{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:26:02Z","timestamp":1777922762355,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T00:00:00Z","timestamp":1459468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>\n                    Antibiotic resistance is the major cause for\n                    <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                    eradication failure.\n                    <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                    clarithromycin resistance mutations were evaluated in 84 (82 phenotypically clarithromycin resistant and 2 intermediately susceptible) strains by allele-specific PCR and 3\u2032-mismatched PCR. Many (57.1%) of these strains were metronidazole resistant. Prevalence of\n                    <jats:italic toggle=\"yes\">cagA<\/jats:italic>\n                    <jats:sup>+<\/jats:sup>\n                    ,\n                    <jats:italic toggle=\"yes\">cagE<\/jats:italic>\n                    <jats:sup>+<\/jats:sup>\n                    ,\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    s1a, m1, i1, and i2 strains was 76.2%, 58.0%, 82.1%, 35.7%, 50.0%, and 50.0%, respectively. A2143G, A2142G, A2142C, and A2143G+A2142G mutation rates were 64.3%, 23.8%, 1.2%, and 10.7%, respectively. Strains harboring the A2142G mutation showed 5.3-fold higher clarithromycin MIC\n                    <jats:sub>50<\/jats:sub>\n                    than those harboring the A2143G mutation. The A2143G mutation alone was 1.7-fold more common in\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i2 strains compared with\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i1 strains, while the A2142G mutation alone was 3-fold more frequent in\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i1 strains than\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i2 strains and 3.1-fold more common in metronidazole-susceptible compared with metronidazole-resistant strains. Briefly, clarithromycin resistance mutations were significantly linked to\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i allele and metronidazole susceptibility. This is the first report about associations between the A2143G mutation and less virulent\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i2 strains, and between the A2142G mutation and more virulent\n                    <jats:italic toggle=\"yes\">vacA<\/jats:italic>\n                    i1 strains. As the 2143G mutation often predicts eradication failure by clarithromycin-based regimens, the results may be linked to the better eradication of more virulent strains compared with the less virulent strains.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2015.0199","type":"journal-article","created":{"date-parts":[[2015,11,30]],"date-time":"2015-11-30T14:56:19Z","timestamp":1448895379000},"page":"227-232","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Clarithromycin Resistance Mutations in\n                    <i>Helicobacter pylori<\/i>\n                    in Association with Virulence Factors and Antibiotic Susceptibility of the Strains"],"prefix":"10.1177","volume":"22","author":[{"given":"Lyudmila","family":"Boyanova","sequence":"first","affiliation":[{"name":"Medical University of Sofia","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumyana","family":"Markovska","sequence":"additional","affiliation":[{"name":"Medical University of Sofia","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Yordanov","sequence":"additional","affiliation":[{"name":"Medical University of Sofia","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galina","family":"Gergova","sequence":"additional","affiliation":[{"name":"Medical University of Sofia","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Mitov","sequence":"additional","affiliation":[{"name":"Medical University of Sofia","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,4]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"32","article-title":"Rapid detection of clarithromycin resistant Helicobacter pylori strains in Spanish patients by polymerase chain reaction-restriction fragment length polymorphism","volume":"24","author":"Agudo S.","year":"2011","unstructured":"Agudo S., , P\u00e9rez-P\u00e9rez G., , Alarc\u00f3n T., , and L\u00f3pez-Brea M. 2011. 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