Analysis of Correlation between the Seven Important Helicobacter pylori (H. pylori) Virulence Factors and Drug Resistance in Patients with Gastritis.

Sinem Oktem-Okullu,Zehra Cekic-Kipritci,Nesteren Mansur-Ozen,Yesim Gurol,Elif Kilic,Ugur Sezerman,Nogayhan Seymen

doi:10.1155/2020/3956838

Abstract

The aim of this study is to evaluate the association between seven important H. pylori virulence factors and antibiotic resistance in patients with gastritis. H. pylori strains isolated from 33 patients with gastritis were examined. Antimicrobial susceptibilities were tested by GenoType® HelicoDR (Hain Life Science, Germany) test kit and RT-PCR. The virulence-factors were determined using conventional PCR. 39% of patients were resistant for clarithromycin and 27% of patients were resistant for fluoroquinolone. 15% of patients were resistant to both clarithromycin and fluoroquinolone. The H. pylori vacA m1/s2 genotype was the most frequent allelic combination. Patients were possessed the vacA s1, m1 (6.1%); s1, m2 (6.1%); s2, m1 (15.1%); and s2, m2 (3.0%) genotypes. 94% of patients with gastritis were positive for H. pylori napA gene. Also, there were no dupA gene-positive gastritis patients. There was no significant correlation between the vacA, cagA, oipA, hpaA, babA, napA, dupA, ureA, ureB virulence genes, clarithromycin, and fluoroquinolone resistance. Herein, we report that the relationship between the H. pylori napA gene and gastritis. Although we found a correlation between H. pylori virulence factor and clinical outcome, there is a need for further studies to enlighten the relation between H. pylori virulence genes and antibiotic resistance.

Highlights

Helicobacter pylori (H. pylori) is one of the most important human pathogenic microorganisms with its spiral shape that can endure asymptomatic or can cause several gastrointestinal diseases, ranging in acute and chronic gastritis, gastric and duodenal ulcers, gastric adenocarcinoma, and MALT lymphoma [1]
Due to the antibiotic resistance test results, 39% of patients were resistant for clarithromycin and 27% of patients were resistant for fluoroquinolone. 15% of patients were resistant to both clarithromycin and fluoroquinolone
H. pylori Vacuolating cytotoxin gene A (vacA) s2/m1 (15.1%) genotypes were detected as the most frequent allelic combination of the vacA gene among gastritis patients followed by vacA s1, m1 (6.1%); s1, m2 (6.1%); and s2, m2 (3.0%) genotypes. 94% of patients with gastritis were positive for H. pylori neutrophilactivating protein A (napA) gene

Summary

Introduction

Helicobacter pylori (H. pylori) is one of the most important human pathogenic microorganisms with its spiral shape that can endure asymptomatic or can cause several gastrointestinal diseases, ranging in acute and chronic gastritis, gastric and duodenal ulcers, gastric adenocarcinoma, and MALT (mucosa-associated lymphoid tissue) lymphoma [1]. The prevalence rate of H. pylori differs between the developed countries that have low prevalence and developing countries that have a high prevalence. H. pylori infection is usually gained during childhood and if it is not treated, it will continue to lifespan [2]. For the treatment of H. pylori, multiple antibiotic regimens have been evaluated including triple therapy, sequential therapy, quadruple therapy, and levofloxacin-based triple therapy. Antimicrobial susceptibility testing is the best approach to choosing the treatment therapy method.

Objectives

Results

Conclusion