期刊
NATURE COMMUNICATIONS
卷 12, 期 1, 页码 -出版社
NATURE PORTFOLIO
DOI: 10.1038/s41467-021-22557-7
关键词
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资金
- New National Excellence Program [UNKP-19-3-I-SE-65, UNKP-19-3-I-SE-73, UNKP-20-3-II-SE-36, UNKP-18-3-I-SE-44]
- Thematic Excellence Programme of the Ministry for Innovation and Technology (Hungary) [2020-4.1.1.-TKP2020]
- National Research, Development and Innovation Office of Hungary [K_18 128881, KKP129877]
- Semmelweis University, Budapest, Hungary
- Ministry of Human Capacities (Hungary) [20391-3/2018/FEKUSTRAT]
Clarithromycin, a macrolide antibiotic, is commonly used to treat Helicobacter pylori infection. The study by Kocsmar et al. on clarithromycin resistance and previous macrolide consumption in 4,744 H. pylori-infected patients sheds light on the sources of primary resistant cases and the impact of prior macrolide consumption for non-eradication purposes.
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. Clarithromycin is a macrolide antibiotic widely used for eradication of Helicobacter pylori infection. Here, Kocsmar et al. study clarithromycin resistance and previous macrolide consumption in 4,744 H. pylori-infected patients, shedding light into the sources of primary resistant cases and the role played by prior consumption of macrolides for non-eradication purposes.
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