Prevalence and genotypic resistance of Helicobacter pylori to clarithromycin in medical staff in the Transbaikal region

The aim of the research. To determine the number of Helicobacter pylori (H. pylori) infected people and genotypic resistance to clarithromycin in residents of the Transbaikal region and medical staff using molecular genetic testing, to analyze the effectiveness of eradication in case of genotypic resistance. Materials and methods. 240 residents of the Transbaikal region were examined, including 58 medical and 182 non-medical staff. In biopsies obtained during gastric endoscopy, H. pylori DNA and mutations A2142G, A2143G, T2717C associated with resistance to clarithromycin were determined. Eradication with clarithromycin was performed in 35 people. Eradication control was performed 6-8 weeks after treatment by determining the H. pylori antigen in feces. Statistical methods: descriptive statistics, unpaired Student’s t-test, x2-test, odds ratio (OR) (Biostatistics). Results. H. pylori DNA was detected in 40.8% (CI: 37.6-44.0%) of individuals, 58.6% in medical staff, and 35.2% in non-medical workers (p=0.002). Mutations A2142G and/or A2143G were detected in 38.8% (52.9% in physicians, 31.2% in non-medical workers, p=0.036). The OR of the presence of H. pylori DNA in medical staff was 2.612 (95% CI: 1.427-4.782), and the presence of mutations A2142G and/or A2143G was 2.475 (95% CI: 1.051-5.826). Successful eradication was 62.8%. In individuals with Helicobacter pylori mutations, the effective treatment was 41.2%, in those without mutations - 83.3%. The OR of effective therapy in individuals with A2142G and/or A2143G mutations was 0.140 (95% CI: 0.029-0.674). Conclusion. The prevalence of H. pylori in the Transbaikal region was 40.8% in a genetic study. A high proportion of clarithromycin-resistant Helicobacter pylori strains was detected - 38.8%. Medical staff have higher rates of H. pylori, including resistant strains. In the presence of clarithromycin-resistant H. pylori, the effectiveness of eradication was reduced by 2 times. Before prescribing H. pylori eradication therapy including clarithromycin, it is advisable to test for H. pylori mutations, especially in medical staff.

Helicobacter pylori, prevalence, clarithromycin resistance, treatment, medical staff, Transbaikal region

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