Diagnostic microbiology and infectious disease · 2026
Resistance of Helicobacter pylori to clarithromycin and levofloxacin in patients residing in the VI Region of Chile.
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Estrella Laura, Mosquera Mauricio, Orosco Juan, Meza Paulina, Orellana Carmen, Orrego Cynthia, González-Hormazábal Patricio, Cárdenas-Oyarzo Areli, Salinas Ana María
Аннотация
BACKGROUND: In Chile, antibiotic resistance in Helicobacter pylori varies by region, with clarithromycin and levofloxacin showing the highest rates of resistance. Data from rural populations remain scarce, limiting regional treatment decisions.
OBJECTIVES: This study aims to determine antibiotic resistance rates and identify the most common mutations associated with clarithromycin and levofloxacin resistance in rural patients from the VI Region of Chile.
METHODS: A prospective cross-sectional analytical study was conducted from 2018 to 2019 at Ricardo Valenzuela Sáez Hospital in Rengo, Chile. DNA was extracted from gastric mucosal tissue on cellulose support obtained during rapid urease test endoscopy in 187 consecutively enrolled, treatment-naïve patients, and antibiotic resistance was detected by mutational analysis using the GenoType HelicoDR commercial kit.
RESULTS: Resistance rates were 18.7% for clarithromycin and 13.4% for levofloxacin, both exceeding international clinical thresholds of 15% and 10%, respectively. Mutations A2147G and N87K were the most prevalent for each antibiotic. Female sex was significantly associated with levofloxacin resistance (p = 0.037). Cellulose support from the rapid urease test proved effective for DNA extraction and mutation detection.
CONCLUSIONS: Our results provide the first evidence of resistance to clarithromycin and levofloxacin in a rural area of Chile. The resistance levels observed compromise the use of both antibiotics as empirical therapy in this population. Furthermore, our method detects antibiotic resistance by molecular DNA-based methods using the same sample obtained for the rapid urease test, without requiring an additional biopsy for this purpose; this approach does not extend to phenotypic, culture-based susceptibility testing.
OBJECTIVES: This study aims to determine antibiotic resistance rates and identify the most common mutations associated with clarithromycin and levofloxacin resistance in rural patients from the VI Region of Chile.
METHODS: A prospective cross-sectional analytical study was conducted from 2018 to 2019 at Ricardo Valenzuela Sáez Hospital in Rengo, Chile. DNA was extracted from gastric mucosal tissue on cellulose support obtained during rapid urease test endoscopy in 187 consecutively enrolled, treatment-naïve patients, and antibiotic resistance was detected by mutational analysis using the GenoType HelicoDR commercial kit.
RESULTS: Resistance rates were 18.7% for clarithromycin and 13.4% for levofloxacin, both exceeding international clinical thresholds of 15% and 10%, respectively. Mutations A2147G and N87K were the most prevalent for each antibiotic. Female sex was significantly associated with levofloxacin resistance (p = 0.037). Cellulose support from the rapid urease test proved effective for DNA extraction and mutation detection.
CONCLUSIONS: Our results provide the first evidence of resistance to clarithromycin and levofloxacin in a rural area of Chile. The resistance levels observed compromise the use of both antibiotics as empirical therapy in this population. Furthermore, our method detects antibiotic resistance by molecular DNA-based methods using the same sample obtained for the rapid urease test, without requiring an additional biopsy for this purpose; this approach does not extend to phenotypic, culture-based susceptibility testing.