ArticleNature communications2021
Primary and secondary clarithromycin resistance in Helicobacter pylori and mathematical modeling of the role of macrolides.
Article in Nature communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Insights intoFrontiers in microbiology · 2024Pooled it
- The prevalence of clarithromycin-resistantPeerJ · 2023Pooled it
- Association of Resistance-AssociatedAntibiotics (Basel, Switzerland) · 2026Article
- Characterizing the profile transformation of Helicobacter pylori: increased secondary and multidrug resistance following failed eradication in Ningxia, China.BMC microbiology · 2026Article
- Genomic characterization and biological activities of cell-free supernatant fromFrontiers in cellular and infection microbiology · 2026Article
- Microplastic biofilm as hotspots of antibiotic resistance genes and potential pathogens.NPJ biofilms and microbiomes · 2025Review
- Resistance to Clarithromycin and Fluoroquinolones inAntibiotics (Basel, Switzerland) · 2025Article
- High Prevalence ofAntibiotics (Basel, Switzerland) · 2025Article
- An pH-responsive liposome for the targeted treatment ofMaterials today. Bio · 2025Article
- Effects of Roxithromycin Exposure on the Nitrogen Metabolism and Environmental Bacterial Recruitment ofPlants (Basel, Switzerland) · 2025Article
- Optimizing the Routine Use of Clinical Guidelines by Addition of Supplements (Probiotics and/or Bismuth) toAntibiotics (Basel, Switzerland) · 2025Article
- Towards EffectiveInternational journal of molecular sciences · 2025Review
- Overcoming antibiotic-resistantWorld journal of gastroenterology · 2025Review
- Genetic Determinants of Clarithromycin and Fluoroquinolones Resistance inAntibiotics (Basel, Switzerland) · 2024Article
- Adopting Mechanistic Molecular Biology Approaches in Exposome Research for Causal Understanding.Environmental science & technology · 2024Review
- Change in Diagnosis ofAntibiotics (Basel, Switzerland) · 2024Review
- Article
- Article
- Polymorphism of virulence genes and biofilm associated with in vitro induced resistance to clarithromycin in Helicobacter pylori.Gut pathogens · 2023Article
- Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clarithromycin is a macrolide antibiotic widely used for eradication of Helicobacter pylori infection, and thus resistance to this antibiotic is a major cause of treatment failure. Here, we present the results of a retrospective observational study of clarithromycin resistance (Cla-res) in 4744 H. pylori-infected patients from Central Hungary. We use immunohistochemistry and fluorescence in situ hybridization on fixed gastric tissue samples to determine H. pylori infection and to infer Cla-res status, respectively. We correlate this information with macrolide dispensing data for the same patients (available through a prescription database) and develop a mathematical model of the population dynamics of Cla-res H. pylori infections. Cla-res is found in 5.5% of macrolide-naive patients (primary Cla-res), with no significant sex difference. The model predicts that this primary Cla-res originates from transmission of resistant bacteria in 98.7% of cases, and derives from spontaneous mutations in the other 1.3%. We find an age-dependent preponderance of female patients among secondary (macrolide-exposed) clarithromycin-resistant infections, predominantly associated with prior use of macrolides for non-eradication purposes. Our results shed light into the sources of primary resistant cases, and indicate that the growth rate of Cla-res prevalence would likely decrease if macrolides were no longer used for purposes other than H. pylori eradication.
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