Yang Y.-J.JYH-CHIN YANGYUNG-MING JENGMEI-HWEI CHANGYEN-HSUAN NI2022-03-042022-03-0420010891-3668https://www.scopus.com/inward/record.uri?eid=2-s2.0-0034946064&doi=10.1097%2f00006454-200107000-00005&partnerID=40&md5=dec4e2ee78db11a4fdedd0573b5146e7https://scholars.lib.ntu.edu.tw/handle/123456789/596531Background. Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. Objective. To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant II. pylori isolates. Methods. Enrolled were 245 children investigated for II. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. Results. H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin resistant and 6 (9%) were metronidazoleresistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. Conclusions. The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.[SDGs]SDG3clarithromycin; metronidazole; ribosome RNA; adolescent; antibiotic resistance; article; bacterium isolate; child; controlled study; diagnostic accuracy; disease severity; female; gastritis; gastroscopy; Gram negative infection; Helicobacter pylori; histopathology; human; major clinical study; male; methodology; minimum inhibitory concentration; point mutation; polymerase chain reaction; prevalence; priority journal; restriction fragment length polymorphism; stomach antrum; Taiwan; Adolescent; Anti-Bacterial Agents; Child; Clarithromycin; DNA, Bacterial; Drug Resistance, Microbial; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Severity of Illness Indexjournal article10.1097/00006454-200107000-00005114658372-s2.0-0034946064