Virulence Genes Distribution and Molecular Characterisation of Antibiotic Resistance in Helicobacter Pylori Infected Patients Presenting with Gastroduodenal Pathologies in the Central Region of Ghana

Abstract

H. pylori is considered one of the most successful pathogens known to cause infections of the gastric mucosa. The associated disease outcome and treatment approach is influenced by a number of factors. The current study examined the prevalence dynamics, risk factors, antibiotic resistance and bacterial virulence factors in persons infected with H. pylori. Sequencing of genes responsible for antibiotic resistance, PCR amplification of virulence factors and resistant genes were also performed. Information from administered questionnaire were used to determine risk factors. Secondary data from endoscopy referral Centres were analysed for dynamics of prevalence. Infection prevalence was found to be 77.09 % in males and 74.54 % in females. All oesophageal cancer cases were males and gastric cancer cases occurred at 2.8 % in males compared to 0.39 % in females. Stomach and duodenal ulcers, gastritis, hiatal hernias, and esophagitis were all significantly linked to H. pylori infection. iceA2, dupA, and cagE were identified at a rate of 28.16 %, 32.04 %, and 12.62 % respectively. The relationship between iceA2 and conditions such as duodenal and gastric ulcers were statistically significant. Phenotypic resistance rate in levofloxacin, tetracycline, clarithromycin, metronidazole and ciprofloxacin were found to be 40 %, 20 %, 100 %, 100 % and 20 % respectively. A number of mutations in gyrA (eg. H200Y, A199V/T, R190S, H189Y and A97V), rdxA (eg. Q11Stop, R16H, E27G, I36T. Q50Stop, D61G and A67G), and pbp1A (eg. T254I, K315E and T438M) were identified. Again, amino acid substitutions may lead to structural modification of antibiotic resistance genes. Studies on other virulence factors and resistance gene are required to fully understand the infection