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Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Molecular tools of antibiotic resistance for Helicobacter pylori: an overview in Latin America
Monica Contreras1, Heisser Mujica1, María Alexandra García-Amado1
1Laboratorio de Fisiología Gastrointestinal, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas (IVIC), Altos de Pipe, Venezuela.
Abstract:
Antibiotic resistance in the treatment of H. pylori infection is the principal reason for the failure of eradication regimens using the triple therapy. We reviewed the mechanisms of H. pylori antibiotic resistance and assessed the molecular tools commonly used to detect antibiotic resistance in Latin America. Most commonly reported molecular techniques were PCR and sequencing, as well as its variants PCR-RFLP and qPCR to detect the genes and mutations involved in the resistance to clarithromycin (CLR), amoxicillin (AMX), levofloxacin (LVX), tetracycline (TET), and metronidazole (MTZ). The mutation-associated resistance rates varied from 2.2% to 83.3% for CLA and 12% to 100% for LVX in 7 and 4 countries, respectively, whereas for MTZ the resistance frequency was between 50% to 100% in 4 countries. For TET and AMX, frequency of the resistance was in the range of 0% to 27% (5 and 3 countries, respectively). Molecular tools can be used for the rapid detection of resistance to CLR, LVX, and TET, whereas genotypic analysis is not appropriate to detect resistance to AMX and MTZ due to genomic changes found in the rdxA and pbp1A genes. The revision of the different molecular methods showed that qPCR and RFLP are the best tools to detect the resistance of H. pylori. Few molecular tools have been developed in Latin America to detect H. pylori resistance to antibiotics. More studies would be needed to understand better efficient strategies to prevent further emergence of antimicrobial resistance.
Insights
Antibiotic resistance hinders Helicobacter pylori eradication. Molecular tools like qPCR and RFLP show promise for detecting resistance, but further development is needed in Latin America.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Biology
Background:
- Antibiotic resistance is a primary cause of treatment failure for *H. pylori* infections.
- Triple therapy regimens for *H. pylori* eradication are increasingly ineffective due to resistance.
- Understanding resistance mechanisms and detection methods is crucial for effective treatment.
Purpose of the Study:
- To review mechanisms of *H. pylori* antibiotic resistance.
- To assess molecular tools used for detecting antibiotic resistance in Latin America.
- To identify optimal molecular methods for resistance detection.
Main Methods:
- Literature review of studies on *H. pylori* antibiotic resistance.
- Analysis of molecular techniques including PCR, sequencing, PCR-RFLP, and qPCR.
- Assessment of resistance rates for clarithromycin, amoxicillin, levofloxacin, tetracycline, and metronidazole.
Main Results:
- High mutation-associated resistance rates were observed for clarithromycin (2.2%–83.3%) and levofloxacin (12%–100%).
- Metronidazole resistance frequency ranged from 50%–100%, while tetracycline and amoxicillin resistance were lower (0%–27%).
- qPCR and RFLP were identified as the most effective tools for detecting *H. pylori* resistance, though genotypic analysis is limited for amoxicillin and metronidazole resistance.
Conclusions:
- Molecular tools offer rapid detection of resistance to certain antibiotics (clarithromycin, levofloxacin, tetracycline).
- Further research and development of molecular tools are needed in Latin America to combat *H. pylori* antimicrobial resistance.
- Optimizing diagnostic strategies is essential for preventing the further emergence of antimicrobial resistance.
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