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 language | English |
|---|---|
| Pages (from-to) | 662-666 |
| Number of pages | 5 |
| Journal | Pediatric Infectious Disease Journal |
| Volume | 20 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 2001 |
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All Science Journal Classification (ASJC) codes
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
- Microbiology (medical)
- Infectious Diseases
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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 journal › Article
TY - JOUR
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
AU - Ni, Yen Hsuan
PY - 2001
Y1 - 2001
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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UR - http://www.scopus.com/inward/citedby.url?scp=0034946064&partnerID=8YFLogxK
U2 - 10.1097/00006454-200107000-00005
DO - 10.1097/00006454-200107000-00005
M3 - Article
C2 - 11465837
AN - SCOPUS:0034946064
VL - 20
SP - 662
EP - 666
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
SN - 0891-3668
IS - 7
ER -