Helicobacter pylori was examined in 110 patients (82 (74.5) with gastritis, 18 (16.4) with duodenitis, six (5.5) with duodenal ulcer and gastroesophageal reflux, and four (3.6 %) with normal) with gastrointestinal problems living in rural area, no history of macrolide use, and detected by culture (71.8) or direct detection from gastric biopsies by PCR (82.7 %). Also, cagA gene was identified using PCR and was found positive in 68/91 (74.7 %) strains. The prevalence of clarithromycin-resistant H. pylori was investigated by two methods including PCR-RFLP (7.7 (A2142G 1.1 and A2143G 6.6 %)) and twofold agar dilution (8.9 %) to detect phenotypic and genotypic status simultaneously. Among all the H. pylori positive patients, eight (8.8 %) isolates were found to be resistant to clarithromycin by at least one of the AD and/or PCR-RFLP methods. H. pylori positive rates were significantly correlated with patients' sex, age, and endoscopic findings (p = 0.040, <0.001 and <0.001, respectively). There were no differences in gender or endoscopic findings related to cagA (+) and cagA (-) patients. The gene of cagA was not significantly helpful in predicting the clinical outcome of H. pylori infection alone. In conclusion, we revealed that there was a low prevalence of primer clarithromycin resistance in patients living in rural area with no history of macrolide use. The prevalence of mutant strains among the macrolide-resistant H. pylori varies even geographically between close provinces.

• MeSH
• Anti-Bacterial Agents pharmacology   therapeutic use   MeSH
• Antigens, Bacterial genetics   MeSH
• Drug Resistance, Bacterial MeSH
• Bacterial Proteins genetics   MeSH
• Biopsy MeSH
• DNA, Bacterial genetics   isolation & purification   MeSH
• Adult MeSH
• Virulence Factors genetics   MeSH
• Helicobacter pylori drug effects   isolation & purification   pathogenicity   MeSH
• Helicobacter Infections drug therapy   microbiology   pathology   MeSH
• Clarithromycin pharmacology   therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Microbial Sensitivity Tests MeSH
• Young Adult MeSH
• Polymerase Chain Reaction MeSH
• Polymorphism, Restriction Fragment Length MeSH
• Rural Population MeSH
• Treatment Outcome MeSH
• Gastric Mucosa microbiology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Turkey MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH
• Antigens, Bacterial MeSH
• Bacterial Proteins MeSH
• cagA protein, Helicobacter pylori MeSH Browser
• DNA, Bacterial MeSH
• Virulence Factors MeSH
• Clarithromycin MeSH