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首页> 外文期刊>Egyptian Journal of Medical Human Genetics >Detection of antimicrobial resistance genes of Helicobacter pylori strains to clarithromycin, metronidazole, amoxicillin and tetracycline among Egyptian patients
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Detection of antimicrobial resistance genes of Helicobacter pylori strains to clarithromycin, metronidazole, amoxicillin and tetracycline among Egyptian patients

机译：埃及患者幽门螺杆菌菌株对克拉霉素，甲硝唑，阿莫西林和四环素类抗生素的耐药基因检测

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Background Antibiotic resistance of Helicobacter pylori ( H. pylori ) treatment is on the rise, and is affecting the efficacy of current used therapeutic regimens. Aim We aimed to enhance the understanding of antimicrobial resistance rates of H. pylori strains recovered from patients at Theodor Bilharz Research Institute Hospital in Egypt, as a mandatory step before starting treatment. Subjects and methods Mutant genes conferring metronidazole, amoxicillin, clarithromycin, and tetracycline resistance were detected in 60 H. pylori strains recovered from patients who underwent upper endoscopic examination. Patients were considered to be infected with H. pylori when rapid urease test and detection of 16S rRNA in gastric biopsies recorded positive. Molecular detection of resistant genes to metronidazole ( rdx gene) and amoxicillin ( pbp1A gene) was carried out by conventional PCR followed by sequencing of PCR products. While detection of 23S rRNA gene conferring clarithromycin resistance and detection of 16S rRNA mutation gene conferring tetracycline resistance were carried out by real-time PCR. Results H. pylori resistance rates to metronidazole, and amoxicillin were 25% and 18.3% respectively. While for clarithromycin and tetracycline, point mutations in 23S rRNA types A2142G and A2143G and in 16S rRNA of H. pylori were assessed by real time PCR assay respectively. Resistance mutant genes were found to be 6.7% of clarithromycin and 1.7% of tetracycline. Combined resistance rates to metronidazole and amoxicillin was (11.6%) followed by metronidazole and clarithromycin (5%), while patterns of clarithromycin and amoxicillin (1.6%), metronidazole, clarithromycin and amoxicillin (1.6%) were revealed. Conclusion Data concerning antimicrobial resistance genes play an important role in empiric treatment of H. pylori infection. According to our results, H. pylori resistance to metronidazole and amoxicillin was relatively high. Clarithromycin is still a good option for first line anti- H. pylori treatment. Combined resistant strains are emerging and may have an effect on the combination therapy.
机译：背景技术幽门螺杆菌（H.pylori）治疗的抗生素抗性正在上升，并且正在影响当前使用的治疗方案的功效。目的我们的目的是增强对从埃及Theodor Bilharz研究所医院的患者中回收的幽门螺杆菌菌株的抗菌素耐药率的了解，这是开始治疗之前的强制性步骤。对象和方法在从接受内镜检查的患者中回收的60株幽门螺杆菌中检测到了赋予甲硝唑，阿莫西林，克拉霉素和四环素耐药性的突变基因。快速尿素酶检测和胃活检中16S rRNA检测显示阳性时，认为患者感染了幽门螺杆菌。对甲硝唑（rdx基因）和阿莫西林（pbp1A基因）的抗性基因的分子检测通过常规PCR进行，然后对PCR产物进行测序。通过实时PCR检测赋予克拉霉素抗性的23S rRNA基因和赋予四环素抗性的16S rRNA突变基因。结果幽门螺杆菌对甲硝唑和阿莫西林的耐药率分别为25％和18.3％。而对于克拉霉素和四环素，分别通过实时PCR分析评估了幽门螺杆菌的23S rRNA类型A2142G和A2143G和16S rRNA中的点突变。发现抗性突变基因为克拉霉素的6.7％和四环素的1.7％。对甲硝唑和阿莫西林的总耐药率是（11.6％），其次是甲硝唑和克拉霉素（5％），同时揭示了克拉霉素和阿莫西林（1.6％），甲硝唑，克拉霉素和阿莫西林（1.6％）的模式。结论有关抗菌素耐药基因的数据在经验性治疗幽门螺杆菌感染中起重要作用。根据我们的结果，幽门螺杆菌对甲硝唑和阿莫西林的耐药性相对较高。克拉霉素仍然是一线抗幽门螺杆菌治疗的好选择。出现了联合耐药株，可能对联合疗法产生影响。

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