Prevalence of Helicobacter pylori resistance to clarithromycin and metronidazole determined by 23S ribosomal RNA and rdxA gene analyses in Hiroshima, Japan.
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.
Hiyama
Toru
T
Health Service Center, Hiroshima University, Higashihiroshima, Japan. tohiyama@hiroshima-u.ac.jp
Tanaka
Shinji
S
Masuda
Hiroshi
H
Shima
Hideyuki
H
Kose
Kazuhiro
K
Tuncel
Handan
H
Ito
Masanori
M
Kitadai
Yasuhiko
Y
Sumii
Masaharu
M
Uemura
Naomi
N
Yoshihara
Masaharu
M
Shimamoto
Fumio
F
Haruma
Ken
K
Chayama
Kazuaki
K
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*
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