Trang: 48
Tập 34, số 8 2024
Point Mutations in the Helicobacter pylori gyrA gene in Patients with peptic ulcer disease and suspected gastric cancer
Tác giả: Bui Thanh Thuyet, Le Huu Phuong Anh, Le Thi Lam Quy, Bui Thi Tho, Phan Quoc Hoan,
Tran Thi Huyen Trang
Tóm tắt:
Helicobacter pylori (H. pylori) is a major causative agent of peptic ulcer disease and gastric cancer. Levofloxacin, a
fluoroquinolone antibiotic, is commonly used in H. pylori treatment regimens. However, the increasing resistance of H.
pylori to levofloxacin in Vietnam has compromised treatment efficacy. This study aimed to determine the prevalence of
point mutations in the gyrA gene and investigate their associated factors. A total of 164 H. pylori strains were isolated
from patients with peptic ulcer disease or suspected gastric cancer at the 108 Military Central Hospital between 2019
and 2022. The gyrA gene was sequenced using the Sanger method to identify mutations conferring levofloxacin (LVX)
resistance. The overall LVX resistance rate was 29.9% (49/164). Eighteen distinct gyrA mutations were identified,
including M191I, G208E/K/R, N87K/I, V199A/I, R130K, R140K, D91G/Y/N, A66T, I194T, D161N, V172I, V65I,
A88P, D155G, D192G, D210N, T132A, and V150A. Among these, M191I (92.7%) and G208E/K/R (30.5%) were
the most prevalent. Etest results showed a significant association between the N87K/I mutation and LVX resistance (p
< 0.05). Logistic regression analysis further revealed that the mutation combinations D91G/Y/N+M191I and N87K/
I+M191I were significantly associated with LVX resistance. These novel findings contribute to a deeper understanding
of fluoroquinolone resistance mechanisms in H. pylori. Continuous monitoring and the development of more effective
diagnostic and treatment strategies are essential for controlling H. pylori infection
Summary:
Từ khóa:
Helicobacter pylori; levofloxacin resistance; antimicrobial resistance; gyrA point mutations
DOI: https://doi.org/10.51403/0868-2836/2024/2143
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