Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit

<b>Background:</b><i> Helicobacter pylori</i> is a Gram-negative bacterium responsible for various gastrointestinal diseases, including peptic ulcers and gastric cancer. Despite available antibiotic therapies, increasing resistance to clarithromycin—a key antibiotic in eradic...

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Main Authors: Tomasz Bogiel, Anna Szaflarska-Popławska, Agnieszka Krawczyk
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/4/352
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author Tomasz Bogiel
Anna Szaflarska-Popławska
Agnieszka Krawczyk
author_facet Tomasz Bogiel
Anna Szaflarska-Popławska
Agnieszka Krawczyk
author_sort Tomasz Bogiel
collection DOAJ
description <b>Background:</b><i> Helicobacter pylori</i> is a Gram-negative bacterium responsible for various gastrointestinal diseases, including peptic ulcers and gastric cancer. Despite available antibiotic therapies, increasing resistance to clarithromycin—a key antibiotic in eradication regimens—poses a significant challenge. This resistance is primarily linked to point mutations in the 23S rRNA gene, particularly A2143G, A2142G, and A2142C, which hinder clarithromycin binding, reducing its bacteriostatic efficacy. This study aimed to assess the prevalence and variability of clarithromycin resistance mutations in pediatric patients from Bydgoszcz, Poland. <b>Methods:</b> A total of 45 gastric biopsy samples from pediatric patients were analyzed using the Bosphore<sup>®</sup> <i>Helicobacter pylori</i> Genotyping Kit v1 to detect clarithromycin resistance-associated mutations. <b>Results:</b> Among the 45 tested samples, 30 were classified as wild-type, while 12 contained resistance-associated mutations. The most frequently detected mutation was A2143G (58.3%), followed by A2142G (33.3%). One sample exhibited both A2142G and A2143G mutations, and another contained a mixture of wild-type and mutant strains. The A2142C mutation was not detected in any sample. <b>Conclusions:</b> Our findings confirm the predominance of A2143G among clarithromycin-resistant <i>H. pylori</i> strains, consistent with global trends. The detection of both mutant and wild-type strains in a single patient highlights potential co-infections or subpopulations with varying resistance profiles. Continuous surveillance and improved diagnostic tools are crucial for optimizing treatment strategies. Tailored eradication protocols based on resistance profiling are necessary to enhance treatment efficacy and mitigate the spread of resistant strains. Further research is needed to understand the clinical implications of mixed infections and double mutations in <i>H. pylori</i> resistance development.
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spelling doaj-art-49f62b21217c485eb038e75e4983a4fd2025-08-20T02:17:21ZengMDPI AGAntibiotics2079-63822025-03-0114435210.3390/antibiotics14040352Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping KitTomasz Bogiel0Anna Szaflarska-Popławska1Agnieszka Krawczyk2Department of Propaedeutics of Medicine and Infection Prevention Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University and Clinical Microbiology Laboratory, Dr. Antoni Jurasz University Hospital No. 1 in Bydgoszcz, 9 Maria Skłodowska-Curie Street, 85-094 Bydgoszcz, PolandDepartment of Pediatric Endoscopy and Gastrointestinal Function Testing Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Bydgoszcz, PolandDepartment of Molecular Medical Microbiology, Chair of Microbiology, Jagiellonian Univeristy Medical College, 31-007 Cracow, Poland<b>Background:</b><i> Helicobacter pylori</i> is a Gram-negative bacterium responsible for various gastrointestinal diseases, including peptic ulcers and gastric cancer. Despite available antibiotic therapies, increasing resistance to clarithromycin—a key antibiotic in eradication regimens—poses a significant challenge. This resistance is primarily linked to point mutations in the 23S rRNA gene, particularly A2143G, A2142G, and A2142C, which hinder clarithromycin binding, reducing its bacteriostatic efficacy. This study aimed to assess the prevalence and variability of clarithromycin resistance mutations in pediatric patients from Bydgoszcz, Poland. <b>Methods:</b> A total of 45 gastric biopsy samples from pediatric patients were analyzed using the Bosphore<sup>®</sup> <i>Helicobacter pylori</i> Genotyping Kit v1 to detect clarithromycin resistance-associated mutations. <b>Results:</b> Among the 45 tested samples, 30 were classified as wild-type, while 12 contained resistance-associated mutations. The most frequently detected mutation was A2143G (58.3%), followed by A2142G (33.3%). One sample exhibited both A2142G and A2143G mutations, and another contained a mixture of wild-type and mutant strains. The A2142C mutation was not detected in any sample. <b>Conclusions:</b> Our findings confirm the predominance of A2143G among clarithromycin-resistant <i>H. pylori</i> strains, consistent with global trends. The detection of both mutant and wild-type strains in a single patient highlights potential co-infections or subpopulations with varying resistance profiles. Continuous surveillance and improved diagnostic tools are crucial for optimizing treatment strategies. Tailored eradication protocols based on resistance profiling are necessary to enhance treatment efficacy and mitigate the spread of resistant strains. Further research is needed to understand the clinical implications of mixed infections and double mutations in <i>H. pylori</i> resistance development.https://www.mdpi.com/2079-6382/14/4/352<i>Helicobacter pylori</i>clarithromycin resistancegenotypic analysismultiplex PCR
spellingShingle Tomasz Bogiel
Anna Szaflarska-Popławska
Agnieszka Krawczyk
Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
Antibiotics
<i>Helicobacter pylori</i>
clarithromycin resistance
genotypic analysis
multiplex PCR
title Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
title_full Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
title_fullStr Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
title_full_unstemmed Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
title_short Prevalence and Variability of <i>Helicobacter pylori</i> Clarithromycin Resistance Mutations in Pediatric Patients in Poland: A Genotypic Analysis Using the Bosphore Genotyping Kit
title_sort prevalence and variability of i helicobacter pylori i clarithromycin resistance mutations in pediatric patients in poland a genotypic analysis using the bosphore genotyping kit
topic <i>Helicobacter pylori</i>
clarithromycin resistance
genotypic analysis
multiplex PCR
url https://www.mdpi.com/2079-6382/14/4/352
work_keys_str_mv AT tomaszbogiel prevalenceandvariabilityofihelicobacterpyloriiclarithromycinresistancemutationsinpediatricpatientsinpolandagenotypicanalysisusingthebosphoregenotypingkit
AT annaszaflarskapopławska prevalenceandvariabilityofihelicobacterpyloriiclarithromycinresistancemutationsinpediatricpatientsinpolandagenotypicanalysisusingthebosphoregenotypingkit
AT agnieszkakrawczyk prevalenceandvariabilityofihelicobacterpyloriiclarithromycinresistancemutationsinpediatricpatientsinpolandagenotypicanalysisusingthebosphoregenotypingkit