Đột biến kháng amoxicillin trên gen pbp1 của vi khuẩn Helicobacter pylori ở trẻ em loét dạ dày tá tràng

Abstract

Amoxicillin is the primary antibiotic used to eradicate Helicobacter pylori (H. pylori) in children. The emergence of amoxicillin resistance in Vietnam is of significant concern. Mutations in the pbp1 gene can lead to changes in the structure of PBP1 and the development of AMO resistance. Objective: This study aims to evaluate the frequency of mutations in the pbp1 gene and their correlation with antibiotic resistance in H. pylori among children with peptic ulcers. Subjects and methods: A cross-sectional analysis was conducted to study 43 pediatric patients diagnosed with peptic ulcers and confirmed H. pylori infection. The E-test method was employed to determine the minimum inhibitory concentration, while Sanger sequencing was utilized to detect gene mutations. Results: All strains carried three or more mutations in the pbp1 gene. The data indicate a significant prevalence of the mutations F366L (90.7%), S414R (81.4%), Ins 464-465 (88,4%), F473V (88.4%), and D534N (95.3%) among strains. Notably, the mutations F366L, S414R, and F473V were significantly associated with amoxicillin resistance (p < 0.05), and the combination of mutations F366L/S414R/F473V correlated with an increased minimum inhibitory concentration. In conclusion, the high frequency of pbp1 gene mutations is a major contributing factor to the elevated rate of amoxicillin resistance in children with peptic ulcers.