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Primary and secondary clarithromycin resistance in Helicobacter pylori and mathematical modeling of the role of macrolides

Nature communications, 2021-04, Vol.12 (1), p.2255-2255, Article 2255 [Peer Reviewed Journal]

The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2021 ;ISSN: 2041-1723 ;EISSN: 2041-1723 ;DOI: 10.1038/s41467-021-22557-7 ;PMID: 33859206

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Title:
Primary and secondary clarithromycin resistance in Helicobacter pylori and mathematical modeling of the role of macrolides
Author: Kocsmár, Éva ; Buzás, György Miklós ; Szirtes, Ildikó ; Kocsmár, Ildikó ; Kramer, Zsófia ; Szijártó, Attila ; Fadgyas-Freyler, Petra ; Szénás, Kató ; Rugge, Massimo ; Fassan, Matteo ; Kiss, András ; Schaff, Zsuzsa ; Röst, Gergely ; Lotz, Gábor
Subjects: Adult ; Age ; Age Factors ; Aged ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Clarithromycin ; Clarithromycin - pharmacology ; Clarithromycin - therapeutic use ; Consumption ; Drug Resistance, Bacterial - drug effects ; Eradication ; Female ; Fluorescence ; Fluorescence in situ hybridization ; Gastric Mucosa - microbiology ; Gastric Mucosa - pathology ; Growth rate ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter Infections - microbiology ; Helicobacter Infections - transmission ; Helicobacter pylori ; Helicobacter pylori - drug effects ; Helicobacter pylori - isolation & purification ; Humans ; Hungary - epidemiology ; Hybridization ; Immunohistochemistry ; Infections ; Male ; Mathematical analysis ; Mathematical models ; Microbial Sensitivity Tests ; Middle Aged ; Model testing ; Models, Biological ; Mutation ; Population dynamics ; Prevalence ; Retrospective Studies ; Risk Factors ; Sex Factors ; Young Adult
Is Part Of: Nature communications, 2021-04, Vol.12 (1), p.2255-2255, Article 2255
Description: Clarithromycin is a macrolide antibiotic widely used for eradication of Helicobacter pylori infection, and thus resistance to this antibiotic is a major cause of treatment failure. Here, we present the results of a retrospective observational study of clarithromycin resistance (Cla-res) in 4744 H. pylori-infected patients from Central Hungary. We use immunohistochemistry and fluorescence in situ hybridization on fixed gastric tissue samples to determine H. pylori infection and to infer Cla-res status, respectively. We correlate this information with macrolide dispensing data for the same patients (available through a prescription database) and develop a mathematical model of the population dynamics of Cla-res H. pylori infections. Cla-res is found in 5.5% of macrolide-naive patients (primary Cla-res), with no significant sex difference. The model predicts that this primary Cla-res originates from transmission of resistant bacteria in 98.7% of cases, and derives from spontaneous mutations in the other 1.3%. We find an age-dependent preponderance of female patients among secondary (macrolide-exposed) clarithromycin-resistant infections, predominantly associated with prior use of macrolides for non-eradication purposes. Our results shed light into the sources of primary resistant cases, and indicate that the growth rate of Cla-res prevalence would likely decrease if macrolides were no longer used for purposes other than H. pylori eradication.
Publisher: England: Nature Publishing Group
Language: English
Identifier: ISSN: 2041-1723
EISSN: 2041-1723
DOI: 10.1038/s41467-021-22557-7
PMID: 33859206
Source: MEDLINE
PubMed Central
ProQuest Central
DOAJ Directory of Open Access Journals

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Primary and secondary clarithromycin resistance in Helicobacter pylori and mathematical modeling of the role of macrolides

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