Efflux Pump Mediated Antibiotic Resistance in Clinical Isolates of Helicobacter Pylori From South West Nigeria

Journal of gastroenterology and hepatology research Pub Date : 2020-08-21 DOI:10.17554/j.issn.2224-3992.2020.09.944

Tolulope Jolaiya, M. Fowora, C. Onyekwere, R. Ugiagbe, I. Agbo, O. Lesi, D. Ndububa, O. Adekanle, Henry Akum Njom, A. Idowu, I. Adeleye, M. Bamidele, Favour Ngoka, Pia Palamides, Stella I Smith

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引用次数: 1

Abstract

Introduction Helicobacter pylori is a spiral shaped gram negative bacterium majorly causing peptic ulcers and gastric cancer in humans. The combinations of two or more antibiotics such as amoxicillin, clarithromycin, metronidazole or tetracycline with anti-secretory agents or bismuth have been used successfully for the treatment of H. pylori . Aim Increasing antibiotic resistance has been a contributory factor to treatment failures; as such evaluation of resistance mechanism will improve the management of H. pylori infection. Methodology The antibiotic resistance in H. pylori isolates from Nigeria was determined using E-test strips from Biomerieux SA, France and PCR for the efflux pump gene detection. Results Resistance to metronidazole was found to be 93% (97/104), amoxicillin 42% (44/104), clarithromycin 39% (41/104) and tetracycline 27% (28/104). However 51% (53/104) of the isolates harboured multidrug efflux pump gene hefA (Hp605) and 34% (35/104) hefD (Hp 971). However, hefG (Hp 1327) was absent in all the isolates. There was significant association between clarithromycin resistance and hefA with p-value 0.014, there was also association between amoxicillin resistance and hefD with p-value 0.004. Conclusion The present study revealed that H. pylori antibiotic resistance is on the increase in Nigerian strains and the mechanism of resistance may possibly include the possession of multidrug efflux pump.

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尼日利亚西南部幽门螺杆菌临床分离株外排泵介导的抗生素耐药性

幽门螺杆菌是一种螺旋形革兰氏阴性菌，主要引起人类消化性溃疡和癌症。阿莫西林、克拉霉素、甲硝唑或四环素等两种或多种抗生素与抗分泌剂或铋的组合已成功用于治疗幽门螺杆菌。目的抗生素耐药性的增加是导致治疗失败的一个因素；因为这样的耐药性机制的评估将改善幽门螺杆菌感染的管理。方法采用法国Biomerieux公司的E试纸条和聚合酶链式反应检测外排泵基因，对尼日利亚幽门螺杆菌分离株的抗生素耐药性进行检测。结果甲硝唑耐药率93%（97/104），阿莫西林耐药率42%（44/104），克拉霉素耐药率39%（41/104），四环素耐药率27%（28/104）。然而，51%（53/104）的分离株携带多药外排泵基因hefA（Hp605）和34%（35/104）的hefD（Hp971）。但所有分离株均未发现hefG（Hp 1327）。克拉霉素耐药性与hefA之间存在显著相关性（p值为0.014），阿莫西林耐药性与hef D之间也存在相关性，p值为0.004。结论尼日利亚菌株对幽门螺杆菌的耐药性呈上升趋势，其耐药机制可能与拥有多药外排泵有关。

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Journal of gastroenterology and hepatology research

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