Antibiotic Resistance of Helicobacter pyloriStrains in Japanese Children

Autor: Kato, Seiichi, Fujimura, Shigeru, Udagawa, Hirokazu, Shimizu, Toshiaki, Maisawa, Shunichi, Ozawa, Kyoko, Iinuma, Kazuie
Zdroj: Journal of Clinical Microbiology; February 2002, Vol. 40 Issue: 2 p649-653, 5p
Abstrakt: ABSTRACTThe resistance of Helicobacter pylorito the recently available antibiotic treatment regimens has been a growing problem. We investigated the prevalence of H. pyloriresistance to clarithromycin, metronidazole, and amoxicillin among 51 H. pyloriisolates from Japanese children. In addition, the mutations of the corresponding gene were studied by PCR and restriction fragment length polymorphism analysis. Primary resistance to clarithromycin, metronidazole, and amoxicillin was detected in 29, 24, and 0% of strains, respectively. The eradication rates in clarithromycin-susceptible and -resistant strains were 89 and 56%, respectively (P< 0.05). The prevalence of strains with acquired resistance to clarithromycin (78%) was higher than that of strains with primary resistance (P< 0.01). Among the clarithromycin-resistant strains studied, 92% showed cross-resistance to azithromycin. No acquired resistance to amoxicillin was demonstrated. The A2144G mutation in the 23S rRNA gene was detected in 11 of 12 (92%) clarithromycin-resistant strains tested, whereas the mutation was not detected in any of the 15 susceptible strains. The deletion of the rdxAgene was not demonstrated in any of the strains. The results indicate that a high prevalence of clarithromycin-resistant strains is associated with eradication failure. Testing of susceptibility to clarithromycin is recommended.
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