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JAC Advance Access originally published online on January 5, 2006
Journal of Antimicrobial Chemotherapy 2006 57(3):466-471; doi:10.1093/jac/dki479
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Association of antibiotic resistance and higher internalization activity in resistant Helicobacter pylori isolates

Chih-Ho Lai1, Chun-Hsien Kuo1, Pei-Yu Chen1, Sek-Kwong Poon2, Chi-Sen Chang2,3 and Wen-Ching Wang1,*

1 Institute of Molecular and Cellular Biology & Department of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan; 2 Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan; 3 Institute of Biochemistry and Biotechnology, Chung Shan Medical University, Taichung, Taiwan

Received 24 October 2005; returned 1 December 2005; revised 9 December 2005; accepted 12 December 2005

* Corresponding author. Tel: +886-3-5742766; Fax: +886-3-5742766; E-mail: wcwang{at}life.nthu.edu.tw

Objectives: Helicobacter pylori resistance to antibiotics is the main factor for therapy failure, while other features remain largely unknown. The aims of this study are to investigate the relationship of antibiotic resistance and in vitro internalization activity between cure and failure isolates and to determine whether failures are associated with persistence of the same predominant strain.

Methods: Fifty-three isolates from forty-seven patients (cure group, n = 31; failure group, n = 16) receiving one of two lansoprazole-based therapies before and/or after therapy were investigated. Antibiotic susceptibility was determined by Etest. Genotyping was determined by cagA, babA, vacA and RAPD analyses. Target cells of internalization assay were AGS cells.

Results: Five of six paired pre- and post-treatment isolates had the same predominant genetic profiles and exhibited similarly high internalization activities. The A2143G point mutation of the 23S rRNA gene conferred clarithromycin resistance. Moreover, increased antibiotic resistance after therapy was found for these five cases. Pre-treatment isolates from the failure group (n = 11) had higher level of internalization activity than those from the cure group (n = 31) (P = 0.00005). Antibiotic-resistant strains were significantly associated with higher internalization activity than were susceptible strains (metronidazole, P < 0.005; clarithromycin, P < 0.005).

Conclusions: Our results suggest that resistant H. pylori strains are associated with antibiotic resistance and superior internalization activity, protecting them against antibiotic treatment.

Keywords: H. pylori , in vitro internalization , triple therapy , 23S rRNA


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[Abstract] [Full Text] [PDF]


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