title: Prevalence of Helicobacter pylori resistance to clarithromycin and metronidazole determined by 23S ribosomal RNA and rdxA gene analyses in Hiroshima, Japan.
abstract: OBJECTIVE
  Resistance to antibiotics in Helicobacter pylori is increasing and becoming a serious problem in eradication treatment of H. pylori. The prevalence of H. pylori infections that are resistant to clarithromycin, metronidazole, or both were determined in H. pylori isolates in Hiroshima, Japan.
  
  
  METHODS
  Sixty Japanese patients with H. pylori infection were collected between 1999 and 2000. To detect the resistance to clarithromycin and metronidazole, mutations of the 23S ribosomal RNA (rRNA) and rdxA genes that are responsible for resistance in H. pylori, were examined by direct sequencing analysis.
  
  
  RESULTS
  Resistance to clarithromycin and metronidazole was detected in 12 (20.0%) and nine (15.0%) of the patients, respectively. Dual resistance to clarithromycin and metronidazole was detected in five (8.3%) patients.
  
  
  CONCLUSIONS
  These results indicate that the relatively high prevalence of the dual resistance in H. pylori isolates may need special attention and new therapeutic approaches in Japan.
authors.affiliation: Health Service Center, Hiroshima University, Higashihiroshima, Japan. tohiyama@hiroshima-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Hiyama
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kose
authors.forename: Handan
authors.initials: H
authors.lastname: Tuncel
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitadai
authors.forename: Masaharu
authors.initials: M
authors.lastname: Sumii
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Fumio
authors.initials: F
authors.lastname: Shimamoto
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D017291:Clarithromycin / Q000494:pharmacology*; D004352:Drug Resistance, Microbial / Q000235:genetics; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008795:Metronidazole / Q000494:pharmacology*; D008875:Middle Aged; D009154:Mutation; D009601:Nitroreductases / Q000235:genetics*; D017354:Point Mutation; D015995:Prevalence; D012338:RNA, Ribosomal, 23S / Q000235:genetics*; D012367:RNA, Viral / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D012338:RNA, Ribosomal, 23S; D012367:RNA, Viral; D008795:Metronidazole; C029492:aromatic NADH-dependent nitroreductase; D009601:Nitroreductases; D017291:Clarithromycin