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Article: High prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kong

TitleHigh prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kong
Authors
Issue Date2000
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
Citation
Alimentary Pharmacology And Therapeutics, 2000, v. 14 n. 7, p. 901-910 How to Cite?
AbstractBackground: Metronidazole resistance is a common problem in most Asian countries, and clarithromycin has been widely used in Hong Kong. Aim: To determine the prevalence of Helicobacter pylori strains resistant to metronidazole and clarithromycin in Hong Kong and to assess the effect on eradication rates. Also to determine the genetic mutation in relation to phenotypic divergence in clarithromycin-resistant strains. Methods: H. pylori were cultured from gastric biopsies obtained from 87 patients during upper endoscopy. Minimal inhibitory concentrations of metronidazole and clarithromycin were determined by Etest and agar dilution methods. Mutations in clarithromycin-resistant strains were identified by polymerase chain reaction and restriction analysis. Random amplified polymorphic DNA fingerprinting was performed on clarithromycin-resistant and susceptible isolates. Results: The prevalences of H. pylori strains resistant to metronidazole and clarithromycin were 49.4% and 10.8%, respectively, in Hong Kong. Dual resistance to metronidazole and clarithromycin were found in 7.2% of patients. The agreement between E-test and agar dilution methods was determined by error-rate bound analysis as 95.4% for metronidazole and 100% for clarithromycin. Dual resistant strains reduced the eradication rate to 66.7%. Among clarithromycin-resistant strains tested, all were due to A2144G point mutation in 23S rRNA gene. Random amplified polymorphic DNA fingerprinting suggested various phenotypically mixed populations. Conclusions: The prevalence of metronidazole-resistant H. pylori strains remained static whilst the prevalence of clarithromycin-resistant strains was not rare in Hong Kong. An alarming 7.2% of patients were resistant to both the antimicrobials, which had a definite impact on treatment success. All cases of resistance to clarithromycin were due to A2144G mutation in 23S rRNA of H. pylori.
Persistent Identifierhttp://hdl.handle.net/10722/48626
ISSN
2015 Impact Factor: 6.32
2015 SCImago Journal Rankings: 2.833
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, WHen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorMukhopadhyay, AKen_HK
dc.contributor.authorBerg, DEen_HK
dc.contributor.authorCho, CHen_HK
dc.contributor.authorLai, KCen_HK
dc.contributor.authorHu, WHCen_HK
dc.contributor.authorFung, FMYen_HK
dc.contributor.authorHui, WMen_HK
dc.contributor.authorLam, SKen_HK
dc.date.accessioned2008-05-22T04:19:24Z-
dc.date.available2008-05-22T04:19:24Z-
dc.date.issued2000en_HK
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2000, v. 14 n. 7, p. 901-910en_HK
dc.identifier.issn0269-2813en_HK
dc.identifier.urihttp://hdl.handle.net/10722/48626-
dc.description.abstractBackground: Metronidazole resistance is a common problem in most Asian countries, and clarithromycin has been widely used in Hong Kong. Aim: To determine the prevalence of Helicobacter pylori strains resistant to metronidazole and clarithromycin in Hong Kong and to assess the effect on eradication rates. Also to determine the genetic mutation in relation to phenotypic divergence in clarithromycin-resistant strains. Methods: H. pylori were cultured from gastric biopsies obtained from 87 patients during upper endoscopy. Minimal inhibitory concentrations of metronidazole and clarithromycin were determined by Etest and agar dilution methods. Mutations in clarithromycin-resistant strains were identified by polymerase chain reaction and restriction analysis. Random amplified polymorphic DNA fingerprinting was performed on clarithromycin-resistant and susceptible isolates. Results: The prevalences of H. pylori strains resistant to metronidazole and clarithromycin were 49.4% and 10.8%, respectively, in Hong Kong. Dual resistance to metronidazole and clarithromycin were found in 7.2% of patients. The agreement between E-test and agar dilution methods was determined by error-rate bound analysis as 95.4% for metronidazole and 100% for clarithromycin. Dual resistant strains reduced the eradication rate to 66.7%. Among clarithromycin-resistant strains tested, all were due to A2144G point mutation in 23S rRNA gene. Random amplified polymorphic DNA fingerprinting suggested various phenotypically mixed populations. Conclusions: The prevalence of metronidazole-resistant H. pylori strains remained static whilst the prevalence of clarithromycin-resistant strains was not rare in Hong Kong. An alarming 7.2% of patients were resistant to both the antimicrobials, which had a definite impact on treatment success. All cases of resistance to clarithromycin were due to A2144G mutation in 23S rRNA of H. pylori.en_HK
dc.format.extent75908 bytes-
dc.format.extent244752 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APTen_HK
dc.relation.ispartofAlimentary Pharmacology and Therapeuticsen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsAlimentary Pharmacology and Therapeutics. Copyright © Blackwell Publishing Ltd.en_HK
dc.rightsThe definitive version is available at www.blackwell-synergy.comen_HK
dc.subject.meshAnti-Bacterial Agents - pharmacology - therapeutic useen_HK
dc.subject.meshClarithromycin - pharmacology - therapeutic useen_HK
dc.subject.meshDNA Mutational Analysisen_HK
dc.subject.meshDrug Resistance, Multiple - geneticsen_HK
dc.subject.meshGene Frequencyen_HK
dc.titleHigh prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0269-2813&volume=14&issue=7&spage=901&epage=910&date=2000&atitle=High+prevalence+of+Helicobacter+pylori+infection+with+dual+resistance+to+metronidazole+and+clarithromycin+in+Hong+Kongen_HK
dc.identifier.emailWong, BCY:bcywong@hku.hken_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.description.naturepostprinten_HK
dc.identifier.doi10.1046/j.1365-2036.2000.00795.xen_HK
dc.identifier.pmid10886046-
dc.identifier.scopuseid_2-s2.0-0033922945en_HK
dc.identifier.hkuros50521-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033922945&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue7en_HK
dc.identifier.spage901en_HK
dc.identifier.epage910en_HK
dc.identifier.isiWOS:000087842300007-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridWang, WH=23390847100en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridMukhopadhyay, AK=7201816905en_HK
dc.identifier.scopusauthoridBerg, DE=7202401139en_HK
dc.identifier.scopusauthoridCho, CH=14067000400en_HK
dc.identifier.scopusauthoridLai, KC=7402135595en_HK
dc.identifier.scopusauthoridHu, WHC=25932937100en_HK
dc.identifier.scopusauthoridFung, FMY=7003833944en_HK
dc.identifier.scopusauthoridHui, WM=7103196477en_HK
dc.identifier.scopusauthoridLam, SK=7402279473en_HK

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