| Antibiotics Heteroresistance of Paired-strains of Helicobacter pylori Isolated from the Antrum and Corpus of the same Patient and PCR-based RAPD Fingerprinting Analysis |
| 동일 환자의 위전정부와 체부에서 분리된 Helicobacter pylori 의 이형내성과 RAPD-PCR을 이용한 DNA 분석 |
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육청미·김재준·김영호·이풍렬·이종철·권동현* |
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성균관대학교 의과대학 삼성서울병원 내과학교실, *Department of Medicine of Baylor College of Medicine and Veterans Affairs Medical Center |
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| Abstract |
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Antibiotic resistance amongst Helicobacter pylori is increasing such that it adversely affects the efficacy of current treatment regimens. Recent reports have shown that multiple strains can colonized within a single stomach, and it has been shown that heteroresistance in a single stomach may exist. Agar dilution MIC testing was performed to determine the primary antibiotics resistance rates among 218 paired H. pylori isolates(antrum and corpus isolates from each patient) collected from 1993 to 1999 from Korea. Genotype analysis of heteroresistant pairs of strains was performed by PCR-based RAPD fingerprinting. For metronidazole susceptibility, 13.3%(29/218) showed discrepancy in antibiotic resistance: fourteen had susceptible antral isolates simultaneously with resistant corpus isolates while fifteen patients had susceptible corpus isolates but resistant antral isolates. Discrepancy rates were 4.1% for clarithromycin, 4.6% for tetracycline, and 1.8% for furazolidone and nitrofurantoin. PCR-based RAPD analysis of 39 heteroresistant pairs revealed 38.5% of H. pylori isolates to have different DNA restriction patterns. In conclusion, we found a high rate of heteroresistance to metronidazole suggesting that susceptibility testing of H. pylori from both the antrum and corpus may be necessary for successful eradication therapy. Strain diversity may be a reason for the heteroresistance to antibiotics. (Korean J Helicobacter Res Prac 2002;2:25-29) |
| Key Words:
Helicobacter pylori, Heteroresistence, RAPD, Genetic diversity |
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