Published online Apr 14, 2018. doi: 10.3748/wjg.v24.i14.1531
Peer-review started: January 22, 2018
First decision: February 6, 2018
Revised: February 25, 2018
Accepted: March 18, 2018
Article in press: March 18, 2018
Published online: April 14, 2018
To characterize punctual mutations in 23S rRNA gene of clarithromycin-resistant Helicobacter pylori (H. pylori) and determine their association with therapeutic failure.
PCR products of 23S rRNA gene V domain of 74 H. pylori isolates; 34 resistant to clarithromycin (29 from a low-risk gastric cancer (GC) population: Tumaco-Colombia, and 5 from a high-risk population: Tuquerres-Colombia) and 40 from a susceptible population (28 from Tumaco and 12 from Túquerres) were sequenced using capillary electrophoresis. The concordance between mutations of V domain 23S rRNA gene of H. pylori and therapeutic failure was determined using the Kappa coefficient and McNemar’s test was performed to determine the relationship between H. pylori mutations and clarithromycin resistance.
23S rRNA gene from H. pylori was amplified in 56/74 isolates, of which 25 were resistant to clarithromycin (20 from Tumaco and 5 from Túquerres, respectively). In 17 resistant isolates (13 from Tumaco and 4 from Túquerres) the following mutations were found: A1593T1, A1653G2, C1770T, C1954T1, and G1827C in isolates from Tumaco, and A2144G from Túquerres. The mutations T2183C, A2144G and C2196T in H. pylori isolates resistant to clarithromycin from Colombia are reported for the first time. No association between the H. pylori mutations and in vitro clarithromycin resistance was found. However, therapeutic failure of eradication treatment was associated with mutations of 23S rRNA gene in clarithromycin-resistant H. pylori (κ = 0.71).
The therapeutic failure of eradication treatment in the two populations from Colombia was associated with mutations of the 23S rRNA gene in clarithromycin-resistant H. pylori.
Core tip: Mutations in 23S rRNA gene V domain of Helicobacter pylori (H. pylori) were studied in order to determine their association with therapeutic failure. In clarithromycin-resistant H. pylori isolated from individuals at high-risk of gastric cancer (GC) in Túquerres-Colombia and at low-risk of GC in Tumaco-Colombia, mutations A1593T1, A1653G2, C1770T, C1954T1, and G1827C in isolates from Tumaco, and A2144G from Túquerres were found. Mutations T2183C and C2196T from both cities were not associated with clarithromycin resistance. However, therapeutic failure of eradication treatment in the sampled Colombian populations was associated with mutations of 23S rRNA gene in clarithromycin-resistant H. pylori.