Lopera Brandonn, Lemos Kellys, Atehortúa José Danilo, Valencia-Cárdenas Joaquín, Vélez-Gómez Diego, Martinez Alonso, Pérez-Cala Tania, Salazar Beatriz
Universidad de Antioquia, Escuela de Microbiología, Medellín, Colombia.
Universidad de Antioquia, Facultad de Medicina, Departamento de Microbiología y Parasitología, Grupo Bacterias & Cáncer, Medellín, Colombia.
Rev Inst Med Trop Sao Paulo. 2025 Apr 4;67:e20. doi: 10.1590/S1678-9946202567020. eCollection 2025.
Estimates suggest that over 50% of the global population suffer from Helicobacter pylori infections. Nowadays, first-line quadruple therapy is recommended to eradicate the bacteria due to the increasing failures of the standard triple therapy. Thus, antibiotics such as furazolidone have emerged as a new treatment due to their success rate (>90%) in rescue therapies. Nevertheless, furazolidone is not routinely used for treatment of H. pylori in Colombia. Still, some Asian countries commonly prescribe it. This study aimed to determine the susceptibility of H. pylori to furazolidone in isolates from patients with gastroduodenal diseases in Colombia that were extracted from 2019-2022. A descriptive study was carried out with 179 patients with gastroduodenal diseases. Susceptibility was determined by the agar dilution method. The gene oorD from resistant isolates was amplified by polymerase chain reaction, and their PCR products were sequenced. The frequency of H. pylori equaled 23.5% (42/179); the bacterium was isolated in 84 gastric biopsies. Moreover, 1.7% (3/179) of patients had one resistant isolate to furazolidone in at least one of the two gastric biopsies, corresponding to 5.95% (5/84) of the isolates resisting furazolidone. Overall, three new mutations in the oorD gene occurred in one isolate, and two of the mutations in the five isolates had been reported in Iran, Brazil, and China. This research found low in vitro resistance of H. pylori isolates to furazolidone in Colombia. Finally, all five isolates showed mutations in the oorD gene.
据估计,全球超过50%的人口感染幽门螺杆菌。如今,由于标准三联疗法的失败率不断上升,一线四联疗法被推荐用于根除该细菌。因此,诸如呋喃唑酮之类的抗生素因其在挽救疗法中的成功率(>90%)而成为一种新的治疗方法。然而,呋喃唑酮在哥伦比亚并非常规用于治疗幽门螺杆菌。尽管如此,一些亚洲国家普遍会开这种药。本研究旨在确定2019年至2022年从哥伦比亚胃十二指肠疾病患者中分离出的幽门螺杆菌对呋喃唑酮的敏感性。对179例胃十二指肠疾病患者进行了描述性研究。通过琼脂稀释法测定敏感性。通过聚合酶链反应扩增耐药菌株的oorD基因,并对其PCR产物进行测序。幽门螺杆菌的检出率为23.5%(42/179);在84份胃活检样本中分离出该细菌。此外,1.7%(3/179)的患者在两份胃活检样本中的至少一份中有一种对呋喃唑酮耐药的菌株,占耐药呋喃唑酮菌株的5.95%(5/84)。总体而言,一个菌株的oorD基因出现了三个新突变,五个菌株中的两个突变在伊朗、巴西和中国已有报道。本研究发现哥伦比亚的幽门螺杆菌菌株对呋喃唑酮的体外耐药性较低。最后,所有五个菌株的oorD基因均显示出突变。