Prevalence and rapid identification of clarithromycin-resistant Helicobacter pylori isolates in children

Yao-jong Yang, Jyh Chin Yang, Yung Ming Jeng, Mei Hwei Chang, Yen Hsuan Ni

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant II. pylori isolates. Methods. Enrolled were 245 children investigated for II. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin resistant and 6 (9%) were metronidazoleresistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. Conclusions. The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.

Original languageEnglish
Pages (from-to)662-666
Number of pages5
JournalPediatric Infectious Disease Journal
Volume20
Issue number7
DOIs
Publication statusPublished - 2001

Fingerprint

Clarithromycin
Helicobacter pylori
Restriction Fragment Length Polymorphisms
Polymerase Chain Reaction
Pylorus
Anti-Bacterial Agents
Mutation
23S Ribosomal RNA
Sensitivity and Specificity
Metronidazole
Helicobacter Infections
Gastritis
DNA-Directed DNA Polymerase
rRNA Genes
Point Mutation
Stomach
Infection
Genes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Yang, Yao-jong ; Yang, Jyh Chin ; Jeng, Yung Ming ; Chang, Mei Hwei ; Ni, Yen Hsuan. / Prevalence and rapid identification of clarithromycin-resistant Helicobacter pylori isolates in children. In: Pediatric Infectious Disease Journal. 2001 ; Vol. 20, No. 7. pp. 662-666.
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abstract = "Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant II. pylori isolates. Methods. Enrolled were 245 children investigated for II. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12 (18{\%}) of them were clarithromycin resistant and 6 (9{\%}) were metronidazoleresistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. Conclusions. The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18{\%}. PCR-RFLP had a high sensitivity (92{\%}) and specificity (100{\%}) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.",
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Prevalence and rapid identification of clarithromycin-resistant Helicobacter pylori isolates in children. / Yang, Yao-jong; Yang, Jyh Chin; Jeng, Yung Ming; Chang, Mei Hwei; Ni, Yen Hsuan.

In: Pediatric Infectious Disease Journal, Vol. 20, No. 7, 2001, p. 662-666.

Research output: Contribution to journalArticle

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T1 - Prevalence and rapid identification of clarithromycin-resistant Helicobacter pylori isolates in children

AU - Yang, Yao-jong

AU - Yang, Jyh Chin

AU - Jeng, Yung Ming

AU - Chang, Mei Hwei

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PY - 2001

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N2 - Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant II. pylori isolates. Methods. Enrolled were 245 children investigated for II. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin resistant and 6 (9%) were metronidazoleresistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. Conclusions. The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.

AB - Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant II. pylori isolates. Methods. Enrolled were 245 children investigated for II. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin resistant and 6 (9%) were metronidazoleresistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. Conclusions. The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.

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