Abstract
The study evaluated the antibiotic resistance patterns of Helicobacter pylori strains against metronidazole and clarithromycin in a hospital in Havana, Cuba. Eighty-five percent, 22.5%, and 10% of 40 H. pylori strains investigated were resistant to metronidazole, ciprofloxacin, and clarithromycin respectively but all were susceptible to amoxicillin and tetracycline. RdxA truncation was found only in metronidazole-resistant strains. In such strains, reported are eight and two novel mutations in the rdxA and frxA genes respectively. Two-point mutations in the 23S rRNA genes of clarithromycin-resistant strains were detected. A high prevalence of metronidazole resistance was found in Cuban H. pylori strains. Mutations in the rdxA gene may contribute more significantly than frxA gene to the high level of resistance to metronidazole. This study supports the need to continue monitoring the antibiotic susceptibility in H. pylori in Cuba to guide the treatment of such infection.
Highlights
Helicobacter pylori is responsible for chronic gastritis, peptic ulcer disease, and gastric mucosa-associated lymphoid tissue lymphoma and is a major risk factor for the development of gastric adenocarcinoma (1)
Of the 46 strains, 40 were available for antimicrobial susceptibility testing with 67.5% (27 of 40) and 32.5% (13 of 40) of the strains from non-ulcer dyspepsia and peptic ulcer patients respectively
Eighty-five percent, 22.5%, and 10% of the 40 H. pylori strains investigated were resistant to MTZ, CIP, and CLA respectively but all were susceptible to AMX and TET
Summary
Helicobacter pylori is responsible for chronic gastritis, peptic ulcer disease, and gastric mucosa-associated lymphoid tissue lymphoma and is a major risk factor for the development of gastric adenocarcinoma (1). Eradication of such bacteria by treatment with two antimicrobial agents—clarithromycin (CLA) and amoxicillin (AMX) or metronidazole (MTZ)—and a proton pump inhibitor is recommended by various consensus groups (2). Investigation on the susceptibility of H. pylori to antibiotics is one of the main factors associated with successful eradication therapy (3). The prevalence of H. pylori-resistant strains is high in naive patients and even higher in patients suffering unsuccessful eradication therapy (4). The study investigated the demographic and clinical factors associated with antibiotic resistance
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