{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:32:23Z","timestamp":1791005543102,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Torbat Heydariyeh University of Medical Sciences"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Resistant <jats:italic>Helicobacter pylori<\/jats:italic> to commonly used antimicrobial agents are associated with severe upper gastrointestinal disorders. To provide an epidemiological picture of <jats:italic>H\u00a0pylori<\/jats:italic> and characterize the resistance pattern and genetic variation of clinical isolates, stomach biopsies from patients with functional dyspepsia were evaluated in northeast of Iran.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In this study, 80 patients were recruited. Finally, fifty <jats:italic>H\u00a0pylori<\/jats:italic> strains were isolated from antrum and corpus biopsies by culturing on Columbia agar. All strains were identified by standard laboratory procedures. Susceptibility testing of antibiotics was performed using minimum inhibitory concentration test. Allele\u2010specific primer (ASP)\u2010PCR of 23S rRNA which associated with clarithromycin resistance was done among resistant strains. Moreover, <jats:italic>cagA<\/jats:italic> gene and polymorphism in <jats:italic>vacA<\/jats:italic> were detected. Random amplified polymorphic DNA polymerase chain reaction (RAPD\u2010PCR) was applied to investigate the genetic variations among all strains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Antibiotic resistance pattern of <jats:italic>H\u00a0pylori<\/jats:italic> strains was as follows: 68% (34\/50) to metronidazole, 50% (25\/50) to rifampicin, 30% (15\/50) to amoxicillin, 28% (14\/50) to levofloxacin, 22% (11\/50) to clarithromycin, and 16% (8\/50) to tetracycline. Multidrug\u2010resistant strains were observed in 19 strains (38%). ASP\u2010PCR of 23S rRNA showed four strains had A2143G mutation, six strains had A2142G mutation, and one strain had a Wt+A2143G mutation. Amplification of virulence\u2010associated genes revealed that <jats:italic>cagA<\/jats:italic> was present in 27 isolates (54%) and <jats:italic>vacA<\/jats:italic> in 36 isolates (72%). The most common genotype of <jats:italic>H\u00a0pylori<\/jats:italic> was <jats:italic>vacA s1am2<\/jats:italic> (40%) followed by <jats:italic>vacA s2m2<\/jats:italic> (14%), <jats:italic>vacA s1am1<\/jats:italic> (12%), <jats:italic>vacA s1bm1<\/jats:italic> (4%), and <jats:italic>vacA s1bm2<\/jats:italic> (2%). DNA fingerprinting pattern indicated a high heterogeneity among isolated strains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An alarming level of resistance to metronidazole and rifampicin and high heterogeneity among <jats:italic>H\u00a0pylori<\/jats:italic> isolates highlighted the importance of continued monitoring of antimicrobial susceptibility and epidemiological surveillance of this pathogen.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12684","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:10:36Z","timestamp":1582157436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Antibiotic resistance and clonal relatedness of <i>Helicobacter pylori<\/i> strains isolated from stomach biopsy specimens in northeast of 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