Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 123-128, June 2009

Analysis of Resistance to Clarithromycin and Virulence Markers in Helicobacter pylori Clinical Isolates from Eastern Taiwan

  • Chi-Tan Hu

      Affiliations

    • Department of Gastroenterology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
    • Department of Internal Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Pei-Yu Chiou

      Affiliations

    • Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
    • ,
  • Chao-Chuan Wu

      Affiliations

    • Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
    • ,
  • Yi-Hsiung Tseng

      Affiliations

    • Institute of Medical Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
    • ,
  • Yao-Jen Chang

      Affiliations

    • Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
    • ,
  • Nien-Tsung Lin

      Affiliations

    • Institute of Microbiology, Immunology and Molecular Medicine, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Institute of Microbiology, Immunology and Molecular Medicine, Tzu Chi University, 701, Section 3, Chung-Yang Road, Hualien, Taiwan

Received 26 June 2008; received in revised form 25 July 2008; accepted 11 August 2008.

Article Outline

Abstract 

Objective

Little information is available concerning the relationships between clarithromycin resistance and virulence marker genes (iceA, cagA and vacA) in Helicobacter pylori isolated in Taiwan. The aim of this study was to evaluate the possible association between clarithromycin resistance and genotypes of the virulence markers on clarithromycin-resistant H. pylori isolates obtained in eastern Taiwan

Materials and Methods

The genotypes of the virulence marker genes (iceA, cagA and vacA) were analyzed by PCR, and the 23S rDNA region from 18 clarithromycin-resistant clinical isolates of H. pylori was amplified by PCR and sequenced.

Results

Point mutations were found to occur in all isolates. Two isolates had A2143G, six had T2182C, one had C2227T, six had A2143G plus T2182C, and three had heterozygous alleles. The latter included a wild-type allele (A2143) plus (i) an A2143G, (ii) an A2143G plus an A2223G, and (iii) an A2143G plus a T2182C. The prevalence of the marker genes cagA, iceA1, iceA2, and both iceA1 and iceA2, in the isolates was 95.5%, 66.9%, 7.5%, and 25.6%, respectively. The vacAs1 allele was detected in all isolates, whereas the m1 and m2 alleles were found in 44.4% and 55.6% of the isolates, respectively

Conclusion

There were no significant associations between clarithromycin resistance and the presence of the cagA gene, vacA allele mosaicism, and the iceA genotypes. The most notable finding of our study was that the C2227T single mutation in 23S rDNA could also be related to the high clarithromycin minimal inhibitory concentrations in clinical isolates from eastern Taiwan.

Keywords:  Clarithromycin-resistant , Genotyping , Helicobacter pylori , Virulence marker

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PII: S1016-3190(09)60023-9

doi:10.1016/S1016-3190(09)60023-9

Tzu Chi Medical Journal
Volume 21, Issue 2 , Pages 123-128, June 2009

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