Acquisition of double mutation in gyrA caused high resistance to sitafloxacin in Helicobacter pylori after unsuccessful eradication with sitafloxacin-containing regimens

United European Gastroenterology Journal
Hideki MoriTakanori Kanai

Abstract

Although sitafloxacin (STFX)-containing regimens are effective rescue treatments for Helicobacter pylori infection, prevalence of fluoroquinolone resistance in H. pylori has increased rapidly worldwide. The change in resistance levels and gyrA mutations, a major cause of fluoroquinolone resistance, after unsuccessful STFX-containing treatment has not been investigated. We conducted a retrospective, non-randomized study to compare the minimum inhibitory concentrations (MICs) of STFX and the location of gyrA mutations in H. pylori before and after unsuccessful eradication with STFX-containing regimens at Keio University Hospital between December 2011 and March 2015. A total of 266 patients treated with STFX-containing regimens for third-line H. pylori eradication were evaluated. Double mutations in gyrA were acquired by 20.8% of strains that exhibited seven-fold increased STFX MICs, compared to pre-treatment MICs. The STFX MICs did not increase, however, when the location of the gyrA mutations did not change after treatment. Double mutations in gyrA developed in 60.0% of the strains in which eradication failed, which exhibited a baseline mutation at position D91, and in 11.1% of strains with baseline mutations at position N87. Ac...Continue Reading

References

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Citations

Jun 2, 2018·Gastroenterology Research and Practice·Jae Ho ChoiGwang Ho Baik
May 1, 2020·World Journal of Gastroenterology : WJG·Hideki Mori, Hidekazu Suzuki
Nov 6, 2018·World Journal of Gastroenterology : WJG·Te-Fu Lin, Ping-I Hsu
Jan 10, 2020·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Aining ChuYuehua Gong
Nov 20, 2020·United European Gastroenterology Journal·Hidekazu Suzuki, Hideki Mori
Nov 21, 2020·BMC Infectious Diseases·Kana KurokawaKazuhisa Takahashi
May 19, 2021·Nature Reviews. Gastroenterology & Hepatology·Evariste Tshibangu-Kabamba, Yoshio Yamaoka
Jul 3, 2021·Journal of Clinical Medicine·Toshihiro NishizawaHidekazu Suzuki

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Methods Mentioned

BETA
biopsy

Software Mentioned

SPSS

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