Primary Clarithromycin Resistance in Helicobacter pylori: the Multicentric Italian Clarithromycin Resistance Observational (MICRO) Study

Authors

  • Vincenzo De Francesco Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
  • Floriana Giorgio Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
  • Enzo Ierardi Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
  • Mariangela Zotti Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
  • Matteo Neri Department of Medicine and Aging Sciences, CESI Fundation, "G. D'Annunzio" University, Chieti, Italy
  • Angelo Milano Department of Medicine and Aging Sciences, CESI Fundation, "G. D'Annunzio" University, Chieti, Italy
  • Vincenzo Varasano Section of Gastroenterology, "Policoro" Hospital, Matera, Italy
  • Francesco Luzza Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy
  • Evelina Suraci Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy
  • Riccardo Marmo Division of Gastroenterology, "Curto" Hospital, Polla, Salerno, Italy
  • Armando Marone Division of Gastroenterology, "Curto" Hospital, Polla, Salerno, Italy
  • Raffaele Manta Endoscopic Unit, "Nuovo Ospedale Civile Sant'Agostino Estense" Baggiovara, Modena, Italy
  • Vincenzo Giorgio Mirante Endoscopic Unit, "Nuovo Ospedale Civile Sant'Agostino Estense" Baggiovara, Modena, Italy
  • Marina de Matthaeis Department of Gastroenterology, General Hospital, Sanremo, Italy
  • Antonietta Pedroni Department of Gastroenterology, General Hospital, Sanremo, Italy
  • Gianpiero Manes Department of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
  • Stefano Pallotta Department of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
  • Paolo Usai Department of Internal Medical Sciences, University of Cagliari, Italy
  • Mauro Liggi Department of Internal Medical Sciences, University of Cagliari, Italy
  • Giovanni Gatto Gastroenterology and Digestive Endoscopy Unit "Villa Sofia" Hospital, Palermo, Italy
  • Vittorio Peri Gastroenterology and Digestive Endoscopy Unit "Villa Sofia" Hospital, Palermo, Italy
  • Rodolfo Sacco Gastroenterology and Metabolic Diseases, University of Pisa, Italy
  • Giampaolo Bresci Gastroenterology and Metabolic Diseases, University of Pisa, Italy
  • Fabio Monica Endoscopy Unit, "S. Bassiano" Hospital, Bassano del Grappa, Vicenza, Italy
  • Cesare Hassan Gastroenterology and Digestive Endoscopy, "Nuovo Regina Margherita" Hospital, Rome, Italy
  • Angelo Zullo Gastroenterology and Digestive Endoscopy, "Nuovo Regina Margherita" Hospital, Rome, Italy

Keywords:

Clarithromycin, resistance, H. pylori, real time PCR, point mutation

Abstract

Background. Primary clarithromycin resistance markedly reduces Helicobacter pylori eradication rate following standard therapies. Prevalence of primary clarithromycin resistance in H. pylori is increasing, and three point mutations are mainly involved.

Aim. To assess both the prevalence of primary clarithromycin resistance in Italy, and the distribution of the involved point mutations.

Methods. Primary clarithromycin resistance was assessed by TaqMan real-time polymerase chain reaction on antral biopsies of 253 consecutive, H. pylori infected patients enrolled in 13 Italian centres between January and September 2010.

Results. Primary clarithromycin resistance was detected in 25 (9.9%) patients, with prevalence values widely ranging from 0 to 25%. Clarithromycin resistance rate was higher in female as compared to male patients (13.4% vs. 5.3%, p=0.03), and it tended to be higher in non-ulcer dyspepsia than in peptic ulcer patients (10.6% vs. 6.9%, p=0.5), female patients with non-ulcer dyspepsia showing the highest value (15.4%). The A2143G point mutation was detected in 13 (52.0%) patients, the A2142G in 9 (34.6%), whilst a double point mutation (A2143G plus A2142G) in 3 (11.6%) cases.

Conclusions. Primary clarithromycin resistance is highly variable in different Italian geographic areas. High resistance rates were observed in female and in dyspeptic patients. Among the three point mutations of clarithromycin resistance, the A2143G remains the most frequently observed.

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Published

2011-09-01

How to Cite

1.
De Francesco V, Giorgio F, Ierardi E, Zotti M, Neri M, Milano A, Varasano V, Luzza F, Suraci E, Marmo R, Marone A, Manta R, Mirante VG, de Matthaeis M, Pedroni A, Manes G, Pallotta S, Usai P, Liggi M, Gatto G, Peri V, Sacco R, Bresci G, Monica F, Hassan C, Zullo A. Primary Clarithromycin Resistance in Helicobacter pylori: the Multicentric Italian Clarithromycin Resistance Observational (MICRO) Study. JGLD [Internet]. 2011 Sep. 1 [cited 2026 Jun. 15];20(3):235-9. Available from: https://jgld.ro/jgld/index.php/jgld/article/view/2011.3.4

Issue

Vol. 20 No. 3: September 2011

Section

Original Article