PCR-RFLP Detection of Point Mutations in 23sr RNA Gene Responsible for Clarithromycin Resistance in Helicobacter pylori Isolates of Ahvaz, Iran

Helicobacter pylori is a spiral-shaped gram-negative bacterium that infects half of the world’s population and is the main cause of chronic gastritis, gastric ulcer and gastric malignancies including gastric adenocarcinoma and mucus-associated lymphoid tissue (MALT) lymphoma [1,2]. Helicobacter pylori is the most common human pathogen and a successful pathogen and has been specifically transmitted to humans in early childhood and through the family and can persist for decades in the gastric mucosa despite inherent and acquired immune responses [3,4]. The prevalence of bacteria in developing countries is between 70% 90%, and in developing countries it is 35-40% [5]. During a Helicobacter pylori infection, persistent inflammation and abnormal epithelial proliferation might be the major causes of Helicobacter pylori associated gastric disorders [6,7]. Successful bacterial eradication is an effective method not only for the improvement of peptic ulcer, but also for gastric cancer. Succeeded bacterial elimination reduces the inflammation and atrophy of the gastric mucosa and can be effective in reducing the incidence of peptic ulcer and gastric cancers associated with Helicobacter pylori infection [8]. Helicobacter pylori eradication therapy is usually a combination of one proton pump inhibitor with several antibiotics such as clarithromycin, metronidazole, amoxicillin and tetracycline [9-11]. Expecting an increase in the resistance of Helicobacter pylori to these antibiotics is due to an increase in the number of treated patients, incomplete contribution of patients during treatment and an increase in the use of antibiotics in recent years [9,10]. The prevalence of resistance to mentioned drugs in different geographical areas is very different. Therefore, prior to administration of any drug for the treatment of Helicobacter pylori infections, it is necessary to determine the regional susceptibility pattern for each geographical region [9,12,13]. Several factors have contributed to reducing the efficacy of current treatments on Helicobacter pylori infections, but antibiotic resistance is the first factor of this decline in the world [14].