Dino
中科院分区：
文献类型：
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作者：
De Francesco, Vincenzo;Zullo, Angelo;Vaira, Dino
原发性克拉霉素耐药是影响幽门螺杆菌治疗效果的主要因素。本研究旨在：（i）评估耐药菌株表型（培养）和基因型（实时PCR）检测之间的一致性;（ii）在方法之间不一致的情况下，搜索除欧洲报告的最常见点突变以外的点突变;（iii）比较与单点突变相关的MIC。为了进行实时PCR，我们从H。pylori感染通过细菌培养成功诊断，并使用Etest评估克拉霉素耐药性。只有那些以前从未接受过治疗的患者，以及H。包括仅对克拉霉素耐药或无任何耐药的幽门螺杆菌菌株。对82例感染患者的活检进行了分析，其中包括42株克拉霉素耐药菌株和40株克拉霉素敏感菌株。在基因型分析中，仅23例（54.8%）检测到三种最常报告的点突变（A2142 C、A2142 G和A2143 G）中的至少一种，两种方法之间的一致性为0.67。在19例不一致病例中，14例检出新的点突变（A2115 G、G2141 A和A2144 T），使PCR的耐药检出率提高到88%（P
Primary clarithromycin resistance is the main factor affecting the efficacy of Helicobacter pylori therapy. This study aimed: (i) to assess the concordance between phenotypic (culture) and genotypic (real-time PCR) tests in resistant strains; (ii) to search, in the case of disagreement between the methods, for point mutations other than those reported as the most frequent in Europe; and (iii) to compare the MICs associated with the single point mutations. In order to perform real-time PCR, we retrieved biopsies from patients in whom H. pylori infection was successful diagnosed by bacterial culture and clarithromycin resistance was assessed using the Etest. Only patients who had never been previously treated, and with H. pylori strains that were either resistant exclusively to clarithromycin or without any resistance, were included. Biopsies from 82 infected patients were analysed, including 42 strains that were clarithromycin resistant and 40 that were clarithromycin susceptible on culture. On genotypic analysis, at least one of the three most frequently reported point mutations (A2142C, A2142G and A2143G) was detected in only 23 cases (54.8%), with a concordance between the two methods of 0.67. Novel point mutations (A2115G, G2141A and A2144T) were detected in a further 14 out of 19 discordant cases, increasing the resistance detection rate of PCR to 88% (P