Detection of clarithromycin resistance and 23srRNA point mutations in Helicobacter Pylori isolates from patients in National Liver institute

Background: Helicobacter pylori are a motile, gram-negative bacteria that thrive under microaerophilic conditions notable for its unique capability to survive and remain in the human stomach over time. Its presence has been correlated with multiple disorders, both within and beyond the gastrointestinal tract. Although clarithromycin-containing triple therapy is widely prescribed to eliminate H. pylori, increasing rates of antibiotic resistance have reduced its success rate. Objective: To evaluate the frequency of H. pylori infection in patients diagnosed with chronic gastritis at the National Liver Institute, to investigate clarithromycin resistant rate among H. pylori isolates., and to identify the A2143G point mutation within the 23S rRNA gene. Methodology: A cross-sectional study was done on patients suffered from chronic gastritis at the Endoscopy Unit in Hepatology and Gastroenterology Department - National Liver Institute. Gastric biopsies were obtained via esophagogastroduodenoscopy and analyzed by using rapid urease test and bacterial culture. Antimicrobial susceptibility was determined through the Kirby-Bauer disk diffusion assay. PCR-RFLP was employed to detect the A2143G point mutation in the 23S rRNA gene. Results: 44% of the chronic gastritis patients had H. pylori infection, 77.27% were resistant to Clarithromycin. A2143G point mutation was founded at 29.41% of Clarithromycin resistant H. pylori strains. Conclusion: The results indicated a high level of clarithromycin resistance in H. pylori. The presence of a A2143G point mutation in the 23S rRNA gene is correlated to Clarithromycin resistance.