Clarithromycin-resistant Helicobacter pylori Associated with 23S rRNA Point Mutations in Jeju Island.
10.4166/kjg.2013.61.5.252
- Author:
Taeyun KIM
1
;
Hyun Joo SONG
;
Sun Young SHIN
;
Jo Heon KIM
;
Soo Young NA
;
Sun Jin BOO
;
Eun Kwang CHOI
;
Yoo Kyung CHO
;
Heung Up KIM
;
Byung Cheol SONG
Author Information
1. Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. songhj@jejunu.ac.kr
- Publication Type:Original Article ; English Abstract ; Research Support, Non-U.S. Gov't
- Keywords:
23S rRNA;
Point mutation;
Clarithromycin;
Resistance;
Helicobacter pylori
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Anti-Bacterial Agents/*therapeutic use;
Clarithromycin/*therapeutic use;
DNA, Bacterial/analysis;
Drug Resistance, Bacterial;
Female;
Gastroscopy;
Helicobacter Infections/*drug therapy;
Helicobacter pylori/drug effects/*genetics;
Humans;
Islands;
Male;
Middle Aged;
Point Mutation;
Polymerase Chain Reaction;
Proton Pump Inhibitors/therapeutic use;
RNA, Ribosomal, 23S/*genetics;
Republic of Korea;
Young Adult
- From:The Korean Journal of Gastroenterology
2013;61(5):252-258
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The point mutations in 23S rRNA gene accounts for the majority of the clarithromycin resistance of Helicobacter pylori. This study aimed to investigate the association between the clarithromycin-resistance of H. pylori and the failure of primary H. pylori eradication therapy in Jeju Island. METHODS: Between April 2011 and October 2012, 6,937 patients underwent endoscopy, and H. pylori infection was evaluated in 2,287 patients (33.0%). Total of 110 patients with H. pylori infection were treated with proton pump inhibitor (PPI)-based triple therapy. The result of eradication was evaluated with urea breath test, histology and PCR which were conducted 4 weeks from the last dose of medicine. RESULTS: The patients who had point mutations were 33 (26.0%). A2142G and A2143G mutations were observed in 10 patients (7.9%) and 23 patients (18.1%). Among 110 patients treated with PPI-based triple therapy, the success rate of the eradication therapy was 52.7% (58/110) and 70.7% (58/82) by intention-to-treat and per-protocol analysis, respectively. Fifteen of the 24 patients who failed the eradication therapy showed point mutations; 1 patient (4.2%) showed A2142G mutation and 14 patients (58.3%) showed A2143G mutation. Patients with A2143G mutation H. pylori showed higher failure rate of 87.5%. Patients with A2142G mutation H. pylori showed similar failure rate compared to those of the patients with wild type H. pylori. CONCLUSIONS: In Jeju Island, the frequency of 23S rRNA point mutations is similar (26.0%) with other regions of Korea (15.8-31.3%). A2143G mutation is associated with the failure of H. pylori eradication.
