NGHIÊN CỨU ĐỘT BIẾN KHÁNG CLARITHROMYCIN VÀ LEVOFLOXACIN CỦA VI KHUẨN HELICOBACTER PYLORI Ở BỆNH NHÂN VIÊM DẠ DÀY TẠI BỆNH VIỆN ĐA KHOA BẠC LIÊU VÀ BỆNH VIỆN ĐA KHOA THANH VŨ MEDIC BẠC LIÊU NĂM 2022-2023

Abstract

Background: Helicobacter pylori infection in Vietnam accounts for 70-90% of the population. It is the main cause of gastritis and stomach cancer; H. pylori bacteria can be effectively treated with antibiotics. However, the drug-resistance of H. pylori getting more concerning. Objectives: To determine the rate of 23S rRNA and gyrA gene mutations resistant to clarithromycin and levofloxacin of H. pylori in gastritis patients and some related factors. Materials and methods: A cross-sectional descriptive study on H. pylori-positive gastritis patients at Bac Lieu General Hospital and Thanh Vu Medic Bac Lieu General Hospital. Results: The rate of mutations resistant to clarithromycin was (85.7%) and levofloxacin (60.3%). For clarithromycin, the mutation at position T2182C accounted for the highest rate (80.9%), A2143G (57.2%) and the lowest was A2142G (1.6%). For levofloxacin with two common sites, amino acids 87 and 91, the rate of levofloxacin antibiotic resistance mutations for positions N87K, T87I, D91N, D91Y and D91G is (31.7%), (3.7%, respectively, 2%), (12.7%), (1.6%) and (14.3%). In particular, there is a newly discovered mutation capable of causing levofloxacin resistance, H (Histidine) at position 87H with the rate (1.6%). Up to 24 H. pylori samples had both levofloxacin and clarithromycin resistance mutations with the rate of 38.1%. Conclusion: The study determined the rate of drug-resistant mutations and the resistant mutants to the antibiotics clarithromycin and levofloxacin currently being used to treat H. pylori, the rate of mutations in the study was really very high. worthy of attention and should be treated with care.