title: Molecular Detection of Helicobacter pylori and its Antimicrobial Resistance in Brazzaville, Congo.
abstract: BACKGROUND
  Helicobacter pylori infection is involved in several gastroduodenal diseases which can be cured by antimicrobial treatment. The aim of this study was to determine the prevalence of H. pylori infection and its bacterial resistance to clarithromycin, fluoroquinolones, and tetracycline in Brazzaville, Congo, by using molecular methods.
  
  
  METHODS
  A cross- sectional study was carried out between September 2013 and April 2014. Biopsy specimens were obtained from patients scheduled for an upper gastrointestinal endoscopy and were sent to the French National Reference Center for Campylobacters and Helicobacters where they were tested by molecular methods for detection of H. pylori and clarithromycin resistance by real-time PCR using a fluorescence resonance energy transfer-melting curve analysis (FRET-MCA) protocol, for detection of tetracycline resistance by real-time PCR on 16S rRNA genes (rrnA and rrnB), for detection of point mutations in the quinolone resistance-determining regions (QRDR) of H. pylori gyrA gene, associated with resistance to quinolones, by PCR and sequencing.
  
  
  RESULTS
  This study showed a high H. pylori prevalence (89%), low rates of clarithromycin and tetracycline resistance (1.7% and 2.5%, respectively), and a high rate of quinolone resistance (50%).
  
  
  CONCLUSIONS
  Therefore, the use of standard clarithromycin-based triple therapy is still possible as an empiric first-line treatment as well as prescription of bismuth-based quadruple therapy, which includes tetracycline, but not a levofloxacin-based triple therapy because of the high rate of resistance to fluoroquinolones.
authors.affiliation: Microbiology and Haematology Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Esther Nina
authors.initials: EN
authors.lastname: Ontsira Ngoyi
authors.affiliation: Medicine Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Blaise Irénée
authors.initials: BI
authors.lastname: Atipo Ibara
authors.affiliation: Molecular and Cellular Biology Department, Technical and Sciences Faculty, Brazzaville, Congo.
authors.forename: Rachelle
authors.initials: R
authors.lastname: Moyen
authors.affiliation: Medicine Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Philestine Clausina
authors.initials: PC
authors.lastname: Ahoui Apendi
authors.affiliation: Medicine Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Jean Rosaire
authors.initials: JR
authors.lastname: Ibara
authors.affiliation: Microbiology and Haematology Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: O
authors.initials: O
authors.lastname: Obengui
authors.affiliation: Medicine Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Roland Bienvenu
authors.initials: RB
authors.lastname: Ossibi Ibara
authors.affiliation: Molecular and Cellular Biology Department, Technical and Sciences Faculty, Brazzaville, Congo.
authors.forename: Etienne
authors.initials: E
authors.lastname: Nguimbi
authors.affiliation: Molecular and Cellular Biology Department, Technical and Sciences Faculty, Brazzaville, Congo.
authors.forename: Rock Fabien
authors.initials: RF
authors.lastname: Niama
authors.affiliation: Chemistry plant and life unit, Technical and Sciences Faculty, Brazzaville, Congo.
authors.forename: Jean Maurille
authors.initials: JM
authors.lastname: Ouamba
authors.affiliation: Microbiology and Haematology Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Fidèle
authors.initials: F
authors.lastname: Yala
authors.affiliation: Biochemistry Department, Health Sciences Faculty, Brazzaville, Congo.
authors.forename: Ange Antoine
authors.initials: AA
authors.lastname: Abena
authors.affiliation: University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Jamuna
authors.initials: J
authors.lastname: Vadivelu
authors.affiliation: University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Khean Lee
authors.initials: KL
authors.lastname: Goh
authors.affiliation: INSERM U853, Bordeaux, France.
authors.forename: Armelle
authors.initials: A
authors.lastname: Menard
authors.affiliation: French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Benejat
authors.affiliation: French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Sifre
authors.affiliation: INSERM U853, Bordeaux, France.|French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lehours
authors.affiliation: INSERM U853, Bordeaux, France.|French National Reference Center for Campylobacters and Helicobacters, University of Bordeaux, Bordeaux, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Megraud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D003223:Congo; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D060888:Real-Time Polymerase Chain Reaction; D013752:Tetracycline / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D013752:Tetracycline; D017291:Clarithromycin
keywords: Macrolides; fluoroquinolones; gastric biopsies; real-time PCR; tetracycline