Navigating Antibiotic Resistance in Helicobacter pylori: Genetic Insights and Therapeutic Strategies

Abstract

Background: Helicobacter pylori [H. pylori] is a bacterium linked to several gastrointestinal disorders, such as peptic ulcers and gastric cancer. Although antibiotics are commonly used to treat H. pylori infections, increasing antibiotic resistance poses a major challenge.Patients and Methods: The study, a prospective analysis of gastric biopsies from 100 patients testing positive for H. pylori via rapid urease tests, was conducted at Suez Canal University Hospitals from December 2021 to March 2022. Ethical approval was granted by the Al-Azhar-Assiut Faculty of Medicine Ethics Committee [Committee No. 68, item 3, dated 12/12/2021], in accordance with the 2013 revised Helsinki standards. Informed written consent was obtained from all participants.Results: Helicobacter pylori [H. pylori] infections are more prevalent in women than in men, and smoking increases the likelihood of infection. This bacterium affects various physiological parameters: it raises systolic and diastolic blood pressure, alanine transaminase [ALT], creatinine, and white blood cell counts. Conversely, it reduces hemoglobin, red blood cells, packed cell volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet counts. There is also a notable increase in DNA mutations, particularly Asp495→His and Asn87→Lys, which are the most frequently observed mutations. Regarding antibiotic susceptibility, H. pylori shows moderate resistance to fluoroquinolones but strong resistance to Metronidazole and Clarithromycin.Conclusion: Understanding how Helicobacter pylori [H. pylori] develops resistance to antibiotics is vital for enhancing treatment strategies. Insights from this study can guide clinical decision-making about antibiotic use and support the creation of tailored treatment plans, especially in areas with significant resistance.