Genotypic detection of metronidazole and clarithromycin resistance in dyspeptic patients with helicobacter pylori

• Published in: Environmental science and pollution research international 2022-06, Vol.29 (27), p.41467-41474
• Main Authors: Nemr, Nader, Kishk, Rania M., Salem, Ayman, Abdalla, Mohamed O., Abd El-Fadeal, Noha M., Soliman, Nashaat M.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Aquatic Pollution; Atmospheric Protection/Air Quality Control/Air Pollution; Biopsy; Clarithromycin; Clarithromycin - pharmacology; Cross-Sectional Studies; Deoxyribonucleic acid; DNA; Drug Resistance, Bacterial - genetics; Earth and Environmental Science; Ecotoxicology; Endoscopy; Environment; Environmental Chemistry; Environmental Health; Environmental science; Helicobacter Infections; Helicobacter pylori; Helicobacter pylori - genetics; Humans; Metronidazole; Metronidazole - pharmacology; Microbial Sensitivity Tests; Mutation; Nucleotide sequence; Patients; Polymerase chain reaction; Rdx gene; RdxA gene; Research Article; rRNA; rRNA 23S; Sensitivity analysis; Sequence analysis; Urease; UreC gene; Waste Water Technology; Water Management; Water Pollution Control
• ISSN: 0944-1344; 1614-7499
• DOI: 10.1007/s11356-021-18198-4

In Egypt, antibiotic sensitivity analysis for Helicobacter pylori is not routinely performed. We aimed to identify the clarithromycin and metronidazole resistance directly from gastric biopsies for better guide treatment regimens. This cross-sectional descriptive study included 75 adult dyspeptic patients referred to the upper endoscopy unit in Suez Canal University Hospital, Ismailia, Egypt. Gastric biopsies were taken for rapid urease test (RUT) and cultured on brucella agar with antibiotic supplements. Genomic DNA was extracted directly from the specimen, and PCR was performed for direct detection of H. pylori . Also, to explore clarithromycin and metronidazole resistance, mutations in the 23S rRNA gene and the rdxA gene were investigated. We found that 60 samples were positive to RUT (80%), and only 4 samples were positive by culture. UreC gene was detected in 45 specimens. Meanwhile, 26 isolates were contained mutations at positions 2142 and 2143. Amplification of the metronidazole rdx gene was performed by conventional PCR. Out of 45 isolates, DNA sequence analysis of PCR product showed the wild type (ACA) in 9 isolates, while the mutant type (ATA) was detected in 28 isolates. We found a significant proportion of clarithromycin and metronidazole resistance among H. pylori infected patients in our region.