Related Experiment Video
Updated: Aug 1, 2025
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Novel Mutations Conferring Amoxicillin Resistance in Helicobacter pylori in South Korea
Soon Young Park1, Eun Hwa Lee1, Dokyun Kim2
1Division of Infectious Diseases, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea.
Abstract:
Helicobacter pylori is the primary causative agent of gastritis, gastric ulcers, duodenal ulcers, gastric cancer, and peripheral B-cell lymphoma. H. pylori eradication often fails due to elevated antibiotic resistance. However, no previous studies have thoroughly examined amoxicillin resistance. Here, the objective was to identify clinical strains of H. pylori with amoxicillin resistance and to analyze single-nucleotide polymorphisms (SNPs) associated with amoxicillin resistance. From March 2015 to June 2019, genotypic and phenotypic amoxicillin resistance was analyzed using an E-test and whole-genome sequencing (WGS). Analysis of 368 clinical strains confirmed amoxicillin resistance in 31 strains (resistance rate of 8.7%). The genomes were extracted from nine resistant (<0.125 mg/L) strains, and WGS was performed for genetic analysis. WGS analysis identified SNPs present in pbp1a, pbp2, nhaC, hofH, hofC, and hefC in all nine isolates. Some of these genes may be related to amoxicillin resistance. A total of six SNPs (A69V, V374L, S414R, T503I, A592D, and R435Q) were identified in PBP2 of H-8, the most resistant strain. We predict that these six SNPs are associated with high amoxicillin resistance. Amoxicillin resistance should be considered in the clinical setting for the treatment failure of H. pylori eradication.
Insights
Amoxicillin resistance in Helicobacter pylori, a common cause of stomach issues, was identified in 8.7% of clinical strains. Specific gene mutations, particularly in PBP2, are linked to this resistance, impacting H. pylori eradication success.
Area of Science:
- Microbiology
- Genetics
- Clinical Medicine
Background:
- Helicobacter pylori infection is a leading cause of various gastrointestinal diseases.
- Treatment failure in H. pylori eradication is often linked to antibiotic resistance.
- Limited research exists on amoxicillin resistance mechanisms in H. pylori.
Purpose of the Study:
- To identify clinical H. pylori strains exhibiting amoxicillin resistance.
- To analyze single-nucleotide polymorphisms (SNPs) associated with amoxicillin resistance in H. pylori.
Main Methods:
- Phenotypic and genotypic amoxicillin resistance was assessed using E-test and whole-genome sequencing (WGS).
- 368 clinical H. pylori strains were analyzed for amoxicillin resistance.
- WGS was performed on nine resistant strains to identify genetic variations.
Main Results:
- Amoxicillin resistance was confirmed in 8.7% (31/368) of clinical H. pylori strains.
- WGS revealed SNPs in pbp1a, pbp2, nhaC, hofH, hofC, and hefC genes in resistant isolates.
- Six specific SNPs in the PBP2 gene were identified in the most resistant strain, potentially explaining high amoxicillin resistance.
Conclusions:
- Amoxicillin resistance is a significant factor contributing to H. pylori eradication failures.
- SNPs in PBP2 and other identified genes are strongly associated with amoxicillin resistance in H. pylori.
- Clinical consideration of amoxicillin resistance is crucial for effective H. pylori treatment strategies.
Related Concept Videos
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:30Development of Antibiotic Resistance
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.