Correlation between clarithromycin resistance, virulence factors and clinical characteristics of the disease in Helicobacter pylori infected patients in Shahrekord, Southwest Iran

Razieh Sadat Hosseini,Mohammad Hadi Shafigh,Ghorbanali Rahimian,Mansoor Khaledi,Majid Validi,Abolfazl Gholipour

doi:10.1186/s13568-021-01310-9

Razieh Sadat Hosseini, Mohammad Hadi Shafigh + Show 4 more

Open Access

https://doi.org/10.1186/s13568-021-01310-9

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Abstract

The purpose of this study was to determine the mutations associated with clarithromycin resistance in Helicobacter pylori strains isolated from biopsy samples that were collected from the endoscopic ward of Shahrekord Hajar teaching Hospital and also to study the frequency of virulence factor and their correlation and pathological findings with clarithromycin resistance during the years 2019–2020. In this cross-sectional descriptive study, 152 patients with Helicobacter pylori infection were considered, and then, two common A2142G and A2143G mutations in the 23SrRNA gene associated with resistance were analyzed by Real-time PCR (Taq man). The presence of vacA, iceA1, iceA2, cagA, babA2, and oipA virulence genes was investigated by PCR and electrophoresis in 8% polyacrylamide gel. Then, data were analyzed using the relevant statistical tests. In this study, the frequency of Helicobacter pylori was 76% and the frequency of mutant isolates was 57.2%. The frequencies of A2142G and A2143G point mutations were 42.1% and 28.3%. There was a significant correlation among oipA, vacA, and iceA1 virulence factors, type of disease, chronic inflammatory score, and glandular atrophy with the antibiotic resistance to clarithromycin. There was no significant correlation between the age and sex of the patients with antibiotic resistance. According to the results of this study, it seems that the use of clarithromycin to combat this bacterium should be limited.

Highlights

Helicobacter pylori is a gram-negative, microaerophilic, and spiral bacterium identified in 1982 (Marshall Warren 1984)
This study aimed to investigate the relationship between resistance to clarithromycin with virulence factors of iceA, Vacuolating cytotoxin A (vacA), Cytotoxin associated genes A (cagA), babA2, Outer inflammatory protein A (oipA), disease type, and pathological findings in Chaharmahal-oBakhtiari region of Iran
This study aimed to determine the mutations associated with clarithromycin resistance in Helicobacter pylori isolates, and to investigate its correlation with virulence factors iceA1, iceA2, vacA, cagA, babA2, and oipA and the type of disease and pathological findings

Summary

Introduction

Helicobacter pylori is a gram-negative, microaerophilic, and spiral bacterium identified in 1982 (Marshall Warren 1984). The resistance of Helicobacter pylori to these two antibiotics in most of the countries of the world has led to the failure of the first line treatment to become a Problem (Ji et al 2016). Clarithromycin is a family of macrolides having a bacteriostatic effect, which binds to the peptidyl transferase 23SrRNA subunit of the large subunit of the bacterial ribosome and inhibits the protein-making process (Sanches et al 2016). Clarithromycin resistance is the result of structural changes in this region These changes decrease the tendency of the binding of clarithromycin to the target site of the peptidyl transferase ribosomes of the bacterium, and cause lack of protein inhibition and the main reason for these structural changes is the point mutations in the 23SrRNA region. Resistance to clarithromycin is due to a spontaneous mutation in the chromosome in the V domain of the 23SrRNA gene

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