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Antimicrobial Agents and Chemotherapy, May 2009, p. 1884-1891, Vol. 53, No. 5
0066-4804/09/$08.00+0     doi:10.1128/AAC.01449-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

A Redox Basis for Metronidazole Resistance in Helicobacter pylori{triangledown}

N. O. Kaakoush,1 C. Asencio,2,3 F. Mégraud,2,3 and G. L. Mendz1,4*

School of Medical Sciences, The University of New South Wales, Sydney, New South Wales 2052, Australia,1 INSERM U853, 33076 Bordeaux Cedex, France,2 Université Victor Segalen Bordeaux II, Laboratoire de Bacteriologie, 146 rue Leo Saignat, 33076 Bordeaux Cedex, France,3 School of Medicine Sydney, The University of Notre Dame Australia, Sydney, New South Wales 2007, Australia4

Received 29 October 2008/ Returned for modification 29 November 2008/ Accepted 7 February 2009

Metronidazole resistance in Helicobacter pylori has been attributed to mutations in rdxA or frxA. Insufficient data correlating RdxA and/or FrxA with the resistant phenotype, and the emergence of resistant strains with no mutations in either rdxA or frxA, indicated that the molecular basis of H. pylori resistance to metronidazole required further characterization. The rdxA and frxA genes of four matched pairs of metronidazole-susceptible and -resistant strains were sequenced. The resistant strains had mutations in either rdxA, frxA, neither gene, or both genes. The reduction rates of five substrates suggested that metabolic differences between susceptible and resistant strains cannot be explained only by mutations in rdxA and/or frxA. A more global approach to understanding the resistance phenotype was taken by employing two-dimensional gel electrophoresis combined with tandem mass spectrometry analyses to identify proteins differentially expressed by the matched pair of strains with no mutations in rdxA or frxA. Proteins involved in the oxireduction of ferredoxin were downregulated in the resistant strain. Other redox enzymes, such as thioredoxin reductase, alkyl hydroperoxide reductase, and superoxide dismutase, showed a pI change in the resistant strain. The data suggested that metronidazole resistance involved more complex metabolic changes than specific gene mutations, and they provided evidence of a role for the intracellular redox potential in the development of resistance.

* Corresponding author. Mailing address: School of Medicine, Sydney, The University of Notre Dame Australia, 160 Oxford St., Sydney, New South Wales 2010, Australia. Phone: 61282044457. Fax: 61293577680. E-mail: GMendz{at}nd.edu.au

{triangledown} Published ahead of print on 17 February 2009.

Antimicrobial Agents and Chemotherapy, May 2009, p. 1884-1891, Vol. 53, No. 5
0066-4804/09/$08.00+0     doi:10.1128/AAC.01449-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Cambau, E., Allerheiligen, V., Coulon, C., Corbel, C., Lascols, C., Deforges, L., Soussy, C.-J., Delchier, J.-C., Megraud, F. (2009). Evaluation of a New Test, GenoType HelicoDR, for Molecular Detection of Antibiotic Resistance in Helicobacter pylori. J. Clin. Microbiol. 47: 3600-3607 [Abstract] [Full Text]  


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