Prevalence of A2143G and A2144G Point Mutations Responsible for Clarithromycin Resistance among Helicobacter pylori Strains in Bushehr, Iran

Background: Resistance to clarithromycin in Helicobacter pylori has become one of the most important reasons for failure of antibiotic eradication therapies. This resistance is predominantly caused by point mutations in the peptidyl transferase region of 23S rRNA. Objectives: The aim of this study was to determine the prevalence of the A2143G, A2144G, and A2143C point mutations among H. pylori strains from gastric biopsy specimens in Bushehr, in the southwest of Iran. Patients and Methods: Gastric biopsy specimens were obtained from patients with upper gastrointestinal symptoms during endoscopy. Fluorescent in situ hybridization (FISH) using oligonucleotide probes was applied to detect the point mutations responsible for clarithromycin resistance in H. pylori. Results: Of the 135 H. pylori-positive specimens, two harbored strains with the A2143G mutation and nine contained strains with the A2144G mutation. Thus, the prevalences of the A2143G and A2144G point mutations were 1.5% and 6.7%, respectively. The A2143C point mutation was not found. Conclusions: The prevalences of the point mutations A2143G and A2144G were low in our geographic area. Based on the findings of this study, clarithromycin still seems to be a useful antibiotic for initial treatment regimens in Bushehr, Iran.