JAC Advance Access originally published online on March 13, 2003
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Journal of Antimicrobial Chemotherapy (2003) 51, 995-999
© 2003 The British Society for Antimicrobial Chemotherapy
Mutations in Helicobacter pylori rdxA gene sequences may not contribute to metronidazole resistance
Helicobacter Reference Unit, Laboratory of Enteric Pathogens, Central Public Health Laboratory, 61 Colindale Avenue, Colindale, London NW9 5HT, UK
Received 25 October 2002; returned 6 December 2002; revised 3 February 2003; accepted 3 February 2003
Metronidazole resistance in Helicobacter pylori reportedly occurs by mutational inactivation of the oxygen-insensitive nitroreductase gene rdxA. Nucleotide sequences of rdxA were determined in a set of 46 isolates from 19 dyspeptic patients from the UK. The study set comprised matched isolates that were either metronidazole susceptible (four) or mixed metronidazole susceptible and metronidazole resistant (15) before therapy and metronidazole resistant post-therapy (10) in the 11 patients that were followed up. Various mutation types were identified in rdxA of metronidazole-resistant strains (post-treatment) that were absent in matched metronidazole-susceptible strains (pre-treatment). However, rdxA sequences from pre-treatment metronidazole-resistant and metronidazole-susceptible subpopulations were identical in 11 of 15 patients. Thus, mutations in rdxA may not always be essential for metronidazole resistance. Future examination of rdxA expression at the transcription and translational level may provide further insight into the role of this locus in metronidazole action and resistance in H. pylori.
Keywords: Helicobacter pylori, metronidazole resistance, rdxA, mutation
* Corresponding author. Tel: +44-20-8200-4400; Fax: +44-20-8905-9929; E-mail: schisholm{at}phls.nhs.uk
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