Molecular Mechanisms of Antibiotic Resistance in Helicobacter pylori

An estimated 4 to 5 million individuals in the Netherlands are actively infected with Helicobacter pylori. Eradication of this bacterium becomes more difficult as the prevalence of antibiotic resistance is increasing worldwide. Most H. pylori infections are now diagnosed by non-invasive testing (i.e. urea breath test, serology, stool test), and thus data on antibiotic susceptibility are lacking. Furthermore, once the antibiotic susceptibility is assessed using conventional culture-based methods by means of an E-test, agar dilution or disc-diffusion, then data are difficult to compare between different centers due to lack of standardization. Molecular-based methods are reproducible and easily standardized, and thus they can offer an attractive alternative. To develop molecular-based methods knowledge of molecular mechanisms underlying antibiotic resistance is mandatory. The research presented in this thesis aims to obtain information on molecular mechanisms of antibiotic resistance in H. pylori.