Đột biến kháng levofloxacin trên gen gyrA, gyrB của Helicobacter pylori trên bệnh nhân viêm loét dạ dày tá tràng

Abstract

Peptic ulcer disease is one of five leading causes of hospitalization. The most common cause of peptic ulcer disease is H. pylori infection which represented from 50% to 70.3%. In term of H. pylori treatment, the antibiotic resistant of H. pylori is the most concerning issue which woud determined a successful therapy. Consequently, it is important to evaluate the antibiotic resistant among antibiotics that are presently prescribed in H. pylori eradication regimens and to update the clinical guideline on the treatment and management of H. pylori infection. The E-test method is performed to evaluate the minimum inhibitory concentration (MIC) of levofloxacin and identify the point mutation on gyrA and gyrB gene to explore the molecular genetic resistant mechanism. The results showed that among samples, the levofloxacin resistant strains occupied 56.9%. There are 4 important mutations among gyrA gene found including N87K(12.3%), N87Y(1.5%), D91N(1.5%), D91G(3.1%). Besides, we found one novel mutation S457A in gyrB. Notably, the bearing point mutation strains had significant higher MIC level when compared with those with no mutation (p < 0.05). In conclusion, we suggest to study the point mutation of gyrA and gyrB to regulate the antibiotic resistant of H. pylori as well as to determine the therapeutic dosage of levofloxacin.