Mutations Related to Antibiotics Resistance in <i>Helicobacter pylori</i> Clinical Isolates from Bangladesh

• Main Authors: Kartika Afrida Fauzia (Author), Hafeza Aftab (Author), Evariste Tshibangu-Kabamba (Author), Ricky Indra Alfaray (Author), Batsaikhan Saruuljavkhlan (Author), Alain Cimuanga-Mukanya (Author), Takashi Matsumoto (Author), Phawinee Subsomwong (Author), Junko Akada (Author), Muhammad Miftahussurur (Author), Yoshio Yamaoka (Author)
• Format: Book
• Published: MDPI AG, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Current management of gastric inflammation involves the eradication of <i>Helicobacter pylori</i>. However, the effectiveness of commonly used antibiotics against <i>H. pylori</i> infection has decreased due to antibiotic resistance. Phenotypic-based diagnostics are laborious and finding the cause of resistance can be difficult. Therefore, early detection and understanding of the underlying mechanism of this resistance are necessary. This study evaluated the mutations in the genes related to the Antimicrobial Resistance (AMR) of the clinical isolates from Bangladeshi subjects. Whole-genome sequencing was performed on 56 isolates and the genes (such as <i>pbp1a</i>, <i>rdxA</i>, <i>ribF</i>, <i>fur</i>, <i>gyrA</i>, <i>gyrB</i>, <i>23S rRNA,</i> and <i>infB</i>) were extracted. The reads were assembled, and the SNPs were extracted by the latest pipeline for antibiotic mutation analysis, ARIBA. The mutations and the association with the antibiotic phenotypes were evaluated using Fisher's exact test. In this study, the clarithromycin resistance rate was high, 39.3% (22/56), with the median MIC 24 mg/L ranging from 2 to 128 mg/L. The mutation of A2147G was significantly associated with resistance (<i>p</i> = 0.000018) but not in locus A2146G (<i>p</i> = 0.056). Levofloxacin also posed a high resistance. We observed that the mutation of D91N (but not D91Y) (<i>p</i> = 0.002) and N87K (<i>p</i> = 0.002) of <i>gyrA</i> was associated with levofloxacin resistance. Mutations in locus A343V (<i>p</i> = 0.041) of <i>gyrB</i> also showed a significant association. Meanwhile, in the <i>pbp1a</i> gene, several mutations might explain the resistance; they were G594fs (<i>p</i> = 0.036), K306R (<i>p</i> = 0.036), N562Y (<i>p</i> = 0.0006), and V45I (<i>p</i> = 0.018). The prevalence of metronidazole was exceptionally high (96.4%), and numerous mutations occurred in <i>rdxA</i> genes, including the truncation of genes. These results imply that the mutation in genes encoding the target protein of antibiotics remains the critical resistance mechanism in <i>H. pylori</i>.

Item Description

10.3390/antibiotics12020279
2079-6382