Abstract
This aim of this work was to determine the in vitro activity of clarithromycin, amoxycillin, metronidazole and tetracycline against Helicobacter pylori and clonality among resistant and sensitive strains isolated from North India. A total of 68 H. pylori isolates from peptic ulcer disease and non ulcer dyspepsia patients were examined. These strains were subjected for determination of minimum inhibitory concentration of clarithromycin, amoxycillin, metronidazole and tetracycline. For molecular characterization of resistant and sensitive strains, enterobacterial repetitive intergenic consensus sequences (ERIC) and random amplified polymorphic DNA-PCR (RAPD-PCR) methods were used. All the tested isolates were found resistant to metronidazole, while 65% were resistant to amoxycillin and 4.7% were resistant to clarithromycin. However, none of the isolates were found to be resistant to tetracycline. Molecular fingerprinting and cluster analysis of resistant and sensitive strains did not give clues for clonal spread of resistant strains. Various chromosomal mutations were seen in the putative resistance genes of resistant strains, possibly indicating selection pressure as the major cause of high resistance.
Highlights
Helicobacter pylori is a gram-negative bacterium that colonizes the gastric mucosa of more than half of the world’s population [1]
H.pylori is known for its panmictic population structure [4,5], i.e., genetic recombination is so frequent that it randomizes the DNA sequences and generates linkage equilibrium [4]
A recent report has indicated that genomic regions encoding phenotypic features required in drug resistance and virulence mechanisms tend to evolve faster than other regions due to diversifying selection pressure exerted by the host immune response [6]
Summary
Helicobacter pylori is a gram-negative bacterium that colonizes the gastric mucosa of more than half of the world’s population [1]. The development of antibiotic resistance can be considered one of the significant examples of this strategy. This aim of this work was to determine the in vitro activity of clarithromycin, amoxycillin, metronidazole and tetracycline against Helicobacter pylori and clonality among resistant and sensitive strains isolated from North India. Methodology: A total of 68 H. pylori isolates from peptic ulcer disease and non ulcer dyspepsia patients were examined. These strains were subjected for determination of minimum inhibitory concentration of clarithromycin, amoxycillin, metronidazole and tetracycline. Conclusions: Various chromosomal mutations were seen in the putative resistance genes of resistant strains, possibly indicating selection pressure as the major cause of high resistance
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