Korean J Clin Microbiol.  2008 Oct;11(2):84-89. 10.5145/KJCM.2008.11.2.84.

Multicenter Study for the Frequency of 23S rRNA Point Mutations Associated with Clarithromycin Resistance in Helicobacter pylori in Korea

• Lee HK
• Chae HS
• Kang JO
• Lee MK
• Sung H
• Kim MN
• Lee J
• Lee M
• Shim KN

• KMID: 1480974
• DOI: http://doi.org/10.5145/KJCM.2008.11.2.84

Abstract

BACKGROUND: Clarithromycin resistance in Helicobacter pylori is a major cause of eradication therapy failure. The objective of this study was to determine the frequency and type of mutations in the 23S rRNA gene in Korea, which are associated with clarithromycin resistance.
METHODS
From January 2008 to March 2008, 353 gastric biopsy specimens were collected from five university hospitals in Seoul and Kyunggido. H. pylori infection was defined as showing a positive result in at least one of the following three tests: a microaerophilic culture, a CLO test, and a Giemsa/silver stain. The frequencies of A2143G, A2142G, and the wild type of 23S rRNA and the presence of H. pylori were determined by Seeplex ClaR-H. pylori PCR (Seegene Inc., Seoul, Korea). Twenty-nine culture isolates were tested for susceptibility to clarithromycin by E-test (AB Biodisk, Solna, Sweden) or the CLSI (Clinical and Laboratory Standards Institute) disk diffusion test.
RESULTS
From 176 H. pylori PCR-positive specimens, 23S rRNA gene mutations were detected in 38 isolates (21.6%), including 27 isolates of A2143G and 11 isolates of A2142G. Total mutation rates varied from 15.8% to 31.3% with the frequency of A2143G mutation alone varying from 8.5% to 25.0% among the five hospitals studied. There were 10 clarithromycin-resistant isolates found by susceptibility test and they were all positive for A2143G mutation. But, 3 of the 19 susceptible isolates were also positive for either A2143G or A2142G mutation.
CONCLUSION
In Korea, the overall frequency of clarithromycin-resistant H. pylori was 21.6%; however, the type and frequency of the 23S rRNA mutations varied from hospital to hospital.

Keyword

Clarithromycin resistance; Helicobacter pylori; 23S rRNA mutation; Korea

MeSH Terms

Biopsy
Clarithromycin
Diffusion
Genes, rRNA
Helicobacter
Helicobacter pylori
Hospitals, University
Korea
Mutation Rate
Point Mutation
Polymerase Chain Reaction
Clarithromycin

Figure

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  Fig. 1. Detection of the point mutations at 2143 (A to G) and 2142 (A to G) in 23S rRNA gene by polymerase chain reaction products. Lane M, DNA ladder; lane 1–3 and 5–7, wild type; lane 4, mutant type of A2142G.

Reference

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