Mutations in the 23S rRNA gene of Helicobacter pylori associated with clarithromycin resistance

J Korean Med Sci. 2002 Oct;17(5):599-603. doi: 10.3346/jkms.2002.17.5.599.


Among 12 clarithromycin-resistant Helicobacter pylori strains isolated in Guri, Korea, 8 showed an adenine to guanine mutation at position 2143 (formerly A2144G or E. coli 2059) in the 23S rRNA gene by the PCR-restriction fragment length polymorphism (RFLP) method. The remaining 4 strains, digested by neither BsaI nor BbsI, showed a thymine to cytosine mutation at position 2182 (T2182C) by direct sequencing of the PCR products. The T2182C mutants showed a tendency of higher levels of minimum inhibitory concentration to clarithromycin than the A2143G mutants. In conclusion, either the A2143G or the T2182C mutation was present in 100% of clarithromycin-resistant H. pylori isolates examined. The PCR-RFLP technique with restriction enzymes BbsI and BsaI was a rapid and relatively simple method to detect the clarithromycin resistance. But undigested isolates were quite frequent among our isolates (33.3%), the PCR-RFLP method with restriction enzymes BbsI and BsaI should not be used alone, and development of other rapid detection method for clarithromycin resistance is mandatory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • Anti-Bacterial Agents / pharmacology*
  • Base Sequence
  • Clarithromycin / pharmacology*
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial / genetics
  • Genes, Bacterial*
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / drug effects*
  • Helicobacter pylori / genetics*
  • Humans
  • Korea
  • Molecular Sequence Data
  • Mutation
  • RNA, Bacterial / genetics
  • RNA, Ribosomal, 23S / genetics
  • Sequence Homology, Nucleic Acid


  • Anti-Bacterial Agents
  • DNA, Bacterial
  • RNA, Bacterial
  • RNA, Ribosomal, 23S
  • Clarithromycin