rdxA, frxA, and efflux pump in metronidazole-resistant Helicobacter pylori: Their relation to clinical outcomes.

BACKGROUND AND AIM: rdxA and frxA mutations and enhancement of efflux pump have been suggested as the cause of metronidazole resistance in Helicobacter pylori. This study was performed to investigate the resistance mechanisms related to clinical eradication outcome, and to examine direct involvement of hefA in metronidazole-resistant isolates with intact rdxA and frxA. METHODS: A total of 53 H. pylori-positive patients who were treated with metronidazole-containing sequential or quadruple therapy from 2011 to 2015 were enrolled. The metronidazole susceptibility of H. pylori isolates was examined by agar dilution test. Mutations in rdxA and frxA, were analyzed with DNA sequencing, and impact of hefA on metronidazole resistance was examined with quantitative real-time reverse transcription polymerase chain reaction, knockout and genetic complementation test for hefA. RESULTS: Seven mutation types of rdxA and/or frxA were found in H. pylori isolated from non-eradicated subjects. rdxA mutation was associated with eradication failure (P = 0.002), and nonsense mutation in rdxA reduced eradication efficacy (P = 0.009). hefA expression was significantly higher in resistant isolates (P < 0.001), especially in rdxA(-)frxA(-) as compared to rdxA(+)frxA(+) (P = 0.027). Resistant isolates with no mutation in rdxA and frxA became susceptible after hefA knockout. Genetic complementation for hefA recovered metronidazole resistance in all of three hefA knockout mutants. CONCLUSIONS: These results suggest that rdxA mutations play a critical role in metronidazole resistance as well as the outcomes of eradication therapy. In addition, hefA seems to be directly involved in metronidazole resistance, which explains the resistance in clinical isolates with intact rdxA and frxA.

Effects of Size and Degree of Abdomen Inflation of the Mother Fish on Ovulation Induction of Red Spotted Grouper, Epinephelus akaara.

We determined the morphologic characteristics (body weight and degree of abdomen inflation) of the red spotted grouper, Epinephelus akaara, mother fish producing healthy eggs. Experimental fish were chosen from fish reared in a sea cage. The fish were divided into four size groups by body weight: 400~600, 600~800, 800~1,000, and 1,000~1,200 g and four stages (Ⅰ~Ⅳ) of the degree of abdomen inflation. After hormone treatment, we observed the amount of ovulation-induced eggs, and rates of buoyancy, fertilization, embryonic survival, and hatching. As a result, mother fish with a body weight of 600 g or more spawned, and the fertilization rate, embryonic survival rate, and hatching rate were high in the 800~1,000 g range, thus showing effective ovulation induction. As a result of dividing the degree of abdomen inflation based on the anal fin of the mother fish into I-IV stages and determining hormone treatment time, the GSI was 0.9 ± 0.2% at stage I, 2.3 ± 0.2% at stage II, 5.6 ± 0.2% at stage III, and 7.9 ± 0.9% at stage IV. The flotation rate and hatching rate were highest at stage III, and the fertilization rate and embryonic survival rate were highest at stage IV. Therefore, in terms of egg quality, the amount of eggs collected per mother fish, maturation, and histology were different depending on the degree of abdomen inflation. At stage III, where the abdomen inflation degree of the mother fish was based on the basal part of the dorsal fin relative to the height of the anal fin was 1, the egg quality was highest.

Specific mutations of penicillin-binding protein 1A in 77 clinically acquired amoxicillin-resistant Helicobacter pylori strains in comparison with 77 amoxicillin-susceptible strains.

BACKGROUND: Amoxicillin (Amx) is one of the most important antibiotics for eradication of Helicobacter pylori (H. pylori). Main determinants of genetically stable Amx resistance are mutations in the C-terminus of penicillin-binding protein 1A (pbp1A). However, contribution of individual mutation remains unclear. METHODS: 77 Amx-resistant (AmxR ) and 77 Amx-susceptible (AmxS ) H. pylori strains were isolated from gastric tissues, and DNA sequencing was performed to compare C-terminus sequences of pbp1A gene between AmxR and AmxS strains. Natural transformation of these mutated genes into amoxicillin-susceptible strains was performed. RESULTS: Among many mutations in pbp1A, D479E (OR: 37.4, 95% CI: 5.53-252.49, P < .001), and T593 mutation (OR: 32.0, 95% CI: 4.04-252.86, P < .001) independently contributed to Amx resistance in H. pylori strains. In the transformation experiment, T593 mutations were identified in their transformants showing Amx resistance. However, PCR product of D479E was not inserted into recipient (ATCC 43504) resulting in transformation failure. CONCLUSION: Amx resistance is associated with various substitutions in pbp1A and T593 mutation contributes to Amx resistance of H. pylori.

Early Osteological Development of Larvae and Juveniles in Red Spotted Grouper, Epinephelus akaara (Pisces: Serranidae).

We observed the osteological development of larval and juvenile red spotted grouper (Epinephelus akaara) in order to generate data for the assessment of skeletal deformities and to inform phylogenetic systematics research. Larvae and juveniles were obtained from a aquafarm in Muan-gun, Jeolla-namdo Province, Korea. The average water temperature at the time of breeding was 23.0°C and average water salinity was 33.0 psu. Freshly hatched fish larvae had not undergone any ossification, but ossification of the parasphenoid bone, which forms the base of the cranium, occurred as the juveniles reached an average body length (BL) of 2.49 mm. At the same time, ossification of the preopercle and opercle occurred in the operculum, and ossification of the maxilla, which forms the upper jaw, and the dentary bones, which form the lower jaw, began. In addition, ossification of the vertebra occurred by formation of 7 vertebral centra and the neural spine in the abdominal vertebra. When the juveniles reached an average (BL) of 5.22 mm, ossification of the nasal, lateral ethmoid, and alisphenoid bones occurred in the cranium; ossification of the endopterygoid and metapterygoid bones began in the palatine region; and ossification of the hypohyal and interhyal bones occurred in the hyoid arch. At an average (BL) of 20.9 mm, ossification of the basisphenoid bone in the cranium and the suborbital bone in the orbital region occurred. Ossification of the vertebra then occurred by the formation of long pairs of ribs from the third to the ninth abdominal vertebrae, completing osteological development.

Survival Rate and Hematological Responses with Temperature Changes of Red Spotted Grouper, Epinephelus akaara in South Korea.

The effect of sudden changes of water temperature (WT) on the survival rate and physiological responses of the red spotted grouper (Epinephelus akaara) were examined by manipulating WT control system for 9 days. Experimental condition was divided in two different regimes at low (from 10°C to 4°C, decreased 1℃/d) and high (from 28°C to 34°C, increased 1°C/d) WT. Survival rate of experimental fishes were observed, and determined the changes of hematological characteristics by analyzing plasma levels of cortisol, glucose, total protein, and electrolytes (Na(+), Cl-, K(+)). No mortality was observed until low WT 6°C (144 h) and high WT 32°C (96 h), and 100% mortality was observed at low WT 4°C (216 h) and high WT 35°C (171 h). Plasma levels of cortisol and glucose increased rapidly as decreasing WT, and the loss of swimming ability and respiration response was observed at low WT 7°C and high WT 34°C conditions.

Artificial Spawning Behavior and Development of Eggs, Larvae and Juveniles of the Red Spotted Grouper, Epinephelus akaara in Korea.

This study was conducted in order to examine the egg development in red spotted grouper, Epinephelus akaaraand the morphological development of its larvae and juveniles, and to obtain data for taxonomic research. This study was conducted in June 2013, and 50 male and female fish were used for the study. One hundred µg/kg of LHRHa was injected into the body of the fish for inducing spawning, and the fish were kept in a small-sized fish holder (2×2×2 m). Eggs were colorless transparent free pelagic eggs, 0.71-0.77 mm large (mean 0.74±0.02 mm, n=30), and had an oil globule. Hatching started within 27 h after fertilization. Pre-larvae that emerged just after hatching were 2.02-2.17 mm in total length (mean 2.10±0.11 mm), their mouth and anus were not opened yet, and the whole body was covered with a membrane fin. Post-larvae that emerged 15 days post hatching were 3.88-4.07 mm in total length (mean 3.98±0.13 mm), and had a ventral fin with two rays and a caudal fin with eight rays. Juveniles that were formed at 55 d post hatching, were 31.9-35.2 mm in total length (mean 33.6±2.33 mm), with red color deposited over the entire body, and black chromophores deposited in a spotted pattern. The number of fin rays, body color, and shape were the same as that in the adult fish.

High Efficacy of Finafloxacin on Helicobacter pylori Isolates at pH 5.0 Compared with That of Other Fluoroquinolones.

Finafloxacin is a novel fluoroquinolone with improved antimicrobial efficacy, especially in an acidic environment. The efficacy of finafloxacin for the inhibition of Helicobacter pylori infection was compared with the efficacies of levofloxacin and moxifloxacin at neutral and acidic pH. The impacts of gyrA point mutation on the efficacy of those three fluoroquinolones were also investigated. A total of 128 clinical H. pylori strains were utilized. MICs of levofloxacin, moxifloxacin, and finafloxacin were determined at pH 5.0 and pH 7.0 by the agar dilution method. The impact of gyrA point mutations that are responsible for fluoroquinolone resistance was analyzed; the results showed 50 strains with an Asn-87 point mutation, 48 strains with an Asp-91 point mutation, and the remaining 30 strains with no gyrA mutations. The use of finafloxacin led to MIC values at pH 5.0 that were lower than the values seen at pH 7.0 for 112 strains (112/128, 87.5%), and this proportion was higher than that seen with moxifloxacin (21/128, 16.4%, P < 0.001). Finafloxacin also demonstrated a rate of susceptibility (MIC, <1 µg/ml) (37.5%, 48/128) at pH 5.0 that was higher than that seen with moxifloxacin (2.3%, 3/128) (P < 0.001). The trends were similar regardless of which of the Asn-87, Asp-91, and A2143 point mutations were present. In conclusion, the superior antimicrobial efficacy of finafloxacin against H. pylori in an acidic environment suggests the possible use of finafloxacin for treatment of H. pylori infection, as has been proposed by its developer, Merlion Pharma.

Gonadal Development, Spawning and Plasma Sex Steroid Levels of the Indoor Cultured Grunt, Hapalogenys nitens.

The gonadosomatic index (GSI), gonadal development and changes in hormones in plasma level of the indoor cultured grunt (Hapalogenys nitens) were investigated by histological study from August 2011 to October 2012. The GSI showed similar trends with gonad developmental stages during the culture periods. Changes in plasma level of estradiol-17ß of female H. nitens reached the highest value before the spawning period, and seasonal changes in plasma level of estradiol-17ß were similar in trends of oocyte developments and GSI changes. Testosterone levels of male H. nitens reached the highest value before and after the spent stage. Ovarian developmental stages of H. nitens could be classified into early growing stage, late growing stage, mature stage, ripe and spawning stage, recovery and resting stage. The testicular developmental stages could be divided into growing stage, mature stage, ripe and spent stage, and recovery and resting stage.