在哥伦比亚,单核酸多态SNP与多重疗法耐药性相关
Kevin Guzman1, Lidia Montenegro1, Alvaro Pazos1,2
1Grupo Salud Pública, Centro de Estudios en Salud Universidad de Nariño (CESUN), Universidad de Nariño, Pasto, Colombia.
Frontiers in microbiology
|July 24, 2023
概括
在哥伦比亚高风险人群中发现了Helicobacter pylori对美特罗尼达 (99.3%) 和阿莫西西林 (25.9%) 的高耐药性. 甲尼达应该被排除在根除疗法之外,而澄素和四环素仍然是可行的选择.
科学领域:
- 基因组学和微生物学
- 传染性疾病 传染性疾病
- 药物耐药性 药物耐药性 药物耐药性
背景情况:
- 消灭Helicobacter pylori (H. pylori) 对于预防胃癌至关重要.
- 由遗传突变驱动的H. pylori的抗生素耐药性损害了治疗的有效性.
- 了解耐药性模式对于优化高风险人群中H. pylori根除策略至关重要.
研究的目的:
- 确定与高胃癌风险的哥伦比亚队列中特定的H. pylori基因突变相关的抗生素耐药率.
- 为了确定关键突变赋予耐药性克拉里素,四环素,阿莫西西林,勒沃素,和美特罗尼达.
- 为制定有效的H. pylori治疗方案提供信息,以适应局部耐药性概况.
主要方法:
- 从哥伦比亚高风险胃癌队列中分离出166种H. pylori的全基因组测序.
- 鉴定与抗生素耐药性相关的23S rRNA,16S rRNA,pbp1A,gyrA和rdxA基因中的突变.
- 使用H. pyloriATCC 26695参考菌株的核心基因组 (1,594个基因) 的家族基因组分析.
主要成果:
- 对甲尼达 (99.3%,rdxA突变) 和阿莫西西林 (25.9%,pbp1A突变) 观察到高耐药率.
- 对于勒沃素 (12.04%,GyrA突变) 和四环素 (7.23%,16S rRNA突变) 发现了中等耐药率.
- 克拉胺素的耐药性率较低 (3.62%,23S rRNA突变);对四环素和克拉胺素的耐药性率低于哥伦比亚的临界值.
结论:
- 由于几乎普遍的耐药性,在这个人群中,应该将甲尼达排除在H. pylori根除方案之外.
- 对勒沃素和阿莫西西林的抗药性增加可能导致哥伦比亚的治疗失败.
- 鉴定的H. pylori血统 (hspColombia) 和耐药性数据需要对治疗方案进行局部调整.
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