Monroy, F.P.; Brown, H.E.; Acevedo-Solis, C.M.; Rodriguez-Galaviz, A.; Dholakia, R.; Pauli, L.; Harris, R.B. Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study. Microorganisms2023, 11, 2290.
Monroy, F.P.; Brown, H.E.; Acevedo-Solis, C.M.; Rodriguez-Galaviz, A.; Dholakia, R.; Pauli, L.; Harris, R.B. Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study. Microorganisms 2023, 11, 2290.
Monroy, F.P.; Brown, H.E.; Acevedo-Solis, C.M.; Rodriguez-Galaviz, A.; Dholakia, R.; Pauli, L.; Harris, R.B. Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study. Microorganisms2023, 11, 2290.
Monroy, F.P.; Brown, H.E.; Acevedo-Solis, C.M.; Rodriguez-Galaviz, A.; Dholakia, R.; Pauli, L.; Harris, R.B. Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study. Microorganisms 2023, 11, 2290.
Abstract
Helicobacter pylori (H. pylori) is a common bacterial infection linked to gastric malignancies. While H. pylori infection and gastric cancer rates are decreasing, antibiotic resistance varies greatly by community. Little is known about resistance rates among rural Indigenous populations in the United States. From 2018 to 2021, 396 endoscopy patients were recruited from a Northern Arizona clinic, where community H. pylori prevalence is near 60%. Gastric biopsy samples positive for H. pylori (n=67) were sequenced for clarithromycin and metronidazole-associated mutations, 23S ribosomal RNA (23S), and oxygen-insensitive NADPH nitroreductase (rdxA) regions. Medical record data were extracted for endoscopic findings and prior H. pylori history. Data analysis was restricted to individuals with no history of H. pylori infection. Of 49 individuals, representing 64 samples that amplified in the 23S region, a clarithromycin-associated mutation was present in 38.8%, with T2182C the most common mutation, 90%. While prevalence of metronidazole resistance-associated mutations was higher, 93.9%, mutations were more variable, with D95N the most common, followed by L62V. No statistically significant sex differences were observed for either antibiotic. Given the risk of treatment failure with antibiotic resistance, there is a need to consider the resistance profile during treatment selection. The resistance rates in this population of American Indian patients undergoing endoscopy are similar to other high-risk populations. This is concerning given the high H. pylori prevalence and low rates of resistance testing in clinical settings. The mutations reported are associated with antibiotic resistance, but clinical resistance must be confirmed.
Keywords
Helicobacter pylori; Antibiotic resistance; Mutation rates; American Indian
Subject
Biology and Life Sciences, Immunology and Microbiology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
,
,
