1921
Volume 98, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

The treatment of infection is complicated by antibiotic resistance. A high levofloxacin (LVX) resistance rate was previously demonstrated in isolates from gastric mucosa (40%) and esophagus (19%) in individual hosts of a Venezuelan population. We aimed to assess the molecular mechanisms of LVX resistance and susceptibility in isolates from the gastroesophageal mucosa, by studying point mutations in the quinolone resistance–determining region of and genes. Sequencing of and genes ( = 120) helped to identify point mutations in 60 isolates (30 from antrum and 30 from esophagus) of five dyspeptic patients. Double (Asn87Thr and Asp91Asn) and single (Asn87Ile or Asn87Thr) mutations in the gene were identified in the esophageal mucosa. These mutations have been commonly found in the stomach. Occurrence of a single (Asn87Ile) mutation was associated with high resistance (minimum inhibitory concentration ≥ 32 μg/mL) to LVX. Only a single (Ser479Gly) mutation was found in the gene in both mucosae. One patient presented isolates with no mutations in the two genes studied. Isolates with the same mutation pattern in individual hosts revealed identical genetic profiles for these genes, confirming that isolates identified in the esophageal mucosa come from isolates colonizing the stomach. resistance to LVX in the esophagus is related to double- and single-point mutations in and genes, such as those found in the stomach. Levofloxacin should be applied with caution, because its antibiotic effect on is decreasing in Latin America, perhaps owing to high prescription rates.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.17-0478
2018-02-05
2019-07-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/98/4/tpmd170478.html?itemId=/content/journals/10.4269/ajtmh.17-0478&mimeType=html&fmt=ahah

References

  1. Cover TL, Blaser MJ, , 2009. Helicobacter pylori in health and disease. Gastroenterology 136: 18631873. [Google Scholar]
  2. Pei Z, Yang L, Peek RM, Jr Levine SM, Pride DT, Blaser MJ, , 2005. Bacterial biota in reflux esophagitis and Barrett’s esophagus. World J Gastroenterol 11: 72777283. [Google Scholar]
  3. Cellini L, Grande R, Artese L, Marzio L, , 2010. Detection of Helicobacter pylori in saliva and esophagus. New Microbiol 33: 351357. [Google Scholar]
  4. Contreras M, Salazar V, García-Amado M, Reyes N, Aparcero M, Silva O, Castro D, Romero R, Gueneau P, Michelangeli F, , 2012. High frequency of Helicobacter pylori in the esophageal mucosa of dyspeptic patients and its possible association with histopathological alterations. Int J Infect Dis 16: e364e370. [Google Scholar]
  5. Contreras M, Abrante L, Salazar V, Reyes N, García-Amado M, Fernández-Delgado M, Romero R, Rojas H, Michelangeli F, , 2014. Heterogeneity of cag genotypes of Helicobacter pylori in the esophageal mucosa of dyspeptic patients and its relation to histopathological outcomes. Int J Infect Dis 26: 9195. [Google Scholar]
  6. Peña J, Rojas H, Reyes N, Fernández-Delgado M, García-Amado M-A, Michelangeli F, Contreras M, , 2017. Multiple cag genotypes of Helicobacter pylori isolates colonize the oesophagus in individual hosts in a Venezuelan population. J Med Microbiol 66: 226235. [Google Scholar]
  7. Blaser MJ, , 2012. Heterogeneity of Helicobacter pylori. Eur J Gastroenterol Hepatol 9 (Suppl 1): S3S6; discussion S6–S7. [Google Scholar]
  8. Gerrits MM, van Vliet AHM, Kuipers EJ, Kusters JG, , 2006. Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis 6: 699709. [Google Scholar]
  9. Chu YT, Wang YH, Wu JJ, Lei HY, , 2010. Invasion and multiplication of Helicobacter pylori in gastric epithelial cells and implications for antibiotic resistance. Infect Immun 78: 41574165. [Google Scholar]
  10. Dib J, Alvarez B, Mendez L, Cruz M, , 2013. Efficacy of PPI, levofloxacin and amoxicillin in the eradication of Helicobacter pylori compared to conventional triple therapy at a Venezuelan hospital. Arab J Gastroenterol 14: 123125. [Google Scholar]
  11. Wang LH, Cheng H, Hu FL, Li J, , 2010. Distribution of gyrA mutations in fluoroquinolone resistant Helicobacter pylori strains. World J Gastroenterol 16: 22722277. [Google Scholar]
  12. Chung JW, Lee GH, Jeong JY, Lee SM, Jung JH, Choi KD, Song HJ, Jung HY, Kim JH, , 2012. Resistance of Helicobacter pylori strains to antibiotics in Korea with a focus on fluoroquinolone resistance. J Gastroenterol Hepatol 27: 493497. [Google Scholar]
  13. Domínguez-Bello MG, 1997. Modification of Christensen urease test as an inexpensive tool for detection of Helicobacter pylori. Diagn Microbiol Infect Dis 28: 149152. [Google Scholar]
  14. Peek RM, Jr Miller GG, Tham KT, Pérez-Pérez GI, Cover TL, Atherton JC, Dunn GD, Blaser MJ, , 1995. Detection of Helicobacter pylori gene expression in human gastric mucosa. J Clin Microbiol 33: 2832. [Google Scholar]
  15. Kansau I, Raymond J, Bingen E, Courcoux P, Kalach N, Bergeret M, Braimi N, Dupont C, Labigne A, , 1996. Genotyping of Helicobacter pylori isolates by sequencing of PCR products and comparison with the RAPD technique. Res Microbiol 147: 661669. [Google Scholar]
  16. Germani Y, Dauga C, Duval P, Huerre M, Levy M, Pialoux G, Sansonetti P, Grimont PA, , 1997. Strategy for the detection of Helicobacter species by amplification of 16S rRNA genes and identification of H. felis in human gastric biopsy. Res Microbiol 148: 315326. [Google Scholar]
  17. Miyachi H, 2006. Primary levofloxacin resistance and gyrA/B mutations among Helicobacter pylori in Japan. Helicobacter 11: 243249. [Google Scholar]
  18. Nishizawa T, Suzuki H, Umezawa A, Muraoka H, Iwasaki E, Masaoka T, Kobayashi I, Hibi T, , 2007. Rapid detection of point mutations conferring resistance to fluoroquinolone in gyrA of Helicobacter pylori by allele-specific PCR. J Clin Microbiol 45: 303305. [Google Scholar]
  19. Cuadrado-Lavin A, 2012. Antimicrobial susceptibility of Helicobacter pylori to six antibiotics currently used in Spain. J Antimicrob Chemother 67: 170173. [Google Scholar]
  20. Tay CY, Windsor HM, Thirriot F, Lu W, Conway C, Perkins TT, Marshall BJ, , 2012. Helicobacter pylori eradication in Western Australia using novel quadruple therapy combinations. Aliment Pharmacol Ther 36: 10761083. [Google Scholar]
  21. Fathi MS, EL-Folly RF, Hassan RA, El-Arab ME, , 2013. Genotypic and phenotypic patterns of antimicrobial susceptibility of Helicobacter pylori strains among Egyptian patients. Egypt J Med Hum Genet 14: 235246. [Google Scholar]
  22. Almeida N, Romãozinho JM, Donato MM, Luxo C, Cardoso O, Cipriano MA, Marinho C, Fernandes A, Calhau C, Sofia C, , 2014. Helicobacter pylori antimicrobial resistance rates in the central region of Portugal. Clin Microbiol Infect 20: 11271133. [Google Scholar]
  23. Boltin D, Ben-Zvi H, Perets TT, Kamenetsky Z, Samra Z, Dickman R, Niv Y, , 2015. Trends in secondary antibiotic resistance of Helicobacter pylori from 2007 to 2014: has the tide turned? J Clin Microbiol 53: 522527. [Google Scholar]
  24. Caliskan R, 2015. Antimicrobial resistance of Helicobacter pylori strains to five antibiotics, including levofloxacin, in northwestern Turkey. Rev Soc Bras Med Trop 48: 278284. [Google Scholar]
  25. Zaki M, Othman W, Ali MA, Shehta A, , 2016. Fluoroquinolone-resistant Helicobacter pylori strains isolated from one Egyptian University Hospital: molecular aspects. J Microbiol Antimicrobial Agents 2: 2631. [Google Scholar]
  26. Eisig JN, Silva FM, Barbuti RC, Navarro-Rodriguez T, Morales-Filho JP, Pedrazzoli P, , 2011. Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option. Arq Gastroenterol 48: 261264. [Google Scholar]
  27. Mochizuki-Tamayo H, Noriega-Aldave AP, , 2011. Antimicrobial susceptibility of Helicobacter pylori to levofloxacin determined in a miniwell format and disk diffusion tests using egg yolk agar. Rev Gastroenterol Peru 31: 224229. [Google Scholar]
  28. Zerbetto De Palma G, Mendiondo N, Wonaga A, Viola L, Ibarra D, Campitelli E, Salim N, Corti R, Goldman C, Catalano M, , 2016. Occurrence of mutations in the antimicrobial target genes related to levofloxacin, clarithromycin, and amoxicillin resistance in Helicobacter pylori isolates from Buenos Aires city. Microb Drug Resist 23: 351358. [Google Scholar]
  29. Garcia M, Raymond J, Garnier M, Cremniter J, Burucoa C, , 2012. Distribution of spontaneous gyrA mutations in 97 fluoroquinolone-resistant Helicobacter pylori isolates collected in France. Antimicrob Agents Chemother 56: 550551. [Google Scholar]
  30. Seck A, Burucoa C, Dia D, Mbengue M, Onambele M, Raymond J, Breurec S, , 2013. Primary antibiotic resistance and associated mechanisms in Helicobacter pylori isolates from Senegalese patients. Ann Clin Microbiol Antimicrob 12: 3. [Google Scholar]
  31. Tanih NF, Ndip RN, , 2013. Molecular detection of antibiotic resistance in South African isolates of Helicobacter pylori. Gastroenterol Res Pract 2013: 259457. [Google Scholar]
  32. Trespalacios AA, Rimbara E, Otero W, Reddy R, Graham DY, , 2015. Improved allele-specific PCR assays for detection of clarithromycin and fluoroquinolone resistant of Helicobacter pylori in gastric biopsies: identification of N87I mutation in gyrA. Diagn Microbiol Infect Dis 81: 251255. [Google Scholar]
  33. Trespalacios-Rangél AA, Otero W, Arévalo-Galvis A, Poutou-Piñales RA, Rimbara E, Graham D, , 2016. Surveillance of levofloxacin resistance in Helicobacter pylori isolates in Bogotá-Colombia (2009–2014). PLoS One 11: e0160007. [Google Scholar]
  34. Tankovic J, Lascols C, Sculo Q, Petit JC, Soussy JJ, , 2003. Single and double mutations in gyrA but not in gyrB are associated with low- and high-level fluoroquinolone resistance in Helicobacter pylori. Antimicrob Agents Chemother 47: 39423944. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.17-0478
Loading
/content/journals/10.4269/ajtmh.17-0478
Loading

Data & Media loading...

  • Received : 16 Jun 2017
  • Accepted : 20 Dec 2017
  • Published online : 05 Feb 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error