BACKGROUND: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. METHODS: H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. RESULTS: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5% for the clarithromycin-sensitive strains, which was higher than the 67.9% for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100% in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23%) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. CONCLUSIONS: Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.
BACKGROUND: The current prevalence of primary antibiotic resistance of H. pylori is not known in Korea. This study was done to evaluate the prevalence of primary antibiotic resistance of H. pylori, and to evaluate the effect of point mutations of 23S rRNA on the rate of eradication of H. pylori. METHODS:H. pylori were isolated from gastric mucosal biopsy specimens obtained from 222 Koreans. The susceptibilities of the H. pylori isolates to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin were examined using the agar dilution method. DNA sequencing was carried out to detect H. pylori 23S rRNA mutations. RESULTS: The resistance to clarithromycin, tetracycline, ciprofloxacin, and levofloxacin increased during the period of 2007 to 2009 compared with 2003 to 2005 (P<0.05). However, amoxicillin and metronidazole resistance slightly decreased. The rates of eradication were 95.5% for the clarithromycin-sensitive strains, which was higher than the 67.9% for the clarithromycin-resistant strains (P=0.001). By contrast, the eradication rate was 100% in patients with amoxicillin-resistant H. pylori. Among 26 clarithromyin-resistant strains, 6 (23%) had A2143G mutations, and all of the cases in which these mutations were present were not eradicated by proton pump inhibitor-based triple therapy (P=0.0004). By contrast, none of the 26 clarithromyin-sensitive strains had A2143G mutations. The T2183C and A2223G mutations were frequently found in the sensitive strains and in the resistant strains. CONCLUSIONS:Clarithromycin resistance of H. pylori, which determined the efficacy of H. pylori eradication of proton pump inhibitor triple regimen, was found to be increased in a single center study. A2143G was an important 23S rRNA mutation associated with clarithromycin resistance and affected the H. pylori eradication efficacy.
Authors: Jai Hoon Yoon; Gwang Ho Baik; Kyoung Min Sohn; Dae Yong Kim; Yeon Soo Kim; Ki Tae Suk; Jin Bong Kim; Dong Joon Kim; Jin Bae Kim; Woon Geon Shin; Hak Yang Kim; Il Hyun Baik; Hyun Joo Jang Journal: World J Gastroenterol Date: 2012-12-07 Impact factor: 5.742
Authors: Jae Jin Hwang; Dong Ho Lee; Ae-Ra Lee; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Nayoung Kim Journal: World J Gastroenterol Date: 2015-07-14 Impact factor: 5.742
Authors: Ju Yup Lee; Nayoung Kim; Min Soo Kim; Yoon Jin Choi; Jung Won Lee; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Dong Ho Lee; Hyun Chae Jung Journal: Dig Dis Sci Date: 2014-03-06 Impact factor: 3.199
Authors: Woo Chul Chung; Sung Hoon Jung; Jung Hwan Oh; Tae Ho Kim; Dae Young Cheung; Byung Wook Kim; Sung Soo Kim; Jin Il Kim; Eun Young Sin Journal: World J Gastroenterol Date: 2014-06-07 Impact factor: 5.742
Authors: Sang-Pil Yun; Han Gyung Seon; Chang Soo Ok; Kwang Ho Yoo; Min Kyung Kang; Won Hee Kim; Chang Il Kwon; Kwang Hyun Ko; Seong Gyu Hwang; Pil Won Park; Sung Pyo Hong Journal: Gut Liver Date: 2012-10-18 Impact factor: 4.519