Observational studyWorld journal of gastroenterology2016
Detection of Helicobacter pylori resistance to clarithromycin and fluoroquinolones in Brazil: A national survey.
Observational study in World journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The prevalence of clarithromycin-resistantPeerJ · 2023Pooled it
- The magnitude of antibiotic resistance to Helicobacter pylori in Africa and identified mutations which confer resistance to antibiotics: systematic review and meta-analysis.BMC infectious diseases · 2018Pooled it
- LOW-NICKEL DIET AS A STRATEGY IN THE TREATMENT OF HELICOBACTER PYLORI INFECTION.Arquivos de gastroenterologia · 2025Trial
- Article
- VTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION.Arquivos de gastroenterologia · 2026Article
- Differences and trends in worldwide clinical guidelines forTranslational gastroenterology and hepatology · 2026Review
- Resistance to Clarithromycin and Fluoroquinolones inAntibiotics (Basel, Switzerland) · 2025Article
- Overcoming antibiotic-resistantWorld journal of gastroenterology · 2025Review
- Multiplex PCR-Mass Spectrometry Mini-Sequencing Technology Detected Antibiotic Resistance ofInternational journal of molecular sciences · 2025Article
- Detection by Real-Time PCR ofMicroorganisms · 2024Article
- Molecular Characterization and Mutational Analysis of Clarithromycin- and Levofloxacin-Resistance Genes inInternational journal of molecular sciences · 2023Article
- Helicobacter pylori Infection, Its Laboratory Diagnosis, and Antimicrobial Resistance: a Perspective of Clinical Relevance.Clinical microbiology reviews · 2022Review
- Clarithromycin-resistant H. pylori primary strains and virulence genotypes in the Northeastern region of Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2022Article
- Article
- Clinical Effect of Clarithromycin Combined with Tinidazole on Helicobacter pylori-Related Gastritis and Its Influence on COX-2 Expression.BioMed research international · 2021Article
- Primary Resistance Pattern ofInfection and drug resistance · 2020Review
- Molecular Assessment of Resistance to Clarithromycin inBioMed research international · 2020Article
- Can bacterial virulence factors predict antibiotic resistantWorld journal of gastroenterology · 2018Article
- The interplay between mutations in cagA, 23S rRNA, gyrA and drug resistance in Helicobacter pylori.Revista do Instituto de Medicina Tropical de Sao Paulo · 2018Article
- Article
Corrections and comments
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Authors and funding
18 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate bacterial resistance to clarithromycin and fluoroquinolones in Brazil using molecular methods.
methodsThe primary antibiotic resistance rates of Helicobacter pylori (H. pylori) were determined from November 2012 to March 2015 in the Southern, South-Eastern, Northern, North-Eastern, and Central-Western regions of Brazil. Four hundred ninety H. pylori patients [66% female, mean age 43 years (range: 18-79)] who had never been previously treated for this infection were enrolled. All patients underwent gastroscopy with antrum and corpus biopsies and molecular testing using GenoType HelicoDR (Hain Life Science, Germany). This test was performed to detect the presence of H. pylori and to identify point mutations in the genes responsible for clarithromycin and fluoroquinolone resistance. The molecular procedure was divided into three steps: DNA extraction from the biopsies, multiplex amplification, and reverse hybridization.
resultsClarithromycin resistance was found in 83 (16.9%) patients, and fluoroquinolone resistance was found in 66 (13.5%) patients. There was no statistical difference in resistance to either clarithromycin or fluoroquinolones (P = 0.55 and P = 0.06, respectively) among the different regions of Brazil. Dual resistance to clarithromycin and fluoroquinolones was found in 4.3% (21/490) of patients. The A2147G mutation was present in 90.4% (75/83), A2146G in 16.9% (14/83) and A2146C in 3.6% (3/83) of clarithromycin-resistant patients. In 10.8% (9/83) of clarithromycin-resistant samples, more than 01 mutation in the 23S rRNA gene was noticed. In fluoroquinolone-resistant samples, 37.9% (25/66) showed mutations not specified by the GenoType HelicoDR test. D91N mutation was observed in 34.8% (23/66), D91G in 18.1% (12/66), N87K in 16.6% (11/66) and D91Y in 13.6% (9/66) of cases. Among fluoroquinolone-resistant samples, 37.9% (25/66) showed mutations not specified by the GenoType HelicoDR test.
conclusionThe H. pylori clarithromycin resistance rate in Brazil is at the borderline (15%-20%) for applying the standard triple therapy. The fluoroquinolone resistance rate (13.5%) is equally concerning.
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