Drug resistance of Helicobacter pylori and related gene mutations

doi:10.3969/j.issn.1673-8640.2016.05.015

Abstract

Abstract:

Objective To study the drug resistance of Helicobacter pylori （HP） to common antibiotics and investigate the correlation of drug resistance and related gene mutations. Methods Gastric mucosa biopsy samples were collected from Huadong Hospital and Tongji Hospital, HP was isolated,and the minimal inhibitory concentrations （MIC） to clarithromycin （CLA）,metronidazole （MTZ）,amoxicillin （AMX） and levofloxacin （LEV）were determined by E-test. Meanwhile,the related gene mutations were determined by gene sequencing,and the correlation of drug resistance and gene mutations was analyzed. Results A total of 129 HP isolates were isolated from 514 cases of gastric mucosa biopsy samples. Among them,68.6% isolates were resistant to 1 kind of antibiotic at least,and the drug resistance rates to CLA,MTZ and LEV were 19.8%,57.0% and 29.1%,respectively,while double- and triple-drug resistance rates were 23.3% （20 isolates）and 7.0%（6 isolates）. The main drug resistance gene mutation loci were 23S rRNA（A2143G）,rdxA（C148T）,pbp1A（A1777G） andgyrA（C261A/G）,and their mutation rates were 20.9%,7.0%,9.3% and 12.8%. Conclusions The drug resistance rate of HP is high in Shanghai,and drug susceptibility test should become a standard practice during the determination of HP for eradication. Furthermore,specific gene mutations are associated with drug resistance.

Key words: Helicobacter pylori, Drug resistance, Gene mutation

CLC Number:

R446.5

ZHANG Yanmei, HU Binjie, ZHAO Fuju, XIANG Ping, YANG Changqing, FANG Yi, ZHAO Hu. Drug resistance of Helicobacter pylori and related gene mutations[J]. Laboratory Medicine, 2016, 31(5): 412-418.

Figures/Tables 4

References 28

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抗菌药物	MIC（μg/mL）		R	S
抗菌药物	MIC₅₀	MIC₉₀	[例（%）]	[例（%）]
CLA	2.25	64.00	17（19.8）	69（80.2）
MTZ	2	96	49（57.0）	37（43.0）
AMX	0.032	0.250	0（0.0）	86（100.0）
LEV	0.079	12.000	25（29.1）	61（70.9）

抗菌药物	MIC（μg/mL）		R	S
抗菌药物	MIC₅₀	MIC₉₀	[例（%）]	[例（%）]
CLA	2.25	64.00	17（19.8）	69（80.2）
MTZ	2	96	49（57.0）	37（43.0）
AMX	0.032	0.250	0（0.0）	86（100.0）
LEV	0.079	12.000	25（29.1）	61（70.9）

抗菌药物	DNA测序分析		突变率[例（%）]
抗菌药物	耐药基因	突变位点	突变率[例（%）]
CLA	23S rRNA	A2143G	18（20.9）
		A2142G	2（2.3）
		T2182C	30（34.9）
MTZ	rdxA	C148T	6（7.0）
		T184G	63（73.3）
		G616A	40（46.5）
AMX	pbplA	C1667G	3（3.5）
		A1684G	1（1.2）
		A1777G	8（9.3）
LEV	gyrA	C261A	5（5.8）
		C261G	6（7.0）
		G271A	6（7.0）
		G271T	2（2.3）
		A272G	3（3.5）

抗菌药物	DNA测序分析		突变率[例（%）]
抗菌药物	耐药基因	突变位点	突变率[例（%）]
CLA	23S rRNA	A2143G	18（20.9）
		A2142G	2（2.3）
		T2182C	30（34.9）
MTZ	rdxA	C148T	6（7.0）
		T184G	63（73.3）
		G616A	40（46.5）
AMX	pbplA	C1667G	3（3.5）
		A1684G	1（1.2）
		A1777G	8（9.3）
LEV	gyrA	C261A	5（5.8）
		C261G	6（7.0）
		G271A	6（7.0）
		G271T	2（2.3）
		A272G	3（3.5）

抗菌药物	DNA测序分析		基因突变
抗菌药物	耐药基因	突变位点	耐药组[例（%）]	敏感组[例（%）]	χ²值（P值）
CLA	23SrRNA	A2143G	16（94.1）	2（2.9）	68.578（0.000）
		A2142G	2（11.8）	0（0.0）	8.311（0.004）
		T2182C	6（35.3）	24（34.8）	0.002（0.968）
MTZ	rdxA	C148T	6（12.2）	0（0.0）	4.870（0.027）
		T184G	36（79.6）	24（64.9）	2.334（0.127）
		G616A	27（55.1）	14（37.8）	3.219（0.073）
AMX	pbp1A	C1667G	0（0.0）	3（3.5）
		A1684G	0（0.0）	1（1.2）
		A1777G	0（0.0）	8（9.3）
LEV	gyrA	C261A	5（20.0）	0（0.0）	12.953（0.000）
		C261G	6（24.0）	0（0.0）	15.738（0.000）
		G271A	6（24.0）	0（0.0）	15.738（0.000）
		G271T	2（8.0）	0（0.0）	4.996（0.025）
		A272G	3（12.0）	0（0.0）	7.585（0.006）