Table_1_Phenotypic and Genotypic Antibiotic Resistance Patterns in Helicobacter pylori Strains From Ethnically Diverse Population in México.xlsx

Helicobacter pylori strains carry a range of mutations in genes that confer antimicrobial resistance and restrict the available options to treat the infection. Latin America is a region that conserve a large number of indigenous communities relatively isolated that practice a traditional medicine without consumption of drugs. We hypothesized that rates of antibiotic resistance are lower in these communities. Recent progress in whole-genome sequencing has allowed the study of drug susceptibility by searching for the known mutations associated with antibiotic resistance. The aim of this work was to study trends of antibiotic resistance over a 20-year period in Mexican H. pylori strains and to compare susceptibility between strains from Mexican mestizos and from indigenous population; we also aimed to learn the prevalence of mutational patterns in genes gyrA, gyrB, rdxA, frxA, rpsU, omp11, dppA, and 23S rRNA and its association with phenotypic tests. Resistance to clarithromycin, metronidazole, amoxicillin and levofloxacin was determined in167 H. pylori isolates by E-test, and the occurrence of mutational patterns in specific genes was determined by whole genome sequencing (WGS). The trend of resistance over 20 years in mestizo isolates showed significant resistant increase for clarithromycin and levofloxacin to frequencies that banned its clinical use. Resistance in H. pylori isolates of native communities was lower for all antibiotics tested. Phenotypic resistance showed good to moderate correlation with genotypic tests. Genetic methods for characterizing antibiotic resistance require further validation in each population.

幽门螺杆菌（Helicobacter pylori）菌株的耐药相关基因携带多种突变，这会限制该感染的临床治疗选择。拉丁美洲拥有大量相对隔绝的原住民社群，这些社群采用无需药物干预的传统医疗方式。本研究假设，此类社群中的幽门螺杆菌抗生素耐药率更低。全基因组测序（whole-genome sequencing）技术的最新进展，使得研究者可通过搜寻与抗生素耐药相关的已知突变，开展药物敏感性研究。本研究的核心目标为：分析20年间墨西哥幽门螺杆菌菌株的抗生素耐药趋势，并对比墨西哥印欧混血人群与原住民群体来源菌株的药物敏感性；同时还旨在明确gyrA、gyrB、rdxA、frxA、rpsU、omp11、dppA及23S rRNA基因的突变模式流行率，并探讨其与表型检测的关联。本研究通过E-test法对167株幽门螺杆菌分离株的克拉霉素、甲硝唑、阿莫西林及左氧氟沙星耐药性进行检测，并通过全基因组测序（WGS）明确特定基因的突变模式存在情况。印欧混血人群分离株的20年耐药趋势显示，克拉霉素与左氧氟沙星的耐药率显著上升，已达到临床禁用的水平。原住民社群来源的幽门螺杆菌分离株，对所有受试抗生素的耐药率均更低。表型耐药结果与基因型检测结果呈现中等至良好的相关性。用于抗生素耐药性表征的基因检测方法，仍需在各人群中开展进一步验证。