Clarithromycin-Based Triple Therapy is Still Useful as an Initial Treatment for Helicobacter pylori Infection in the Dominican Republic

• DOI: 10.4269/ajtmh.16-0729
• Publication Date: 2017-02-14T01:40:26Z
• Authors: Muhammad Miftahus...; Modesto Cruz; Phawinee Subsomwong; José A. Jiménez A...; Celso Hosking; Hiroyuki Nagashima; Junko Akada; Yoshio Yamaoka
• Keywords: Helicobacter Infections

AbstractHelicobacter pylori antibiotic susceptibility in the Dominican Republic has not been monitored. We assessed H. Republic, and analyzed mutations associated with resistance. recruited 158 dyspeptic patients Santo Domingo used agar dilution to test five antibiotics. Polymerase chain reaction-based sequencing was assess gyrA, gyrB, rdxA, frxA, 23S rRNA mutations; next-generation identify other metronidazole resistance-associated genes. Among 64 strains isolated, we identified two (3.1%), one (1.6%), no clarithromycin, amoxicillin, tetracycline resistance, respectively. Moreover, high frequency of resistance (53/64, 82.8%) observed, whereas levofloxacin is emerging (23/64, 35.9%). many rdxA frxA metronidazole-resistant strains, but synergistic effect apparent. revealed novel dppA, dppB, fdxA, fdxB, irrespective mutations. Novel at Ser-14 trx1 Arg-221 dapF were different levels Most levofloxacin-resistant had a substitution Asn-87 including strain highest only three substitutions found Ser-479 gyrB effect. Besides A2142G mutation, observed another mutation T1958G both clarithromycin-resistant strains. confirmed genetic Republic. However, prevalence clarithromycin low, suggesting that standard clarithromycin-based triple therapy remains useful as initial treatment infection.