JAC Advance Access published online on March 13, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg192
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Helicobacter Reference Unit, Laboratory of Enteric Pathogens,
Central Public Health Laboratory, 61 Colindale Avenue, Colindale,
London NW9 5HT, UK
* Corresponding author. E-mail: schisholm{at}phls.nhs.uk.
Received 25 October 2002
; revised 6 December 2002
; 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
Mutations in Helicobacter pylori rdxA gene sequences may not contribute to metronidazole
resistance
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