DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy

T Nada, T Ando, K Nobata, T Tsuzuki, M Minami, K Ina, Y Iinuma, S Ichiyama, M Ohta, E El-Omar, K Kusugami, H Goto

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents.

Aim: We aimed to study differences between H. pylori strains isolated before and after eradication failure.

Methods: We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed-field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method.

Results: Eradication therapy failed in 12 patients (14%); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole-sensitive to -resistant, one changed from clarithromycin- and metronidazole-sensitive to -resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin- and metronidazole-sensitive to -resistant.

Conclusion: Eradication of H. pylori by first-line therapy is an important goal in the treatment of H. pylori-positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalAlimentary Pharmacology & Therapeutics
Volume20
Publication statusPublished - 2004

Keywords

  • FIELD GEL-ELECTROPHORESIS
  • PROTON PUMP INHIBITORS
  • RANDOMIZED OPEN TRIAL
  • RIBOSOMAL-RNA GENE
  • TRIPLE THERAPY
  • PEPTIC-ULCER
  • CYTOTOXIN PRODUCTION
  • CURE RATES
  • CLARITHROMYCIN
  • INFECTION

Cite this

DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy. / Nada, T ; Ando, T ; Nobata, K ; Tsuzuki, T ; Minami, M ; Ina, K ; Iinuma, Y ; Ichiyama, S ; Ohta, M ; El-Omar, E ; Kusugami, K ; Goto, H .

In: Alimentary Pharmacology & Therapeutics, Vol. 20, 2004, p. 39-47.

Research output: Contribution to journalArticle

Nada, T, Ando, T, Nobata, K, Tsuzuki, T, Minami, M, Ina, K, Iinuma, Y, Ichiyama, S, Ohta, M, El-Omar, E, Kusugami, K & Goto, H 2004, 'DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy' Alimentary Pharmacology & Therapeutics, vol. 20, pp. 39-47.
Nada, T ; Ando, T ; Nobata, K ; Tsuzuki, T ; Minami, M ; Ina, K ; Iinuma, Y ; Ichiyama, S ; Ohta, M ; El-Omar, E ; Kusugami, K ; Goto, H . / DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy. In: Alimentary Pharmacology & Therapeutics. 2004 ; Vol. 20. pp. 39-47.
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title = "DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy",
abstract = "Background: Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents.Aim: We aimed to study differences between H. pylori strains isolated before and after eradication failure.Methods: We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed-field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method.Results: Eradication therapy failed in 12 patients (14{\%}); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole-sensitive to -resistant, one changed from clarithromycin- and metronidazole-sensitive to -resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin- and metronidazole-sensitive to -resistant.Conclusion: Eradication of H. pylori by first-line therapy is an important goal in the treatment of H. pylori-positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.",
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author = "T Nada and T Ando and K Nobata and T Tsuzuki and M Minami and K Ina and Y Iinuma and S Ichiyama and M Ohta and E El-Omar and K Kusugami and H Goto",
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language = "English",
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}

TY - JOUR

T1 - DNA typing for Helicobacter pylori isolates from eradication-failed patients: comparison of the isolates before and after therapy

AU - Nada, T

AU - Ando, T

AU - Nobata, K

AU - Tsuzuki, T

AU - Minami, M

AU - Ina, K

AU - Iinuma, Y

AU - Ichiyama, S

AU - Ohta, M

AU - El-Omar, E

AU - Kusugami, K

AU - Goto, H

PY - 2004

Y1 - 2004

N2 - Background: Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents.Aim: We aimed to study differences between H. pylori strains isolated before and after eradication failure.Methods: We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed-field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method.Results: Eradication therapy failed in 12 patients (14%); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole-sensitive to -resistant, one changed from clarithromycin- and metronidazole-sensitive to -resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin- and metronidazole-sensitive to -resistant.Conclusion: Eradication of H. pylori by first-line therapy is an important goal in the treatment of H. pylori-positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.

AB - Background: Failure of Helicobacter pylori eradication occurs frequently despite use of multiple microbial agents.Aim: We aimed to study differences between H. pylori strains isolated before and after eradication failure.Methods: We treated 87 patients with peptic ulcer using triple therapy consisting of omeprazole plus combinations of clarithromycin, amoxicillin, or metronidazole. We studied the status of cagA, vacA, and iceA by PCR, and examined the differences in H. pylori isolates by pulsed-field gel electrophoresis and arbitrary primer polymerase chain reaction. The minimum inhibitory concentration of clarithromycin, amoxicillin, or metronidazole was determined by an agar dilution method.Results: Eradication therapy failed in 12 patients (14%); H. pylori isolates were obtained from all of these both before and after therapy. After eradication therapy, 10 patients were colonized with the same strain as before therapy, while the other two patients were colonized with different strains from those before therapy. In the former group, one isolate changed from metronidazole-sensitive to -resistant, one changed from clarithromycin- and metronidazole-sensitive to -resistant, and four were resistant to clarithromycin or metronidazole both before and after therapy. The other four isolates remained sensitive to clarithromycin and metronidazole after therapy. In the two patients who yielded apparently different isolates after therapy, they changed from clarithromycin- and metronidazole-sensitive to -resistant.Conclusion: Eradication of H. pylori by first-line therapy is an important goal in the treatment of H. pylori-positive peptic ulcer, and that appropriate antimicrobial sensitivity testing should be conducted in patients with eradication failure.

KW - FIELD GEL-ELECTROPHORESIS

KW - PROTON PUMP INHIBITORS

KW - RANDOMIZED OPEN TRIAL

KW - RIBOSOMAL-RNA GENE

KW - TRIPLE THERAPY

KW - PEPTIC-ULCER

KW - CYTOTOXIN PRODUCTION

KW - CURE RATES

KW - CLARITHROMYCIN

KW - INFECTION

M3 - Article

VL - 20

SP - 39

EP - 47

JO - Alimentary Pharmacology & Therapeutics

JF - Alimentary Pharmacology & Therapeutics

SN - 0269-2813

ER -