CLARITHROMYCIN RESISTANCE MUTATIONS OF HELICOBACTER PYLORI IN CHILDREN WITH GASTRITIS AND PEPTIC ULCER

Trung Kien Nguyen1,, Do Hung Tran 1, Hong Phong Nguyen1, Huy Thanh Ong2, Nhat Ngan Tuyen Vo 1, Phan Hai Sam Nguyen1, Thi Thuy Loan Le 1, Duc Long Tran 1
1 Can Tho University of Medicine and Pharmacy
2 Can Tho Children’s Hospital

Main Article Content

Abstract

Background: Clarithromycin (CLA) is one of the first-line antibiotics used in the eradication of Helicobacter pylori in children. However, CLA resistance in H. pylori is currently increasing and varies across different regions of the world. This condition is associated with mutations in the macrolide resistance-determining region of the 23S rRNA gene. Objectives: To determine the rate of CLA resistance mutations in the 23S rRNA gene of H. pylori in children aged 6-16 with gastritis, peptic ulcer disease, and some related factors. Materials and methods: A cross-sectional descriptive study was conducted on 59 pediatric patients aged 6-16 with gastritis, peptic ulcer disease, and H. pylori infection at Can Tho Children's Hospital, using gene sequencing to identify CLA resistance mutations. Results: Among H. pylori-infected pediatric patients, the rate of CLA resistance mutations in the 23S rRNA gene was 100%. Eight point mutations were detected in the 23S rRNA gene segment, with nucleotide A being replaced by G at positions 2142 and 2143, and no strain carrying the A2142C mutation. The A2143G and T2182C mutations were the most common, accounting for 91.5% and 96.6%, respectively. There was no statistically significant association between CLA resistance gene mutations and age, gender, endoscopic findings, or history of H. pylori treatment. Conclusion: The rate of CLA resistance in H. pylori among patients with gastritis and peptic ulcer disease in the Mekong Delta region is quite high, warning of the risk of treatment failure with H. pylori eradication regimens containing CLA. Therefore, testing for this antibiotic resistance should be indicated before treatment, especially in cases with a history of treatment failure.

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References

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