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제주 지역에서 23S rRNA 점 돌연변이와 관련된 Clarithromycin 내성 Helicobacter pylori
김태윤 ( Taeyun Kim,),송현주 ( Hyun Joo Song ),신선영 ( Sun Young Shin ),김조헌 ( Jo Heon Kim ),나수영 ( Soo Young Na ),부선진 ( Sun Jin Boo ),최은광 ( Eun Kwang Choi ),조유경 ( Yoo Kyung Cho ),김흥업 ( Heung Up Kim ),송병철 ( Byu 대한소화기학회 2013 대한소화기학회지 Vol.61 No.5
Background/Aims: The point mutations in 23S rRNA gene accounts for the majority of the clarithromycin resistance of Helicobacterpylori. This study aimed to investigate the association between the clarithromycin-resistance of H. pylori and the failure of primary H. pylori eradication therapy in Jeju Island. Methods: Between April 2011 and October 2012, 6,937 patients underwent endoscopy, and H. pylori infection was evaluated in 2,287 patients (33.0%). Total of 110 patients with H. pylori infection were treated with proton pump inhibitor (PPI)-based triple therapy. The result of eradication was evaluated with urea breath test, histology and PCR which were conducted 4 weeks from the last dose of medicine. Results: The patients who had point mutations were 33 (26.0%). A2142G and A2143G mutations were observed in 10 patients (7.9%) and 23 patients (18.1%). Among 110 patients treated with PPI-based triple therapy, the success rate of the eradication therapy was 52.7% (58/110) and 70.7% (58/82) by intention-to-treat and per-protocol analysis, respectively. Fifteen of the 24 patients who failed the eradication therapy showed point mutations; 1 patient (4.2%) showed A2142G mutation and 14 patients (58.3%) showed A2143G mutation. Patients with A2143G mutation H. pylori showed higher failure rate of 87.5%. Patients with A2142G mutation H. pylori showed similar failure rate compared to those of the patients with wild type H. pylori. Conclusions: In Jeju Island, the frequency of 23S rRNA point mutations is similar (26.0%) with other regions of Korea (15.8-31.3%). A2143G mutation is associated with the failure of H. pylori eradication.
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