Zhonghua yi shi za zhi

[This article belongs to Volume - 53, Issue - 08]

Abstract : Antibiotic resistance in Helicobacter pylori (H. pylori), the bacterium responsible for gastric diseases, poses a significant public health challenge on a global scale. The assessment of resistance profiles among circulating strains in the southern regions of Morocco holds paramount importance in guiding antibiotic therapy selection. A total of 22 strains of H. pylori were isolated from gastric biopsies of 19 patients with dyspeptic symptoms who had undergone endoscopy. Subsequently, antibiotic sensitivity assessments were conducted on these strains employing the disk diffusion method. Concurrently, bacterial DNA was extracted from the biopsies to molecularly detect mutations in the rdx and 23S rRNA H. pylori genes. The overall resistance rates to the tested antibiotics were as follows: metronidazole (59.10 %), clarithromycin (31.81 %), levofloxacin (31.81 %), amoxicillin (18.18 %), and tetracycline (13.63 %). We observed a significant association between age (above 50 years) and resistance to clarithromycin and levofloxacin. Among isolates, 59.10% showed resistance, with dual resistance observed in 36.40%, triple resistance in 13.60%, quadruple resistance in 4.55% and quintuple resistance in 4.55%. Monoresistance was not detected in any of the isolates studied. The molecular analysis confirmed the absence of the rdx gene deletion mutation as well as the A2142G and A2143G point mutations in the 23S rRNA gene. This study highlights an alarming emergence of multi-resistance to antibiotics commonly recommended in anti-H. pylori therapies. More research is needed to determine the precise mutations responsible for the resistance identified in our strains.