Department of Biochemistry, Department of the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Mole Biological Technology Co., Ltd, Hangzhou, China.
Eur J Clin Microbiol Infect Dis. 2021 Aug;40(8):1599-1608. doi: 10.1007/s10096-021-04188-4. Epub 2021 Mar 1.
In China, there is a high prevalence of antibiotic-resistant Helicobacter pylori infections in the population. The aim of the study was to assess a new ARMS-PCR test for detection of H. pylori clarithromycin resistance (CR) and quinolone resistance (QR) mutations and evaluate the spectrum of antibiotic resistance in patients from three Chinese provinces. Sanger sequencing and multiplex ARMS-PCR were used to detect H. pylori CR and QR bacteria in gastric biopsy samples. Among the 1,182 patients enrolled with gastritis, 643 (54.4%) were positive for H. pylori. Of these, 371 (57.7%) had antibiotic-resistant strains, comprising 236 (63.6%) with a single drug antibiotic-resistant strain and 135 (36.4%) with multiple drug-resistant strains. Following Sanger sequencing analysis of 23S rRNA and gyrA gene for mutations (antibiotic resistance markers), rates of CR, QR, and multidrug resistance (CR and QR) were 19.9, 12.0, and 25.8%, respectively. The 23S rRNA CR mutation A2143G (286, 96.9%) and the gyrA QR mutations C261A (85, 31.5%) and G271A (71, 26.3%) were common. Benchmarking against Sanger sequencing results, multiplex ARMS-PCR test had a high diagnostic sensitivity and specificity for detection of CR (96 and 93%), QR (95 and 92%) and multidrug resistance (95 and 95%). Based on our findings, the high incidence of single and multiple antibiotic resistance requires the routine checking of antibiotic resistance in all patients with suspected H. pylori infections. Multiplex ARMS-PCR is a simple and rapid test that can be now used for more efficient treatment of H. pylori infections and reduces the misuse of antibiotics.
在中国，人群中存在高比例的抗生素耐药幽门螺杆菌感染。本研究旨在评估一种新的 ARMS-PCR 检测方法，用于检测幽门螺杆菌克拉霉素耐药（CR）和喹诺酮耐药（QR）突变，并评估来自中国三个省份的患者的抗生素耐药谱。Sanger 测序和多重 ARMS-PCR 用于检测胃活检样本中的幽门螺杆菌 CR 和 QR 细菌。在纳入的 1182 例胃炎患者中，有 643 例（54.4%）幽门螺杆菌阳性。其中，371 例（57.7%）为耐药菌株，包括 236 例（63.6%）单药耐药菌株和 135 例（36.4%）多药耐药菌株。对 23S rRNA 和 gyrA 基因的突变（抗生素耐药标志物）进行 Sanger 测序分析后，CR、QR 和多药耐药（CR 和 QR）的发生率分别为 19.9%、12.0%和 25.8%。23S rRNA CR 突变 A2143G（286，96.9%）和 gyrA QR 突变 C261A（85，31.5%）和 G271A（71，26.3%）较为常见。与 Sanger 测序结果相比，多重 ARMS-PCR 检测对 CR（96%和 93%）、QR（95%和 92%）和多药耐药（95%和 95%）的检测具有较高的诊断敏感性和特异性。根据我们的发现，单一和多种抗生素耐药的发生率较高，因此需要对所有疑似幽门螺杆菌感染的患者常规检查抗生素耐药性。多重 ARMS-PCR 是一种简单快速的检测方法，可用于更有效地治疗幽门螺杆菌感染，减少抗生素的滥用。
