Influence of efflux pump inhibitors on the multidrug resistance of Helicobacter pylori.
OBJECTIVE
To evaluate the effect of efflux pump inhibitors (EPIs) on multidrug resistance of Helicobacter pylori (H. pylori).


METHODS
H. pylori strains were isolated and cultured on Brucella agar plates with 10% sheep's blood. The multidrug resistant (MDR) H. pylori were obtained with the inducer chloramphenicol by repeated doubling of the concentration until no colony was seen, then the susceptibilities of the MDR strains and their parents to 9 antibiotics were assessed with agar dilution tests. The present study included periods before and after the advent of the EPIs, carbonyl cyanide m-chlorophenyl hydrazone (CCCP), reserpine and pantoprazole), and the minimum inhibitory concentrations (MICs) were determined accordingly. In the same way, the effects of 5 proton pump inhibitors (PPIs), used in treatment of H. pylori infection, on MICs of antibiotics were evaluated.


RESULTS
Four strains of MDR H. pylori were induced successfully, and the antibiotic susceptibilities of MDR strains were partly restored by CCCP and pantoprazole, but there was little effect of reserpine. Rabeprazole was the most effective of the 5 PPIs which could decrease the MICs of antibiotics for MDR H. pylori significantly.


CONCLUSIONS
In vitro, some EPIs can strengthen the activities of different antibiotics which are the putative substrates of the efflux pump system in H. pylori.
Zhang
Zhan
Z
Department of Gastroenterology, the Second Affiliated Hospital of Zhengzhou University, 2 Jingba Road, Zhengzhou 450014, Henan Province, China.
Liu
Zhi-Qiang
ZQ
Zheng
Peng-Yuan
PY
Tang
Fu-Ai
FA
Yang
Ping-Chang
PC
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology; D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000378:metabolism; D002258:Carbonyl Cyanide m-Chlorophenyl Hydrazone / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000494:pharmacology*; D012110:Reserpine / Q000494:pharmacology; D014475:Uncoupling Agents / Q000494:pharmacology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D018759:Adrenergic Uptake Inhibitors; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D054328:Proton Pump Inhibitors; D014475:Uncoupling Agents; D002258:Carbonyl Cyanide m-Chlorophenyl Hydrazone; D012110:Reserpine; D000077402:Pantoprazole