ArticleAntimicrobial agents and chemotherapy2011
Genotypic resistance in Helicobacter pylori strains correlates with susceptibility test and treatment outcomes after levofloxacin- and clarithromycin-based therapies.
Article in Antimicrobial agents and chemotherapy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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33 citing papers in PubMed, 69 citations in OpenAlex.
- Precision therapy guided by genotypic antibiotic resistance forWorld journal of gastroenterology · 2025Trial
- Trial
- Levofloxacin Sequential Therapy vs Levofloxacin Triple Therapy in the Second-Line Treatment of Helicobacter pylori: A Randomized Trial.The American journal of gastroenterology · 2016Trial
- Quadruple therapy with moxifloxacin and bismuth for first-line treatment of Helicobacter pylori.World journal of gastroenterology · 2012Trial
- Third-Line and Later Susceptibility-GuidedJournal of clinical medicine · 2026Article
- Epidemiological characteristics of Helicobacter pylori infection and antibiotic resistance in urban areas of Guangdong Province, China: a multi-center, cross-sectional surveillance.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Multiplex PCR-Mass Spectrometry Mini-Sequencing Technology Detected Antibiotic Resistance ofInternational journal of molecular sciences · 2025Article
- Epidemiological and comparative genomic analysis of pathogenicFrontiers in microbiology · 2025Article
- Mutations Related to Antibiotics Resistance inAntibiotics (Basel, Switzerland) · 2023Article
- Personalized Approach in Eradication ofAntibiotics (Basel, Switzerland) · 2022Review
- Next-Generation Sequencing-Based Study ofMicroorganisms · 2022Article
- Treatment of RefractoryGut and liver · 2022Review
- Molecular Epidemiology and Antimicrobial Resistance ofFrontiers in microbiology · 2021Article
- Development and Validation of Multiplex Quantitative PCR Assay for Detection ofInfection and drug resistance · 2021Article
- Genomic Analysis of Antimicrobial Resistance Genotype-to-Phenotype Agreement inMicroorganisms · 2020Article
- Secondary Antibiotic Resistance, Correlation between Genotypic and Phenotypic Methods and Treatment inAntibiotics (Basel, Switzerland) · 2020Article
- Genotypic and Phenotypic Resistance to Clarithromycin inJournal of clinical medicine · 2020Article
- Susceptibility-guided bismuth quadruple therapies for resistantPrecision clinical medicine · 2020Article
- Update on quinolone-containing rescue therapies forWorld journal of gastroenterology · 2020Review
- Characteristics ofAntimicrobial resistance and infection control · 2019Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The accuracy of genotypic resistance to levofloxacin (gyrA mutations) and its agreement with treatment outcomes after levofloxacin-based therapy have not been reported. We aimed to assess the correlation. Helicobacter pylori strains isolated from patients who received levofloxacin-based and clarithromycin-based triple therapies in a previous randomized trial were analyzed for point mutations in gyrA and 23S rRNA. PCR followed by direct sequencing was used to assess the gyrA and 23S rRNA mutations. An agar dilution test was used to determine the MICs of clarithromycin and levofloxacin. We found that the agreement between genotypic and phenotypic resistance to levofloxacin was best when the MIC breakpoint was >1 μg/ml (kappa coefficient, 0.754). The eradication rates in patients with and without gyrA mutations were 41.7% and 82.7%, respectively (P = 0.003). The agreement between genotypic and phenotypic resistance to clarithromycin was best when the MIC breakpoint was >2 μg/ml (kappa, 0.694). The eradication rates in patients with and without 23S rRNA mutations were 7.7% and 93.5%, respectively (P < 0.001). The agreements (kappa coefficient) between therapeutic outcomes after clarithromycin-based triple therapy and genotypic and phenotypic resistance were 0.671 and 0.356, respectively. The agreements (kappa coefficient) between therapeutic outcomes after levofloxacin-based triple therapy and genotypic and phenotypic resistance were 0.244 and 0.190, respectively. In conclusion, gyrA and 23S rRNA mutations in H. pylori strains appeared to be better markers than phenotypic resistance in the prediction of treatment outcomes. The optimal breakpoints for levofloxacin and clarithromycin resistance appeared to be >1 μg/ml and >2 μg/ml, respectively.
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