Helicobacter pylori

Background and objectives: Peptic ulcer disease, chronic gastritis, and stomach cancer are all caused by H.pylori. The most notable drug for the treatment is the antibiotic clarithromycin, which is currently thedrug of choice. H. pylori clarithromycin resistance has been associated with point mutations in23srRNA, the most prominent of which are A2143 and A2144G. In H. pylori bacteria, methylase synthesis,macrolide-inactivating enzyme activity, and active efflux have all been found to be resistance mechanisms. The goal of the study is to determine how resistant H. pylori is to clarithromycin and what the minimum inhibitory concentration is for various antimicrobials. Furthermore, gastro-endoscopy will beperformed on Iraqi patients to detect the presence of A2143G and A2144G point mutations inHelicobacter pylori infections, as diagnosed from the pyloric region and other anatomical regions.Methods: One hundred fifteen samples were collected from patients strongly suspected of H. pylori infection presented for upper gastrointestinal endoscopy at Ramadi Teaching Hospitals and Private Clinics forthe period from January 2020 until February 2021. Specimens were cultured on brain heart infusion agarcontaining various antibiotics and were incubated at 37 C under microaerophilic conditions. For identification of H. pylori, isolates of the biochemical tests and RT-PCR assay were applied. The Epsilometer testwas used in the antibiotic susceptibility testing as dependent on the CLSI standard. The RestrictionFragment Length Polymorphism technique was used to determine point mutations.Results: In total, 55 (47.8%) Helicobacter pylori isolates were cultured from the 115 biopsy specimens,among which 16 (29.1%), 38 (69.1%), 20 (36.4%), and 40 (72.7%) revealed some degree of resistance tolevofloxacin, clarithromycin, ciprofloxacin, and metronidazole, respectively. The frequency of A2144Gand A2143 point mutations were 23 (60.5%) and 19 (50%), respectively.Conclusions: According to our results, Helicobacter pylori showed high resistance to clarithromycin. Ourresults demonstrate the requirement for antibiotic susceptibility testing and molecular methods inselecting drug regimens