Characteristics of Helicobacter pylori Heteroresistance in Gastric Biopsies and Its Clinical Relevance

Frontiers in Cellular and Infection Microbiology

Lin-fu Zhou¹  Xiao-ling Gong²  Xiao-yan Sun³  Rong Zeng⁴  You-hua Wang⁴  Ding-wei Liu⁴  Yong Xie⁴  Dong-sheng Liu⁴ 

[1] Department of Biochemistry, Department of the Children’s Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China;Department of Blood Transfusion, The First Affiliated Hospital of Nanchang University, Nanchang, China;Department of Epidemiology, Bethune International Peace Hospital, Shijiazhuang, China;Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China;

关键词: Helicobacter pylori;    heteroresistance;    clarithromycin;    levofloxacin;    peptic ulcer;   

DOI  :  10.3389/fcimb.2021.819506

来源: DOAJ

【 摘 要 】

BackgroundAntimicrobial susceptibility testing (AST) plays a vital role in anti-Helicobacter pylori treatment, but the traditional AST method has difficulty detecting heteroresistance, which may cause an increased prevalence of resistant strains and eradication failure.AimsTo investigate the characteristics of heteroresistance in H. pylori in gastric biopsies and investigate its clinical relevance.MethodA total of 704 gastric biopsies were selected for 23S rRNA and gyrA gene sequencing, 470 H. pylori isolates from these biopsies were selected for AST, and the clinical characteristics of the patients were reviewed.ResultFor the 699 biopsies that were positive for 23S rRNA gene, 98 (14.0%) showed a heteroresistance genotype, and a wild type (WT) combined with A2143G (86.7%) genotype was found in most samples. For the 694 biopsies that were positive for gyrA gene, 99 (14.3%) showed a heteroresistance genotype, and a WT combined with 87K (26.3%) or WT combined with 91N (23.2%) genotype was predominant. According to the E-test results, the resistance rates of heteroresistance genotype samples for clarithromycin and levofloxacin were 36.2% and 68.1%, respectively. When dividing the heteroresistance samples into different groups according to the sequencing profile peaks of the mutation position, the resistance rates were higher along with mutation peaks at the mutation position. In addition, patients infected with mutated or heteroresistant strains showed lower peptic ulcer detection rates than those infected with the WT strain (p < 0.05).ConclusionHeteroresistance genotypes for clarithromycin and levofloxacin were not rare in H. pylori. Most cases with a heteroresistance genotype showed a susceptible phenotype for clarithromycin and a resistance phenotype for levofloxacin. Patients infected with heteroresistance genotype strains showed a lower peptic ulcer detection rate than those infected with the WT strain.

【 授权许可】

Unknown