CLARITHROMYCIN RESISTANCE OF CLINICAL HELICOBACTER PYLORI

CLARITHROMYCIN RESISTANCE OF CLINICAL HELICOBACTER PYLORI

DETECTION AND CLARITHROMYCIN RESISTANCE OF CLINICAL HELICOBACTER PYLORI ISOLATES IN INDIAN POPULATION

Mr. Angesom Abraham 1, 2 , Dr. Asish Kumar Mukhopadhyay 1

  1. National Institute of Cholera and Enteric Diseases Division of Bacteriology, Kolkata, India. 2. Eritrea Institute of Technology, Mai-Nefhi, Eritrea.

Aim: This study is aimed at detecting the presence of H. pylori and the resistance to clarithromycin in Indian population.

Background: Helicobacter pylori is the most bacterial infection worldwide, infecting almost half of people in developed countries and 80% of people in developing countries (Go MF, 2002).  Clarithromycin therapy is effective in eradicating Helicobacter pylori. However, the resistance of H. pylori to clarithromycin is increasingly reported and it is associated to the point mutation in the 23s rRNA gene (Versalovic et al, 1996).

Methods: Helicobacter pylori is detected in the strains by culturing, positive test for Rapid Urease Test (RUT), oxidase, catalase and positive test to Urease gene by Normal-PCR (amplifying the Urease gene). Clarithromycin resistance detected by MAMA (Mismatch Amplification Mutational Assay)-PCR (amplifying the 23s rRNA gene) and antimicrobial susceptibility test.

Results: All the 40 strains were positive for Helicobacter pylori by culture and positive to urease gene by PCR. Out of the 40 strains 36 (90 %) were sensitive to clarithromycin and 4 (10 %) were resistant to clarithromycin by the PCR (amplifying the 23s rRNA gene). In addition, the MIC method was used and the 36 strains were sensitive to the concentration of 0.125 µg/ml of clarithromycin. However, the remaining 4 (10 %) are able to grow up to >2 µg/ml, as they are resistant to the action of clarithromycin. PCR results showed consistency with CLR MIC data that is ≥ 2 µg/ml MIC value for CLR-resistant strains and MICs ≤ 0.125µg/ml for CLR-sensitive strains.

Conclusions: The resistance of Helicobacter pylori to clarithromycin antibiotic is emerging in the Indian population. As a result, researchers has to work hard on the eradication of Helicobacter pylori infection by designing a better drug (antibiotic) based on the genetic features of the bacteria.

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