Iman Ramzy1, Hassan Elgarem1, Iman Hamza1, Doaa Ghaith2, Tamer Elbaz1, Waleed Elhosary1, Gehan Mostafa1, Mohammad A Mohey Eldin Elzahry1. 1. Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. E-mails: hgarem@yahoo.cpm; Iman_hamza@hotmail.com; Iman_ramzy@hotmail.com; ma_mohey@kasralainy.edu.eg; Wh8609@gmail.com; gehan1511@gmail.com; tamerbaz@yahoo.com. 2. Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. E-mail: doaa.ghaith@kasralainy.edu.eg.
Abstract
INTRODUCTION: : Several genetic mutations affect the first-line triple therapy for Helicobacter pylori. We aimed to study the most common genetic mutations affecting the metronidazole and clarithromycin therapy for H. pylori-infected Egyptian patients. PATIENTS AND METHODS:: In our study, we included 100 successive dyspeptic patients scheduled for diagnosis through upper gastroscopy at Cairo's University Hospital, Egypt. Gastric biopsies were tested for the presence of H. pylori by detection of the 16S rRNA gene. Positive biopsies were further studied for the presence of the rdxA gene deletion by Polymerase Chain Reaction (PCR), while clarithromycin resistance was investigated by the presence of nucleotide substitutions within H. pylori 23S rRNA V domain using MboII and BsaI to carry out a Restricted Fragment Length Polymorphism (RFLP) assay. RESULTS: : Among 70 H. pylori positive biopsies, the rdxA gene deletion was detected in 44/70 (62.9%) samples, while predominance of the A2142G mutations within the H. pylori 23S rRNA V domain was evidenced in 39/70 (55.7%) of the positive H. pylori cases. No statistically significant difference was found between the presence of gene mutations and different factors such as patients 'age, gender, geographic distribution, symptoms and endoscopic findings. CONCLUSION: : Infection with mutated H. pylori strains is considerably high, a finding that imposes care in the use of the triple therapy to treat H. pylori in Egypt, since the guidelines recommend to abandon the standard triple therapy when the primary clarithromycin resistance rate is over 20%1.
INTRODUCTION: : Several genetic mutations affect the first-line triple therapy for Helicobacter pylori. We aimed to study the most common genetic mutations affecting the metronidazole and clarithromycin therapy for H. pylori-infected Egyptian patients. PATIENTS AND METHODS:: In our study, we included 100 successive dyspeptic patients scheduled for diagnosis through upper gastroscopy at Cairo's University Hospital, Egypt. Gastric biopsies were tested for the presence of H. pylori by detection of the 16S rRNA gene. Positive biopsies were further studied for the presence of the rdxA gene deletion by Polymerase Chain Reaction (PCR), while clarithromycin resistance was investigated by the presence of nucleotide substitutions within H. pylori 23S rRNA V domain using MboII and BsaI to carry out a Restricted Fragment Length Polymorphism (RFLP) assay. RESULTS: : Among 70 H. pylori positive biopsies, the rdxA gene deletion was detected in 44/70 (62.9%) samples, while predominance of the A2142G mutations within the H. pylori 23S rRNA V domain was evidenced in 39/70 (55.7%) of the positive H. pylori cases. No statistically significant difference was found between the presence of gene mutations and different factors such as patients 'age, gender, geographic distribution, symptoms and endoscopic findings. CONCLUSION: : Infection with mutated H. pylori strains is considerably high, a finding that imposes care in the use of the triple therapy to treat H. pylori in Egypt, since the guidelines recommend to abandon the standard triple therapy when the primary clarithromycin resistance rate is over 20%1.
Authors: J Versalovic; M S Osato; K Spakovsky; M P Dore; R Reddy; G G Stone; D Shortridge; R K Flamm; S K Tanaka; D Y Graham Journal: J Antimicrob Chemother Date: 1997-08 Impact factor: 5.790
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Authors: Tiago Gomes da Silva Benigno; Howard Lopes Ribeiro Junior; Orleâncio Gomes Ripardo de Azevedo; Ronald Feitosa Pinheiro; Roberta Taiane Germano de Oliveira; Felipe Silva Maciel; Edson Luiz de Oliveira; Dulciene Maria Magalhães Queiroz; Lucia Libanez Bessa Campelo Braga Journal: Rev Inst Med Trop Sao Paulo Date: 2022-07-13 Impact factor: 2.169