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Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?

AIM: To evaluate the association between virulence factor status and antibiotic resistance in Helicobacter pylori (H. pylori)-infected patients in Ireland. METHODS: DNA was extracted from antral and corpus biopsies obtained from 165 H. pylori-infected patients. Genotyping for clarithromycin and fluo...

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Autores principales: Brennan, Denise E, Dowd, Colin, O’Morain, Colm, McNamara, Deirdre, Smith, Sinéad M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840472/
https://www.ncbi.nlm.nih.gov/pubmed/29531461
http://dx.doi.org/10.3748/wjg.v24.i9.971
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author Brennan, Denise E
Dowd, Colin
O’Morain, Colm
McNamara, Deirdre
Smith, Sinéad M
author_facet Brennan, Denise E
Dowd, Colin
O’Morain, Colm
McNamara, Deirdre
Smith, Sinéad M
author_sort Brennan, Denise E
collection PubMed
description AIM: To evaluate the association between virulence factor status and antibiotic resistance in Helicobacter pylori (H. pylori)-infected patients in Ireland. METHODS: DNA was extracted from antral and corpus biopsies obtained from 165 H. pylori-infected patients. Genotyping for clarithromycin and fluoroquinolone-mediating mutations was performed using the Genotype HelicoDR assay. cagA and vacA genotypes were investigated using PCR. RESULTS: Primary, secondary and overall resistance rates for clarithromycin were 50.5% (n = 53/105), 78.3% (n = 47/60) and 60.6% (n = 100/165), respectively. Primary, secondary and overall resistance rates for fluoroquinolones were 15.2% (n = 16/105) and 28.3% (n = 17/60) and 20% (n = 33/165), respectively. Resistance to both antibiotics was 12.4% (n = 13/105) in treatment-naïve patients, 25% (n = 15/60) in those previously treated and 17% (n = 28/165) overall. A cagA-positive genotype was detected in 22.4% (n = 37/165) of patient samples. The dominant vacA genotype was S1/M2 at 44.8% (n = 74/165), followed by S2/M2 at 26.7% (n = 44/165), S1/M1 at 23.6% (n = 39/165) and S2/M1 at 4.8% (n = 8/165). Primary clarithromycin resistance was significantly lower in cagA-positive strains than in cagA-negative strains [32% (n = 8/25) vs 56.3% (n = 45/80) P = 0.03]. Similarly, in patients infected with more virulent H. pylori strains bearing the vacA s1 genotype, primary clarithromycin resistance was significantly lower than in those infected with less virulent strains bearing the vacA s2 genotype, [41% (n = 32/78) vs 77.8% (n = 21/27) P = 0.0001]. No statistically significant association was found between primary fluoroquinolone resistance and virulence factor status. CONCLUSION: Genotypic H. pylori clarithromycin resistance is high and cagA-negative strains are dominant in our population. Less virulent (cagA-negative and vacA S2-containing) strains of H. pylori are associated with primary clarithromycin resistance.
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spelling pubmed-58404722018-03-12 Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection? Brennan, Denise E Dowd, Colin O’Morain, Colm McNamara, Deirdre Smith, Sinéad M World J Gastroenterol Basic Study AIM: To evaluate the association between virulence factor status and antibiotic resistance in Helicobacter pylori (H. pylori)-infected patients in Ireland. METHODS: DNA was extracted from antral and corpus biopsies obtained from 165 H. pylori-infected patients. Genotyping for clarithromycin and fluoroquinolone-mediating mutations was performed using the Genotype HelicoDR assay. cagA and vacA genotypes were investigated using PCR. RESULTS: Primary, secondary and overall resistance rates for clarithromycin were 50.5% (n = 53/105), 78.3% (n = 47/60) and 60.6% (n = 100/165), respectively. Primary, secondary and overall resistance rates for fluoroquinolones were 15.2% (n = 16/105) and 28.3% (n = 17/60) and 20% (n = 33/165), respectively. Resistance to both antibiotics was 12.4% (n = 13/105) in treatment-naïve patients, 25% (n = 15/60) in those previously treated and 17% (n = 28/165) overall. A cagA-positive genotype was detected in 22.4% (n = 37/165) of patient samples. The dominant vacA genotype was S1/M2 at 44.8% (n = 74/165), followed by S2/M2 at 26.7% (n = 44/165), S1/M1 at 23.6% (n = 39/165) and S2/M1 at 4.8% (n = 8/165). Primary clarithromycin resistance was significantly lower in cagA-positive strains than in cagA-negative strains [32% (n = 8/25) vs 56.3% (n = 45/80) P = 0.03]. Similarly, in patients infected with more virulent H. pylori strains bearing the vacA s1 genotype, primary clarithromycin resistance was significantly lower than in those infected with less virulent strains bearing the vacA s2 genotype, [41% (n = 32/78) vs 77.8% (n = 21/27) P = 0.0001]. No statistically significant association was found between primary fluoroquinolone resistance and virulence factor status. CONCLUSION: Genotypic H. pylori clarithromycin resistance is high and cagA-negative strains are dominant in our population. Less virulent (cagA-negative and vacA S2-containing) strains of H. pylori are associated with primary clarithromycin resistance. Baishideng Publishing Group Inc 2018-03-07 2018-03-07 /pmc/articles/PMC5840472/ /pubmed/29531461 http://dx.doi.org/10.3748/wjg.v24.i9.971 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Basic Study
Brennan, Denise E
Dowd, Colin
O’Morain, Colm
McNamara, Deirdre
Smith, Sinéad M
Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title_full Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title_fullStr Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title_full_unstemmed Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title_short Can bacterial virulence factors predict antibiotic resistant Helicobacter pylori infection?
title_sort can bacterial virulence factors predict antibiotic resistant helicobacter pylori infection?
topic Basic Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840472/
https://www.ncbi.nlm.nih.gov/pubmed/29531461
http://dx.doi.org/10.3748/wjg.v24.i9.971
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