The present research work is a descriptive and cross-sectional study, in which 1500 gastric biopsies collected from 500 dyspeptic patients were processed with the aim of isolating and cultivating H. pylori strains, determining the resistance profiles in vitro and identify genetic mutations in the rRNA23S, pbp1, gyrA, rdxA and rRNA16S genes to determine the statistical significance and prevalence ratios between antimicrobial resistance to Clarithromycin, Amoxicillin, Levofloxacin, Metronidazole and Tetracycline respectively. As results, a prevalence of 54.6% of dyspeptic patients with H. pylori was obtained with antimicrobial resistance of: Clarithromycin 35.2%, Amoxicillin 65.3%, Metronidazole 68.9%, Levofloxacin 72.1% and Tetracycline 7.8%. In addition, mutations A2143G, A2142G and A2142C are identified within the rRNA23S and N87I, D91G, N87K, D91N and D91Y genes within the gyrA gene, significantly related to resistance to Clarithromycin and Levofloxacin respectively and a high genetic diversity in the genes pbp1 and rdxA, with mutations that do not show a significant relationship with high resistance to Amoxicillin and Metronidazole respectively. Finally, the presence of mutations in positions 926-928 of the rRNA16S gene is reported, without presenting a significant relationship with low resistance to Tetracycline.
El presente trabajo de investigación es un estudio del tipo descriptivo y de corte transversal, en el cual se procesaron 1500 biopsias gástricas colectadas de 500 pacientes dispépticos con el objetivo de aislar y cultivar cepas de H. pylori, determinar los perfiles de resistencia in vitro e identificar mutaciones genéticas en los genes ARNr23S, pbp1, gyrA, rdxA y ARNr16S para determinar la significancia estadística y las razones de prevalencias entre la resistencia antimicrobiana a Claritromicina, Amoxicilina, Levofloxacino, Metronidazol y Tetraciclina respectivamente. Como resultados se obtuvieron una prevalencia del 54.6% de pacientes dispépticos con H. pylori con una resistencia antimicrobiana de: Claritromicina 35.2%, Amoxicilina 65.3%, Metronidazol 68.9%, Levofloxacino 72.1% y Tetraciclina 7.8%. Además, se identifican las mutaciones A2143G, A2142G y A2142C dentro del gen ARNr23S y N87I, D91G, N87K, D91N y D91Y dentro del gen gyrA, relacionadas significativamente con la resistencia a Claritromicina y Levofloxacino respectivamente y una alta diversidad genética en los genes pbp1 y rdxA, con mutaciones que no muestran una relación significativa con la alta resistencia a Amoxicilina y Metronidazol respectivamente. Finalmente se reporta la presencia de mutaciones en las posiciones 926-928 del gen ARNr16S, sin presentar una relación significativa con la baja resistencia a Tetraciclina.