Author/Editor     Skvarč, Miha; Kofol, Romina; Jeverica, Samo; Kopitar, Andreja Nataša; Tepeš, Bojan; Ihan, Alojz
Title     Multi locus sequence typing (MLST) used as a tool to confirm the ability of susceptible Helicobacter pylori strains to gain resistance to clarithromycin during eradication therapy
Type     članek
Vol. and No.     Letnik 61, št. 129
Publication year     2014
Volume     str. 226-231
ISSN     0172-6390 - Hepato-gastroenterology
Language     eng
Abstract     Background/Aims: Primary resistance of H. pylori to clarithromycin is the most common reason for eradication failure, followed by mixed susceptible/ resistant H. pylori strain infection. To distinguish between mixed infections and H. pylori switch to resistance phenotype during eradication therapy, we proceeded with multi locus sequence typing (MLST) of H. pylori strains isolated from gastric biopsy samples of patients before and after eradication therapy. Methodology: We collected H. pylori isolates from gastric biopsies from 133 patients who were never treated for H. pylori. Five patients had eradication failure with the first isolate susceptible and second isolate resistant to clarithromycin. To analyse genotypes of first and second H. pylori isolates, we compared H. pylori strain sequences of 7 housekeeping genes with MLST. Results: Five patients had clarithromycin-sensitive H. pylori before eradication therapy and gained H. pyloriresistant to clarithromycin after eradication therapy. The sensitive and resistant colonies of each of the H. pylori populations, taken from patients before/after antibiotic therapy, had identical sequence types (ST) obtained with MLST. Conclusions: The factors favouring H. pylori survival and switch to antibioticresistance during eradication therapy probably enable milder environmental conditions for H. pylori persistence during therapy. One of such factor is the ineffective destruction of mucosa-adhered H. pylori by immune cells during therapy which may be due to locally induced immune deficit by H. pylori molecules like strain specific H. pylori lipopolysaccharides.
Keywords     multi locus sequence typing
helicobacter pylori
clarithromycin
multi sekvenčna tipizacija
Helicobacter pylori
klaritromicin