1887

Abstract

We aimed to investigate the presence of three recently identified point mutations (A2115G, G2141A and A2144T) of the 23 S rRNA gene and compare them with the three most frequently encountered point mutations (A2142G, A2142C and A2143G) in strains in Turkey.

A total of 63 patients (mean 47.08±12.27) were included. The E-test method (for clarithromycin) was used for the clarithromycin antimicrobial susceptibility test of isolated strains. Real-time PCR was used to detect the point mutations.

A total of 24 out of 63 strains (38.1%) were detected as clarithromycin resistant (>0.5 mg l ). The new A2115G (:6, 25%), A2144T (:7, 29.1%) and G2141A, 8 (:8, 33.3%) mutations and the classical A2142G (:8, 33.3%) and A2143G (:11, 45.8%) point mutations were detected in the 24 clarithromycin-resistant strains. The A2144T point mutation had the highest median MIC value (3 mg l ) amongst the new mutations, but the classical mutations (A2142G and A2143G) had the highest median MIC values (256 mg l ) overall. The presence of the A2115G (OR:31.66), A2144T (OR:36.92) or G2141A (OR:28.16) mutations increased the likelihood of clarithromycin resistance in strains by 31.66-, 36.92- and 28.16-fold (ORs), respectively, according to the binary logistic regression analysis.

. We concluded that classical mutations of the 23 S rRNA gene resulted in higher clarithromycin MIC values than new mutations. These new point mutations caused moderate elevations in the MIC values of clarithromycin-resistant strains.

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2019-04-01
2019-10-17
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