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


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.Acquisition of double mutations in gyrA evoked high-level resistance to STFX in H. pylori after unsuccessful eradication with STFX-containing regimens.

SUBMITTER: Mori H 

PROVIDER: S-EPMC5949976 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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

Mori Hideki H   Suzuki Hidekazu H   Matsuzaki Juntaro J   Masaoka Tatsuhiro T   Kanai Takanori T  

United European gastroenterology journal 20171008 3


<h4>Background and aim</h4>Although sitafloxacin (STFX)-containing regimens are effective rescue treatments for <i>Helicobacter pylori</i> infection, prevalence of fluoroquinolone resistance in <i>H. pylori</i> has increased rapidly worldwide. The change in resistance levels and <i>gyrA</i> mutations, a major cause of fluoroquinolone resistance, after unsuccessful STFX-containing treatment has not been investigated.<h4>Methods</h4>We conducted a retrospective, non-randomized study to compare the  ...[more]

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