MOLECULAR ASPECT OF THE RESISTANCE OF HELICOBACTER PYLORI TO METRONIDAZOLE AND CLARITHROMYCIN AND ITS ASSOCIATION WITH THE VIRULENCE FACTOR CAG A IN A MOROCCAN POPULATION

Aims The aim of our study is to determine the prevalence of resistance of H. pylori to metronidazole and to clarithromycin in a Moroccan population infected with H. pylori and to study the impact of its virulence factor cagA on its resistance to antibiotics. .

Methods A prospective study including 195 consulting patients in the gastroenterology department .Consent patients underwent esogastroduodenal fibroscop.Detection of H. pylori, resistance to clarithromycin, metronidazole and determination of the cagA gene were performed by PCR from gastric biopsies.

Results Our population consists of 89 (48.64%) men and 106 ((54.35%) women. The average age of our population is 50±16 years. The prevalence of H. pylori infection is 94.9% (185/195). The rates of resistance of H. Pylori to Metronidazole and to Clarithromycin were 62.7% and 14.6% respectively. The rate of resistance to metronidazole was similar in cagA positive strains and in cagA-negative strains [63% (n=44/70) vs 63% (n=72/115)]. While the rate of resistance to clarithromycin was slightly elevated in patients infected with strains of H. pylori cagA negative compared to cagA positive strains [18.6% vs 11.6%] (P-value=0.49).

Conclusions Our study revealed a very high prevalence of resistance to metronidazole unlike clarithromycin . Also, Cag A status is not significantly associated with antibiotic resistance in our work. Knowing the rate of antibiotic resistance is crucial in choosing an appropriate and effective first-line empirical treatment for eradication of H. pylori infection.

Publication History

Article published online:
14 April 2022