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Yin S, Liu Y, Yang X, Lubanga N, Tai P, Xiong M, Fan B, Yang X, Nie Z, Zhang Q, He B. Rapid visual detection of Helicobacter pylori and vacA subtypes by Dual-Target RAA-LFD assay. Clin Chim Acta 2025; 564:119927. [PMID: 39153656 DOI: 10.1016/j.cca.2024.119927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/27/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infects over 50% of the global population and is a significant risk factor for gastric cancer. The pathogenicity of H. pylori is primarily attributed to virulence factors such as vacA. Timely and accurate identification, along with genotyping of H. pylori virulence genes, are essential for effective clinical management and controlling its prevalence. METHODS In this study, we developed a dual-target RAA-LFD assay for the rapid, visual detection of H. pylori genes (16s rRNA, ureA, vacA m1/m2), using recombinase aided amplification (RAA) combined with lateral flow dipstick (LFD) methods. Both 16s rRNA and ureA were selected as identification genes to ensure reliable detection accuracy. RESULTS A RAA-LFD assay was developed to achieve dual-target amplification at a stable 37 °C within 20 min, followed by visualization using the lateral flow dipstick (LFD). The whole process, from amplification to results, took less than 30 min. The 95 % limit of detection (LOD) for 16 s rRNA and ureA, vacA m1, vacA m2 were determined as 3.8 × 10-2 ng/μL, 5.8 × 10-2 ng/μL and 1.4 × 10-2 ng/μL, respectively. No cross-reaction was observed in the detection of common pathogens including Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Bacillus subtilis, showing the assay's high specificity. In the evaluation of the clinical performance of the RAA-LFD assay. A total of 44 gastric juice samples were analyzed, immunofluorescence staining (IFS) and quantitative polymerase chain reaction (qPCR) were used as reference methods. The RAA-LFD results for the 16s rRNA and ureA genes showed complete agreement with qPCR findings, accurately identifying H. pylori infection as confirmed by IFS in 10 out of the 44 patients. Furthermore, the assay successfully genotyped vacA m1/m2 among the positive samples, showing complete agreement with qPCR results and achieving a kappa (κ) value of 1.00. CONCLUSION The dual-target RAA-LFD assay developed in this study provides a rapid and reliable method for detecting and genotyping H. pylori within 30 min, minimizing dependency on sophisticated laboratory equipment and specialized personnel. Clinical validation confirms its efficacy as a promising tool for effectively control of its prevalence and aiding in the precise treatment of H. pylori-associated diseases.
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Affiliation(s)
- Sijie Yin
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China; Department of Laboratory Medicine, Yangzhou HongquanHospital, Yangzhou, China
| | - Yanghe Liu
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China; Department of Laboratory Medicine, Nanjing Jiangning Hospital of Chinese Medicine, Nanjing, China
| | - Xinyi Yang
- Nanjing Jinling High School Hexi Campus, Nanjing, China
| | - Nasifu Lubanga
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China
| | - Ping Tai
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China
| | - Mengqiu Xiong
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China
| | - Boyue Fan
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China
| | - Xincheng Yang
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China
| | - Zhenlin Nie
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China.
| | - Qingsong Zhang
- Department of Clinical Laboratory, Xuancheng Central Hospital, Xuancheng, China.
| | - Bangshun He
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, China; H. pylori Research Key Laboratory, Nanjing Medical University, Nanjing, China.
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Alarcón-Millán J, Bonilla-Delgado J, Fernández-Tilapa G, Nieto-Velázquez NG, Sierra-Martínez M, Alvarado-Castro VM, Cortés-Malagón EM. Helicobacter pylori Virulence Factors and Clarithromycin Resistance-Associated Mutations in Mexican Patients. Pathogens 2023; 12:234. [PMID: 36839506 PMCID: PMC9959081 DOI: 10.3390/pathogens12020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Persistent infection with Helicobacter pylori (H. pylori) is an important factor in gastric diseases. The vacA and cagA virulence factors of H. pylori contribute to the development of these diseases. Triple therapy containing clarithromycin has been used to eradicate this infection. Unfortunately, resistance to this antibiotic is the primary cause of treatment failure. This study aimed to determine the prevalence of clarithromycin resistance-associated mutations and to assess the relationship between virulence factors and Mexican patients infected with H. pylori. The cagA and vacA genotypes were determined by multiplex PCR. Furthermore, a qPCR was used to identify mutations of the 23S rRNA gene. This study reported a prevalence of 84.3% of H. pylori among patients with gastric diseases, and the vacA s1m1/cagA+ genotype was the most frequent (44.8%) in antrum and corpus. Analysis of the 23S rRNA gene revealed a 19.8% prevalence of clarithromycin resistance-associated mutations. The most prevalent mutations were A2143G (56%) and A2142C (25%). A significant association (p < 0.05) between the A2142G and the vacA s1m1/cagA+ genotype was detected. In conclusion, we report a high prevalence (>15%) of clarithromycin resistance-associated mutations, and we found an association between the genotypes of virulence factors and a mutation in the 23S rRNA gene.
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Affiliation(s)
- Judit Alarcón-Millán
- Clinical Research Laboratory/Biomolecules Research Laboratory, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo 39070, Mexico
| | - José Bonilla-Delgado
- Departament of Biotechnology, Escuela de Ingeniería y Ciencias, Instituto Tecnológico y de Estudios Superiores de Monterrey, Toluca 50110, Mexico
- Research Unit, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico
| | - Gloria Fernández-Tilapa
- Clinical Research Laboratory/Biomolecules Research Laboratory, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Guerrero, Chilpancingo 39070, Mexico
| | | | - Mónica Sierra-Martínez
- Research Unit, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico
| | | | - Enoc Mariano Cortés-Malagón
- Research Division, Hospital Juárez de México, Mexico City 07760, Mexico
- Genetic Laboratory, Hospital Nacional Homeopático, Mexico City 06800, Mexico
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Buran T, Sürücüoğlu S, Kurutepe S, Gazi H. Recent trends in the antibiotic resistance of Helicobacter pylori in patient with dyspepsia. Medicine (Baltimore) 2022; 101:e29801. [PMID: 35777028 PMCID: PMC9239587 DOI: 10.1097/md.0000000000029801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to determine the resistance status and to identify the point mutations conferring resistance to clarithromycin and fluoroquinolones among dyspeptic patients in Manisa, Turkey. The study included a sample of 140 patients with an indication for upper gastrointestinal endoscopy randomly selected from 2100 dyspeptic patients attending to the Gastroenterology and Endoscopy Unit at Manisa Celal Bayar University Hafsa Sultan Hospital between April 2016 and May 2018. A commercially available GenoType Helico DR test was used to detect the presence of Helicobacter pylori and mutations associated with resistance to clarithromycin and fluoroquinolones in biopsy specimens. In total, 116 (82.9%) of 140 biopsies obtained from the same number of dyspeptic patients were positive for H pylori and 82 (approximately 71%) of them harbored resistance mutations in 23SrRNA and/or gyrA. Resistance to clarithromycin, levofloxacin, or both were detected in 43.1% (50/116), 27.6% (32/116), and 16/116 (13.8%) of tested biopsies, respectively. The most common mutation conferring resistance to clarithromycin was A2147G (96%, 48/50). Resistance to fluoroquinolones was frequently due to mutation in codon 91 and the most common mutation detected was D91G (34.4%). Heteroresistance patterns were observed in 48.0% (24/50) of clarithromycin-resistant samples and 28.1% (9/32) of levofloxacin-resistant samples. The resistance rates and detected mutations in this study are in line with the country data. However, to achieve better H pylori eradication and to prevent the spread of multidrug-resistant strains in Turkey, the molecular-based susceptibility tests should be considered routinely. Further studies are needed to determine the various mutations among resistant strains.
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Affiliation(s)
- Tahir Buran
- Department of Gastroenterology, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Turkey
- * Correspondence: Tahir Buran, Department of Gastroenterology, Manisa Celal Bayar University Faculty of Medicine, Uncubozköy, Manisa, Turkey (e-mail: )
| | - Süheyla Sürücüoğlu
- Department of Medical Microbiology, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Semra Kurutepe
- Department of Medical Microbiology, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Hörü Gazi
- Department of Medical Microbiology, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Turkey
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Li RJ, Qin C, Huang GR, Liao LJ, Mo XQ, Huang YQ. Phillygenin Inhibits Helicobacter pylori by Preventing Biofilm Formation and Inducing ATP Leakage. Front Microbiol 2022; 13:863624. [PMID: 35572695 PMCID: PMC9097866 DOI: 10.3389/fmicb.2022.863624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
With the widespread use and abuse of antibiotics, Helicobacter pylori (H. pylori) has become seriously drug resistant. The development of new antibiotics is an important way to solve H. pylori's drug resistance. Screening antibacterial ingredients from natural products is a convenient way to develop new antibiotics. Phillygenin, an effective antibacterial component, was selected from the natural product, forsythia, in this study. Its minimal inhibitory concentration (MIC) for 18 H. pylori strains was 16-32 μg/ml. The minimum bactericidal concentration (MBC) of H. pylori G27 was 128 μg/ml; the higher the drug concentration and the longer the time, the better the sterilization effect. It was non-toxic to gastric epithelial cell (GES)-1 and BGC823 cells at the concentration of 100 μg/ml. It presented a better antibacterial effect on H. pylori in an acidic environment, and after 24 days of induction on H. pylori with 1/4 MIC of phillygenin, no change was found in the MIC of H. pylori. In the mechanism of action, phillygenin could cause ATP leakage and inhibit the biofilm formation; the latter was associated with the regulation of spoT and Hp1174 genes. In addition, phillygenin could regulate the genes of Nhac, caggamma, MATE, MdoB, flagellinA, and lptB, leading to the weakening of H. pylori's acid resistance and virulence, the diminishing of H. pylori's capacity for drug efflux, H. pylori's DNA methylation, the initiation of human immune response, and the ATP leakage of H. pylori, thus accelerating the death of H. pylori. In conclusion, phillygenin was a main ingredient inhibiting H. pylori in Forsythia suspensa, with a good antibacterial activity, high safety, strong specificity, better antibacterial effect under acidic conditions, and low risk of resistance development by H. pylori. Its mechanism of action was mainly associated with inhibiting the biofilm formation and resulting in ATP leakage. In addition, phillygenin was shown to be able to reduce the acid resistance and virulence of H. pylori.
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Affiliation(s)
- Ru-Jia Li
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
| | - Chun Qin
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
| | - Gan-Rong Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
| | - Li-Juan Liao
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
| | - Xiao-Qiang Mo
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
| | - Yan-Qiang Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infecting, Youjiang Medical University for Nationalities, Baise, China
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A new approach against Helicobacter pylori using plants and its constituents: A review study. Microb Pathog 2022; 168:105594. [DOI: 10.1016/j.micpath.2022.105594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 02/07/2023]
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Lan QL, Sun HY, Ye Y, Wang Y, Liu Y, Weng XJ. Factors Affect the Eradication Rate of Helicobacter pylori by Modified Quadruple Therapy: A Prospective Cohort Study. Infect Drug Resist 2022; 15:2339-2345. [PMID: 35517896 PMCID: PMC9063792 DOI: 10.2147/idr.s358464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to investigate related factors affecting the eradication rate of Helicobacter pylori (Hp) by modified quadruple therapy. Methods Between September 2020 and March 2021, 341 patients who were diagnosed with Hp infection and whose infections were confirmed by gastroscopy, a histological examination, and a C13-UBT without culturing and antimicrobial susceptibility studies received a two-week anti-Hp treatment, a modified quadruple therapy, in our department. The result of C13-UBT was rechecked 4 weeks after the drug withdrawal, and the patients were divided into two groups-a success group and a failure group-according to the final breath result. The general clinical information and related laboratory indexes of each patient were collected, and the factors affecting the eradication rate were analyzed. Results The total clinical eradication rate was 80.06% (273/341), and the failure rate was 19.94% (68/341), correspondingly. Univariate analysis identified statistically significant differences between the two groups in serum 25-hydroxyvitamin D levels, presence of oral diseases, positive cytotoxin-associated gene A (CagA), and medical compliance (P < 0.05). Meanwhile, the use of a proton pump inhibitor (PPIs) and antibiotics was statistically different (P < 0.05). Logistic regression analysis revealed that vitamin D level (<20 ng/mL) [OR = 98.56, 95% CI (29.01-334.83), P < 0.001] and medical compliance [OR = 148.18, 95% CI (37.64-583.33), P < 0.001] were independent effecting factors for eradication rate. Conclusion Serum 25-hydroxyvitamin D level lower than 20 ng/mL may affect the success of eradication of Hp and is an independent risk factor for eradication failure.
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Affiliation(s)
- Qiao-Li Lan
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Hao-Yue Sun
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Yi Ye
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Ying Wang
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Ya Liu
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Xue-Jian Weng
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
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